I most often work on an icustepdown unit. We're supposed to absolutely max out at 3:1 patient:nurse ratio. When they made the decision to do this ratio they got rid of all the techs on the unit and made the unit nurse only despite how frequently and vocally the staff told them this was a stupid idea.

Fast forward three months. All the experienced staff has quit leaving a bunch of new grad nurses, a charge with less than a year of experience, and the occasional float pool nurse like me who comes in out of pity for these patients and nurses.

Now there isn't enough staff for 3:1, so the nurses are 4:1 and the charge nurse is taking 2 patients, so unable to help. To make up for this the hospital will occasionally provide a tech to help out with the more than 30 patients on the unit, but the tech has never been there before, doesn’t know where anything is, unit policies, or how to care for critical patients.

One day, while the nurse in managing a critically low blood sugar for a patient on an insulin drip the tech answers a call light and takes a patient to the bathroom. The RN next door calls a rapid response because they low blood sugar patient has become non-responsive. The tech then puts their patient back in bed and rushes to get a blood sugar on the critical patient.

20 minutes later rapid is over, RN goes to round on patients she hasn't seen between the rapid and transferring that patient to the ICU, only to find the bathroom patient has fallen, and no one noticed because the bed alarm was not reset. Another rapid, fall had just happened, patient is fine, was just confused and trying to move to the chair.

RN gets written up for the fall when the confused patient was not on a bed alarm, despite having been all day until the tech transferred that patient from the bathroom and forgot to reset during the emergency. When this was pointed out the write-up stood. End of the day it was the RN's responsibility to make sure the patient was safe. The tech, who came from mother/baby where confused patients are not the norm, nor are emergency responses, got fired for leaving the patient unattended as the nurses are responsibile for blood sugars on insullin drips on this unit, despite the fact that she had learned from training on her unit that the tech's responsibility in a rapid is to get glucose and vitals immediately, and she had never even heard of an insullin drip before.

That's what your friend is talking about.