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- Dec 9, '12 by TheSquireOne of the docs in my ED who did his residency in NYC describes the EDs there as "like being in the third world," and based on the staffing ratios reported time and again by NYC ED RNs, I believe him. It sounds like understaffing has become an institutionalized standard in the city.
As far as my hospital, I'm at a surburban "comprehensive community" hospital (read: Trauma III) that gets most of its patient load from the neighboring low-socioeconomic-status urban neighborhood. Ratios are 3-4:1 during the day in the "Acute" side, assuming proper staffing and no Boarders, but can reach as high as 5:1 on nights when we're understaffed, have a high acuity night, the house is full, or when combinations of all three occur. When fast track is open, staffing is ideally still 4:1 to facilitate pt clearance but can reach as high as 10:1 if we're short-staffed.
- Dec 9, '12 by applewhiternOur standard med-surg load is 1:8. ICU is 1:3. Really tho, it is rare for us to have that many; they make every effort to staff us well. I have no idea what it is like in any other departments, as I don't work them. I have worked in ICU's where we had to take 4 patients, regardless of acuity.
- Dec 9, '12 by sleepRNMed-surg 4-6:1 on days and eves. 7:1 on nights.Last edit by sleepRN on Dec 9, '12 : Reason: more info
- Dec 10, '12 by DC CollinsTeams of two RNs, each has a 'standard' of three rooms, but often get one additional 'hallway bed'. While we keep our own pts, if one of us is swamped and the other isn't, we 'inherit' anywhere from a few aspects of the teammate's pt care to an entire pt or more.
- Dec 10, '12 by TheSquireQuote from sleepRN...you do realize this is an ED thread, right?Med-surg 4-6:1 on days and eves. 7:1 on nights.
- Dec 12, '12 by Nurseadam4:1 for less acute and 3:1 for trauma rooms.. In Cali.
- Dec 13, '12 by RN-Cardiac68 bed Level I Trauma ED,..4:1 and when we are staffed well we break down to 3:1 with a float!
- Dec 13, '12 by nuangel14/5-1 in my ed .depends on accuity .we use hall beds also.if real acute/icu 3 -1.
- Dec 14, '12 by PengiRN3-5 depending on acuity, more often than not 4:1. Trauma bay 3:1, but usually 2:1 because we reserve one room for the traumas that will need the level 1, intubation, etc., which we don't get every day. But of course, any nurse that has an actively dying patient will get help from other nurses whose loads are lighter.
- Dec 16, '12 by alem-tsahaiWe get as many as we get, meaning it can be as few as 5, and on a particularly bad night up to 12+ EACH! Completely unsafe, and the pt load depends on how busy the ED is as well as staffing. This is a level 1 trauma ED in NYC. Whoever posted that working NYC EDs was similar to working in third world countries was spot on in their assessment. I've done both, and it ain't much of a difference :-(