What's your patient load?

  1. I'm still orienting but I take on about 5-6 patients. Normally we will have 6-7 sometimes 8. I work in NYC. What are the ratios in other states or hospitals? 7 patients is crazy! Granted, not all are super sick, but still, time management is one of the top skills needed, perhaps the hardest for a new nurse. Thoughts?
    Last edit by Joe V on Dec 12, '12 : Reason: spacing
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  2. 29 Comments

  3. by   Altra
    That is a heavy load. 3-5 patients is typical at my Level I trauma center ... even urgent care assignments are generally no more than 5 unless it's a very bad day.
  4. by   thelema13
    The level 2 I am transferring to is 4:1, my current ED is 4:1-6:1, depending on flow and staffing.
  5. by   Prettyladie
    Level 1 in Texas at my facility 4:1 with no trauma room. 3:1, if you are assigned to trauma that day.
  6. by   germsjackson
    Dang. sounds nice
  7. by   humanity
    Level I Trauma primary care nursing
    Med surg 5 max
    ICU 2 max
    Oncology 4 max
    Multiple Myeloma 3 max
    Progressive Care 3-4
  8. by   hiddencatRN
    Inner-city pediatric Level 1 ER: 4:1 or 3:1 with good staffing in ESI 2/3 areas. 7:1 urgent care. 2:1 critical/ trauma bay. If a family brings siblings in to be seen they count as 1 patient unless they are very sick or there are a TON of them.

    Regional Level 1 pediatric ER: 4:1 regardless of acuity.

    Community all ages non trauma center ER: 5-6:1 depending on time of day.
  9. by   BelgianRN
    For every ABC-unstable patient we go 1:1, means the other nurses go up at the same time taking over your load.
    Medsurg anywhere from 3:1 to 6:1 depending on available staff.
    Peds generally 3:1.
    Small surgical cases: task oriented nursing, everyone with available time pitches in, assessment/primary diagnostics ordered by the triage nurse or dedicated ER physician.

    In general our patient load is very variable throughout our shift since we are involved in prehospital care as well. So if all other nurses have to go out on prehospital assignments and/or in-hospital codes, the ER falls back on 1 - 2 nurses for everything and everyone. All remaining patients fall under the responsibility of the remaining nurse, including ABC-unstable ones that get dropped off in the mean time. Luckily we have pretty amazing ER docs that will do many of our tasks themselves if we are too busy.
  10. by   That Guy
    Trauma or trying to actively die 3:1
    High acuity but not dead yet 4:1
    Maybe should be here 5:1
    Really shouldnt be here 6:1

    Granted that is with perfect staffing and not having to use any of our hall beds for bambulances.
  11. by   whichone'spink
    Holy s*** that's a lot of patients, even if they're less acute. I only have three at a time at the most.
  12. by   TheSquire
    One 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.
  13. by   applewhitern
    Our 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.
  14. by   sleepRN
    Med-surg 4-6:1 on days and eves. 7:1 on nights.
    Last edit by sleepRN on Dec 9, '12 : Reason: more info

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