Originally Posted by hwright I would like to know what type of RN/Pt ratios nurses are working with in ER depts in Canada. In the department I work in out of aprox 25 beds it is not unusual to have 15 admitted pts. As well pt's are lined up in halls, on benches and any spare spot. And these are the pts that have been admitted into the er. It's not unusual to have 6 or 7 pts, some waiting for hospital beds (as long as a week) and some ER pts with bleeds, chest pain, etc. Everyone in our department seems to be burning out fast with no solutions in sight.
thanks for any info.
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Depends on the acuity in the ER and how many RN's are staffed on days and nights.
Dayshift
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1 RN trauma 2 beds (3rd) if required
2 RN obs/exam/gyn/eye - 10 beds
1 RN triage
1 RN for amb/minor/consult/family room/fracture - 8 beds and 4 chairs
1 RN charge nurse (who assist when possible)
1 ward clerk (answers the phone, etc...)
2 porters
Nightshift
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1 RN trauma 2 beds
1 RN charge (who is responsible for triage after 23:00 hrs. and amb/minor/consult/family room/fracture - 8 beds and 4 chairs after 03:00 hrs_
1 RN obs/exam/gyn/eye - 10 beds
We have a 10 -22 hrs. shift that is assigned usually until 19:00 hrs. in obs area then reallocates to triage. We have a 19:00 - 03:00 shift which is assigned on amb/minor/consult/family room/fracture - 8 beds and 4 chairs
So really, after 11:00 p.m. on a night shift, we have 3 RN's which is really unsafe and they hospital doesn't have enough money to hire another RN. Dayshift is stacked rather well. Can you see the difference?
Don't tolerate or allow pts. in the hallway? Divert them to other hospitals if you have to. That is totally unsafe and you or a coworker will be held accountable. Say "No"
As well, we use a CTAS level (Canadian Triage Acuity Level Scale) system to assess our patients according to their presentation.
Level 1 - stat MD assess Life threatening, VSA
Level 2 - CP (*Seen by MD within 15 mins)
Level 3 - SOB with good sats, febrile child, (*Seen by MD within 30 mins)
Level 4 - ABD pain less than 5/10 on scale (*Seen by MD with 60 mins)
Level 5 - Prescription refill, minor laceration (*Seen by MD with 120 mins)
Re: CTAS an RN is responsible for reassessing the patient if the MD has not had the opportunity to do so. We also have advanced orders to implement treatment. We can always upgrade a CTAS level BUT never downgrade.
Hope this helps.
RN/Pt ratios in the ER
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