nurse:patient ration in the ED

  1. Just wondering what sort of nurseatient ratio hospitals are working with. I'm only new in an aussie metropolitan ED and find my patient load varies from 5 to 8, in our acute section.
    What are other hospitals working with, what do people think is safe?
    •  
  2. 28 Comments

  3. by   spider
    One hospital I worked in (I work in NYC) the ratio is very high, it's a busy ED that resembles Bosnia on a bad night. But it's team nursing and the MDs do a great deal to help out. In other words, you're just not chasing them around for orders, they're right there, and putting in IVs, etc if you're busy. On the worse days there's only five nurses.

    Another place I've worked, one nurse is assigned a district and you can have over 15 patients. The super critical ones are assigned one nurse (at times two nurses depending on the acuity). The MDs were horrible, and I feared for my license. The pay was incredible tho, the highest in NYC.

    Another hospital was a small commmunity hospital, where, when I took five patients, they accused me of trying to be super nurse.

    Basically, tho, team nursing always wins by a landslide. When you use primary care anywhere, you're at the mercy of your associates to help you out if the district is much heavier than their's, but most people dont.

    Ps: From Australia? My cattle dog (a bluey you guys call them, yes?) died recently. What a great dog they are.
  4. by   GIJeff
    Our PTvsRN ratio varies depending on acuity and constantly changes. I've had as many 7 pt's, and some instances where I had only 1.

    Good staffing is also contingent on good ancillary staffing as well. We must never forget the little guys.
  5. by   Aussie Nurse
    Hello Hayden, I am working on the Gold Coast. In our ED we are split up in 4 main areas: Accident RN:PT 1:3
    Emerg RN:PT 1:2
    Cubes RN:PT 1:4
    Obs RN:PT 1:10
    Note Acc has 10 beds with 4-5 RN's
    Emerg has 5 beds with 3 RN's
    Cubes has 4 beds with 1-2 RN's
    obs has 10 beds with 1-2 RN's

    and their is a RN in charge for both Emerg and Accident with no pt load. Also their is of course a triage nurse that will deal with who ever come thru the doors.
  6. by   Aussie Nurse
    Hello Hayden, I am working on the Gold Coast. In our ED we are split up in 4 main areas: Accident RN:PT 1:3
    Emerg RN:PT 1:2
    Cubes RN:PT 1:4
    Obs RN:PT 1:10
    Note Acc has 10 beds with 4-5 RN's
    Emerg has 5 beds with 3 RN's
    Cubes has 4 beds with 1-2 RN's
    obs has 10 beds with 1-2 RN's

    and their is a RN in charge for both Emerg and Accident with no pt load. Also their is of course a triage nurse that will deal with who ever come thru the doors.
  7. by   Aussie Nurse
    Hello Hayden, I am working on the Gold Coast. In our ED we are split up in 4 main areas: Accident RN:PT 1:3
    Emerg RN:PT 1:2
    Cubes RN:PT 1:4
    Obs RN:PT 1:10
    Note Acc has 10 beds with 4-5 RN's
    Emerg has 5 beds with 3 RN's
    Cubes has 4 beds with 1-2 RN's
    obs has 10 beds with 1-2 RN's

