nurse pt ratio

  1. I have one semester left to graduate and I would like to start in med surg or ER; however, I want to practice safely. From what I have seen in clinicals- med surg doesn't look like the place to do so, esp for a new grad. Most of the nurses look to be running around like chickens with their heads cut off. Very busy and little time to care for each pt. Sure, they get the meds passed in time and keep their pt's alive, but they are not getting good/thorough care and assessment. You shouldn't have to rush rush rush when you are dealing with people's lives. I feel like it compares to working in a restaurant where you are constantly having to run run run and hopefully remember everything you need to do, if not, hope it isn't too important to the pt's health. So... what is a good nurse-pt ratio on a med surg floor that's conducive to being able to be completely thorough, safe, and caring?
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  2. 17 Comments

  3. by   TooterIA
    I beg to differ, I think Med-Surg is the ideal floor for a new nurse to learn. I think you will find nurse-pt ratio varies widely, depending on acuity of patients in each facility. I work in a small hospital and our acuity is fairly low, many of our pts are there for rehab, but rehab pts can be very time consuming. Our typical ratio is each nurse having 4-7 patients, usually 5. With one CNA for the whole floor, so pretty much nurses are doing aide work also-that makes a big difference, considering many of our rehabbing pts are changers/turners.
    I think you make it what you can-we have some new grads on 2nd shift that do excellent-they know how to manage their time and are doing well. Others, with the smae # of pts are doing not quite as well because they dont manage their time, they "run around with their heads cut off".
    Jessica
  4. by   RNperdiem
    For stable med-surg patients I like about 5. I worked with a 6 patient nurse to patient ratio, and that was a lot.
    I also worked night shift with a lot of people in hospital for knee and hip replacements mostly and the ratios were higher, and the nurses seemed fine, the patients were less acute.
    Where patients move along the spectrum from med-surg to stepdown, a ratio of 1:3 for stepdown is ideal.
  5. by   ohmeowzer RN
    you need the skills you learn on a med/surg floor to move up. in my hospital the new grads have to work a year on the med/surg floor before going to another unit. i know this isn't true in all hospitals , so i can only speak for me. med/ surg skills are very important. they teach you to prioritize and you assess the pt the all the time, not just when you walk into their door. you learn to hang blood, tend to PICC lines, labs, calling dr's. it's very important to have your good nursing skills. you will learn so much on the med/surg floor. yes it's rush rush and very stressful. it will give you excellent skills to handle all situations that come up. i think new grads should work med/surg.. for at least a year.. then run as fast as you can ..lol..
  6. by   RN1989
    There is no hard and fast number. It all depends on the acuity of the patient, what kind of ancillary help you have, as well as your own capabilities. Granted - the fewer patient you have is better. But you are always going to have days that suck even if you only have 3 or 4 pts. Stop looking at numbers and take a look at the big picture. If you can't see the big picture you will have a difficult time transitioning from student to real life.
  7. by   nurse grace RN
    I love Med/Surg and our ratio is 1:5 or 1:6. I love it because I tried specialty areas and ended up "asking to go back to med/surg because I felt I needed better skills and to learn to prioritize. It was the best choice I could have made...Some days you can have a horrendous day with 3 or 4 patients depending on acuity. I had 7 once and had a great day. The nursing job is what you make of it and you will develop your own way of doing things. The important things are : treat the patient the way you or your family would like to be treated, be honest with them and yourself, help your co-workers, don't be a know it all and be sure to have some fun during your time off. No one has to knoe it all, don't put too much pressure on yourself. I learned the hard way. Good luck to you.

