[mamao4]

Just wondering...I work in an ER that sees approximately 150+ patients per day. What is your typical patient load? If we are staffed well, we will have 3:1 in our "critical" rooms and then 4:1 in our "regular" rooms. On a bad day, we have 5:1 no matter where you are. Sometimes I feel like my license is flapping in the wind when I have two patients that are ICU candidates and then 2-3 others that are just there for general illness. Just trying to see if anyone else is in the same boat!

[workingforskies]

Sounds like you and I work at the same place. (Do the initials H.C.A. mean anything to you? LOL)

The California staffing law has set the following ratios as an acceptable ER assignment:

General ER - 4:1
Critical care. (ie ICU patients.) - 2:1
Trauma - 1:1

My only complaint with that is that I have no problem with having 2, relatively stable ICU patients. But if one patient is unstable such as on a bunch of drips that still have to be titrated to effect, they should be 1:1.

It can truly be frightening at times to be professionally placed in situations like that. But fortunately, at least where I work, we have a pretty good team that works together and watches out for each other. If that were not the case, I would have been gone quite some time ago.

[mandasueRN]

Staffing levels are our worst issue at our facillity. Regular assignments are 7:1, one particular assignment can have 8:1. Our critical care rooms are 4:1--I'll never understand how they think having 4 ICU admit patients, on drips and vents with one nurse is safe, when even in the ICU they have a 2:1 ratio. In trauma your assigned to a bay with 2 beds, but it's not uncommon to have 3 pts stuck in the room. I've worked "regular" assignments with 7 patients, one of which was an ICU admit for a SAH with q 1 hr neuro checks.

[KatieBell]

It sounds fairly typical to me. I worked at a Level One and before assigned rooms were established, peope woud routienely get these lopsided numbers, one nurse with 6 another with 3 one with 2....
These days we have 4:1 ratios with no hall beds strictly. Its better except when your mistriaged patient ends up having the massigve head bleed or something similar.

[Anagray]

yes, we are in the same boat. Sometimes we have 6-7 patients a piece, no matter what their class is. It is really difficult. Lately, I have stopped picking up so many patients, because I just don't feel it is safe. I let my management worry about it, because it does nothing for me to worry alone.

[mamao4]

Thank you! I know that I have a great team to work with as well, but when we are all busy on a bad day and getting creamed by EMS coming in, it is hard for us to help each other. I am very fortunate to work with the people that I do work with and I agree with you that it makes all the difference in the world!

[mamao4]

How do you get around having no hall beds?! That is GREAT!!!!

[Sarey Gamp 1987]

this sounds very er typical this past sunday as i was working charge rn i also had to care for lol on vent on levo and on dopamine in addition
to triaging ems--that showed no mercy--as a result i ended up with the hallway pt's--five total--ive exhausted the adjectives to describe
the situation admin on call refused to go on int disaster--even temp--im getting crispy burn-out anyone know of their hospital's acuity rating scale??

[AfloydRN]

5 : 1 is the standard where I work. Yes, It sucks but noone cares! We keep doing it because we need the job.