[veronica butterfly]

I work in a "smaller" hospital, a regional medical center which is in an outer-lying suburb of a metropolitan area. '

On days we have typically 4 patients, evenings 4 patients, and nights 6 patients. If staffing is tight, add one more to these numbers. If staffing is good, subtract one, but bet you're first up for an admission.

I know these numbers seem so good, I know it sounds lame.... But we run our tuchas's off. We do our own IV starts, do our own admissions, and since it's a general med/surg floor, we have a huge variety of patients. Usually a rule out MI, hip fracture from a fall/dementia, colon resection, and an etoh withdrawal--some crazy mix like that. We never have enough nursing assistants. Our supplies are often not stocked. And our patients are often spread down two or three very long hallways.

Why does a load of four patients seem like such a huge load???

[eccentricRN]

I work nights on a med/surg unit with 40 beds. We can get anywhere from 6-10 pts/per nurse... days/PMs usually tries to assign no more than 5, but it varies with staffing...they often have students, though...

[Rebekah24]

I think that some of our staffing is due to being in a magnet hospital because the hospitals I worked in for clinicals has much worse nurse to pt ratios that we have.

During days the usual is 1:5 and 1:6 on nights.
They try to have a charge nurse out of staffing, and MR and we always have a monitor tech. Tues-Friday we have a discharge nurse which is so nice!

[quila_2001]

Usually 5-7 on days and anywhere from 6-8 on nights. Have had up to 10 pts one night with no charge nurse....

[ranaazha]

6:1 on days AND nights

There are 4 med/surg/tele units, each with 3 pods that have 12 patients each, so 2 RNs to a pod. (We have a few LPNs who will share the pod with an RN and share pt loads depending on tasks.) On days, each pod has a CNA. On nights, all 3 pods have 0, 1, or 2 CNAs.

On short days... 4 nurses have 7 pts & 1 has 8 pts. Nurses 1, 3, & 5 are on a single pod, while nurses 2 & 4 are split amongst the pods:
Nurse1 has 7 pts on A pod,
Nurse2 has 5 pts on A pod & 2 pts on B pod,
Nurse3 has 7 pts on B pod,
Nurse4 has 3 pts on B pod & 4 pts on C pod, and finally,
Nurse5 has the remaining 8 pts on C pod.
It's a nightmare having to go back and forth between pods...

If we have hall beds, the nurse on that side of the pod takes the pt, so s/he may end up with 7 pts on a "normal" day.

[ranaazha]

Originally Posted by veronica butterfly

I work in a "smaller" hospital, a regional medical center which is in an outer-lying suburb of a metropolitan area. '

On days we have typically 4 patients, evenings 4 patients, and nights 6 patients. If staffing is tight, add one more to these numbers. If staffing is good, subtract one, but bet you're first up for an admission.

I know these numbers seem so good, I know it sounds lame.... But we run our tuchas's off. We do our own IV starts, do our own admissions, and since it's a general med/surg floor, we have a huge variety of patients. Usually a rule out MI, hip fracture from a fall/dementia, colon resection, and an etoh withdrawal--some crazy mix like that. We never have enough nursing assistants. Our supplies are often not stocked. And our patients are often spread down two or three very long hallways.

Why does a load of four patients seem like such a huge load???

When I saw you only had 4, I thought, "I wish!" We also do our own IVs and admissions, so I was still wondering what the problem is! Your mix of pts, not enough CNAs, and supply issues explains the "huge load" though.

Our med/tele pts are relatively stable (I know this is a loose term in nursing/healthcare...). Many are gero and confused or severely HOH which can be frustrating, though, our mix seems a little less acute than yours.

Also, I work in a suburban/community hospital in a upper middle class part of town. Much different mix than those in the center of town!

[Mommy TeleRN]

I've been a nurse for a year on a tele floor. Everyone has some cardiac issue although sometimes it's not their 'current' issue. We get GI bleed, stroke, etc. But majority are CHF, CP, things like post pacemaker, post thoracic surgery, etc. 95% of the time I have 7 patients..occasionally 8. Here lately the charge is taking the same load.
I usually start 1-2 IVs every night, if there is an admit I have to put in their hx and have them sign some paperwork, list their meds etc. The secretary puts in the orders. We have 1:20 CNA ratio..so they do what they can. Here lately we've only had 1 CNA for 40 patients at night ... so we do a lot of our own toileting, etc. If we only have 1 CNA we do our own I/Os. We always do our own VS... q4.
Sometimes I feel whiny taking this load....but I do think this is wayyyy too heavy. I can't do as good a job on charting... because I try to put the patient care first.
Sadly - days is getting this same load more often than not..they have have a few more CNAs.
I can handle 5 patients no problem...stay caught up, chart properly, look up all labs, etc. Those extra 2 just slam me

[Ruffles 1]

I agree 7 patients is too much to handle. The CNA are also over worked and we have such a turn over of CNA's on our med/peds floor because they have to take care of to many patients too. We sure can take our patients money but can not provide the care. I hope that medicare finds out about this and does something but they probably don't care either. The whole healthcare industry is going south.

[Dakota1592]

I work on a 44 bed Med/Onc floor. We typically have 4-5 pts on a day shift and 5-6 on a night shift. Day shift has 4-6 Patient care tech and Nights has 2 PCT's with a 3rd coming in at 4:00 a.m. to help us with lab draws etc.

We are very vocal about pt acuity. It doesn't happen often but if we have a pt requiring an exceptional amount of care we do let the charges know and the rest of the assignment is adjusted when possible.

[sewillia]

when I worked in NC hospitals, The nurse Patient ratio is 1 to 7 on the acute care Med/surg units. When I was in California the nurse patient ratio was 1 to 5. Now...you may say... 5 patients is a light assignment, sometimes it's not, because you may have all heavy patients.Five heavy patients feels like having 8 patients.