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Staffing a telemetry unit



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  #1  
Old Jul 18, 2005, 02:36 AM
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Join Date: Mar 2004
Staffing a telemetry unit

What are the standards in your institutions? On days we have 1 RN for 4-5 patients with an LPN to cover at least one of those patients. On Evenings we have 1:5-6 with an LPN cover and on nights it is about the same. We do try to have 1 extra LPN on evening shift. Also, how many patients do you think is reasonable for an LPN?

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  #2  
Old Jul 18, 2005, 08:34 PM
cheerfuldoer's Avatar
cheerfuldoer (Female)
John 3:16
Join Date: Sep 2001

Having worked on telemetry units before, no more than four patients per nurse should be assigned if those patients have acute cardiac issues. It's hard to deal with more than one or two patients who are in need of bedside monitoring during their c/o of chest pain radiating down their arm or back..... One patient benefits and the others have to wait their turn if there aren't any other nurses to help you out.

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  #3  
Old Jul 21, 2005, 08:14 AM
arak1547 (Male)
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Join Date: May 2004

Originally Posted by cheerfuldoer
Having worked on telemetry units before, no more than four patients per nurse should be assigned if those patients have acute cardiac issues. It's hard to deal with more than one or two patients who are in need of bedside monitoring during their c/o of chest pain radiating down their arm or back..... One patient benefits and the others have to wait their turn if there aren't any other nurses to help you out.
I'm working Southern MO at this time and it isn't uncommon for the night shift to care for eight monitored patients during the shift. Seven is about the norm. It's interesting to note that this hospital doesn't consider telemetry a "critical" care area. It's considered a med/surg area. In OK the telemetry floors are considered critical care areas, but the ratio can be as high as 10 patients on the night shift to each nurse. California limited tele patients to only five per nurse, unless you had an LPN on the "team" then they could give you 10 monitored patients. (Which they routinely did and the LPN could not be assigned any of these patients.) Nevada tried to limit the ratio to a maximum of six patients on the tele floor, but it was fairly common to have seven on the night shift.

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  #4  
Old Jul 21, 2005, 08:28 AM
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LI, NY. Days routeinly have 9 patients, nights 9-11, in the winter as many as 12. Way too many for this nurse, 8 mos. of experience.

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  #5  
Old Jul 21, 2005, 09:43 AM
arak1547 (Male)
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Join Date: May 2004

Originally Posted by Maggie Mae
LI, NY. Days routeinly have 9 patients, nights 9-11, in the winter as many as 12. Way too many for this nurse, 8 mos. of experience.
I agree! Way too many for me as well. Are the nurse aids able to do much of anything in the way of accu-checks, foleys, and that sort of thing? Sometimes that can be a big help.

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  #6  
Old Jul 22, 2005, 08:45 AM
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The nurses aids can only do accu-checks if they are nursing students. The other night 6 out of 10 pts, were accu-checks. They empty foleys and do patient care and work very hard. we have 38 beds and 2 nurses aids. Too much work for everyone. Sometimes I feel lucky to get out of there without anything bad happening.

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  #7  
Old Jul 22, 2005, 10:33 AM
arak1547 (Male)
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Join Date: May 2004

It does sound like a disaster waiting to happen. Is it like this in other area hospitals? I thought it was only Southern states where these kind of conditions were the norm.

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  #8  
Old Aug 01, 2005, 03:51 PM
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The telemetry floor that I work on in Southwest MO 8-7 patients per nurse...on days & evenings...more at night.....patients admitted directly from ED, MD office, or a unit transfer.......

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  #9  
Old Aug 01, 2005, 04:00 PM
cheerfuldoer's Avatar
cheerfuldoer (Female)
John 3:16
Join Date: Sep 2001

No way would I work on a telemetry unit where the patient nurse ratio is larger than 5 to 1. That's insane and dangerous!

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  #10  
Old Aug 01, 2005, 04:01 PM
Angie O'Plasty, RN's Avatar
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Join Date: Aug 2004

Originally Posted by Maggie Mae
LI, NY. Days routeinly have 9 patients, nights 9-11, in the winter as many as 12. Way too many for this nurse, 8 mos. of experience.
That's scary. Day shift RNs here can max out at 7 patients with a tech for each assignment. Evenings get up to 8 with a tech. Nights, we have 6-8 patients and share a tech.

I agree, I wouldn't want to work day shift with 9 patients, especially if your techs can't do accuchecks. Ours can.

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