I work on an ortho-neuro post op floor on nights and weekends. We also get alot of medical overflow on our floor. Our hospital has recently gotten rid of all techs except on our floor and one other and our ratios are usually 1/6 or 1/7 if they want and the other floors are “full”. Unfortunately, because our floor fought to keep our techs I feel that we are punished for keeping ours because all the other floors now have a ratio of 3-4 patients with their charge not taking patients most times and our charge most often times does. I really believe that hospitals should take acuity into consideration, because 6-7 patients with 3 fresh post ops, 2 demented confused medical, and 2 regular medical patients is too much for one nurse, even with a tech. Also, most times we don’t have a tech scheduled and if we complain we get the response “our ratios are like they are because yall wanted to keep the techs” when often times there is actually not a tech, secretary or clerk, and the charge has patients. We are lucky to be able to answer the phone at the nurses station when it rings with yet another admission that we are told we have to take “because the other floors are full” which means that they now have four each and their charge with no patients. I have floated to these other floors and it is indeed like a vacation. I also agree with Jason above where he states that the charting is taking up time we could be spending with the patients. We have went to total computer charting for about a year now and still have not completely went paperless making us check for orders in not only the computer but the paper chart as well. They pile on more and more things to chart about often times duplicating and triplicating some of the things we chart on. I like to spend time taking care of my patients and unfortunately these barriers prevent me from giving the care I feel the patient deserves and with the squeaky wheels getting the most attention at times the “easier” patients get the least attention. We are often lectured about our HCAPS scores being low and when we mention our barriers such as ratios they say, well yall wanted to keep the techs! With the growing obese population getting surgeries more and more it is impossible for us to take care of these patients needs without lots of help for turning, ambulation, ect…and our floor is great about nurses helping one another but if there is no one to help because they have their own patients then what can you do? I feel it is a matter of patient safety for us to have lower ratios, it might save money now but long term it has to cost with litigation, and low HCAP scores.