    and their is a RN in charge for both Emerg and Accident with no pt load. Also their is of course a triage nurse that will deal with who ever come thru the doors.
  8. by   robinma
    I work on the East Coast in a Level I Trauma ED.
    Our 'criticals' (level 1 or serious MVA's, gun shots, falls, etc.) are 1:1 or for the past year 1: 2 patients. We normally double up on the eve shift. This is for staffing as well as space. Our Level 1's have increased by 25%.
    Our urgent areas patients or typically 1:5-10.
    Again our staffing is poor, our ancillary help is virtually non-existent out in the urgent area, and and although team nursing is preached our residents are extremely busy and our attendings are 'old school' or so it seems!
    Our walk-ins are a 1:10 with a CNA or tech. This area is a cake-walk because it is more defined, private area and the team approach works well. Also, acuity is obviously not an issue.
    We see over 200 patients per 24 hours. It is not unheard of to see 20 trauma patients during an 8 hour eve shift. We have 4 trauma rooms with 2 nurses scheduled for this area! We 'pull' staff from the urgent area.
    Our ortho pts are not separated. OB goes to the Woman and Infants hosp. and the peds go to the Children's hosp.
    We, also, mandate nursing staff daily. Regular staff nurses are now being mandated an extra shift once a week!!!!
  9. by   Speers
    I work in a Children's hospital on the east coast and we are spoiled rotten!!
    During peak hours the RN:PT ration is 1:4, and we are also assigned our own ER tech. The techs are great, they do practically everything but give meds!

    I also work in an adult trauma center and things are quite different. We can responsible for as many as 8-10 paitients. That can be difficult when we are busy, which is the majority of the time. The only time you see your pt. is to give meds, complete some other order, or discharge them. I have to admit, I don't feel like I give very good care there and it is not very safe.
  10. by   level1RN
    i work in 1 of the 3 busiest EDs (trauma center) in the US.

    we have about 15 RNs for 40+ beds.

    RN:PT
    for trauma...1:1 or 2:1 depending on the level
    for medical 1:4
    when we get a "sick one"...we swarm...upto 3:1
    in peds...1:3
    non acute...1:6
    2 triage nurses...internal/external

    staffing is good when all of us show up on a given shift, sometimes when we are short...it
    is hell.
  11. by   sheez
    Wow, sound like I am semi-retired where I work! We are very rural, and have 1 RN/MICN and 1 EMT. It doesn't change. If things get wild, I try homehealth, acute/tele (1 RN there), or my manager. I have been known to hi-jack a paramedic/EMT team when they are in my reach. If the doc is available....so much more the better. 1:1 only happens when I have only 1 patient . Very hectic when the medics are busy, as we are a base hospital also, and 1 MICN is on (ER). Last shift I had to keep sending the Doc to the radio as I was busy with an MI pt. After "The big city" ER, I'll take this anyday!

    Sheez
  12. by   Sharon Joseph
    Our ER is semi-rural, 50-80 patients a day. These numbers include Walk-in clinic 4p-10p.
    We have 6 "clinic" beds, 7 ER beds, and 4 trauma beds. There are 3 nurses on duty 24 hours a day, with a "team leader" from 12-10p for now (6 additional hours a day newly acquired with no staff to fill the hours). There is 1 nurse assigned to the "clinic" beds, 1 to triage, and 1 for ER/trauma, until team leader(who will take patients) arrives. Depending on the staff mix for the day, this can become frustrating. When the nurses with team nursing work ethics are on duty, it is much smoother and safer for the patients. I wish there were some magical way to make them all work as a team. All this and a recent(Dec. 6th)move to a new facility and new civilian/military joint hospital. I DO love my job, though. Shrink, anyone??
  13. by   Toots
    Midwest major City, inner city ER non-trauma.
    Patient:nurse ratios - l RN to 3-4 patients sometimes l:l depending on acuity level. We're trying to go to team nursing which is having growing pains with the RNs wining but after reading the postings, we have it made.
    Other ER, smaller community, its l:4 ratio but the acuity is sky-high - you never go l;l with a patient unless you are doing TPA and then your other patients are left to fend for themselves.
  14. by   debrn
    From small hospital in rural, small town..patient to RN ratio in med surge is anywhere from 6:1, to 28:1 depending on who calls in sick, or if the ER nurse is busy, and can help on the floor. We have one RN, 2 CNAs,one LPN, and one ward clerk on any given night,7p-7a shift...thats the whole hospital,baby. Our security is the city police dept. and we have a janitor from 7p to 3a. And, I have to say,we do a darned good job too!!!!

close