    PS remember you are not alone, ask for help--go to your manager etc. if you need it
  8. by   NurseNature
    I do thank you all for the advice; however, I still wouldn't want to put myself or my pt's at risk b/c of having crazy/busy days and having to cut corners to make it/prioritize- not my style. I think I will either have to find a hospital that has a safe ratio or just do home health or ICU where the pt has your complete focus.
  9. by   cmo421
    Quote from FutureNurseLori
    I have one semester left to graduate and I would like to start in med surg or ER; however, I want to practice safely. From what I have seen in clinicals- med surg doesn't look like the place to do so, esp for a new grad. Most of the nurses look to be running around like chickens with their heads cut off. Very busy and little time to care for each pt. Sure, they get the meds passed in time and keep their pt's alive, but they are not getting good/thorough care and assessment. You shouldn't have to rush rush rush when you are dealing with people's lives. I feel like it compares to working in a restaurant where you are constantly having to run run run and hopefully remember everything you need to do, if not, hope it isn't too important to the pt's health. So... what is a good nurse-pt ratio on a med surg floor that's conducive to being able to be completely thorough, safe, and caring?



    Run RUn Run ,,,,,,,this is what a nurse does,,,lol sorry. You will never have the perfect ratio. There is no such thing. One pt can at times do u in,and at times u can have 6-7 or more and it is a breeze. The experience u will gain on a med surg floor will benefit u in ur career for years to come.No one can take that experience away from u. My advice is as always,do a year on a med surg floor and then if ya want ,move on. The ER is a very independent type of nursing. Time management is of the essence. Management is looking to facilitate numbers and pt satisfaction,so u have to be able to move . It is also an area that u see the pt and often can pick up things before they get to see a doc that might save a life.Just my opinion and experience. Good Luck!
  10. by   cmo421
    Quote from FutureNurseLori
    I do thank you all for the advice; however, I still wouldn't want to put myself or my pt's at risk b/c of having crazy/busy days and having to cut corners to make it/prioritize- not my style. I think I will either have to find a hospital that has a safe ratio or just do home health or ICU where the pt has your complete focus.
    Stick with home health then, because ICU is no day in the park. Two to one ratio and sometimes three,only one to one with the sickest of the sick,,,,not the norm. If prioritizing is not ur style then ICU is not ur place. I wish u all the luck in the world.


    DORATHY WE ARE NOT IN KANSAS ANYMORE !!!
  11. by   nursemary9
    My opinion is that the reason the ratios get so high in Med/Surg is because no one wants to work here. Everyone goes off to there specialties with low ratios;
    Right now on nite shift, our ratio is 5-6 per RN. 5 is good, 6 is OK. Our ratios at nite are NEVER more then this. On days, it's 4-5 pt's per RN.
    PM's is the same.
    I think that we give excellent care here; My assessments are top notch & even tho it's night shift, I actually get lots of teaching in. Any time pt's are awake, you can do some teaching--it's all a matter of how you use your time & how good you are at prioritizing.

    Med/Surg experience will help you in so many ways in your future. It's like the foundation of your career. You will be able to use all of your experiences in the future & you can build on them.

    I love med/surg; I love Oncology; I also loved doing home health. I don't think I would have done well in home health without my med-surg experience. It gave me the confidence I needed & gave me assessment skills that have proved invaluable.It also helped me in my Critical thinking & Problem solving skills!!
  12. by   leslymill
    Quote from nursemary9

    Med/Surg experience will help you in so many ways in your future. It's like the foundation of your career. You will be able to use all of your experiences in the future & you can build on them.

    I love med/surg; I also loved doing home health. I don't think I would have done well in home health without my med-surg experience. It gave me the confidence I needed & gave me assessment skills that have proved invaluable.It also helped me in my Critical thinking & Problem solving skills!!
    I second this and think you wouold rregret not getting one year of med-surg under your belt. It will give you the confident nursing judgement you will need when your out in the boonies.
  13. by   HealthyRN
    I agree with the other posters about there being no perfect ratio, no matter the speciality. I started my career in the ER and I regret not getting the year of med-surg experience, which is why I'm giving med-surg a try after a year and a half as a nurse.
  14. by   underpaidrn
    Most home health agencies do not hire new grads. They need at least a year's worth of work in a med-surg unit. New grads just do not have the assessment skills needed to work totally independently. In home health, you are it. You can't stick your head out the door and ask someone else come and look at your patient. Nursing is not easy. It's always going to be hectic and God forbid if you ever use the q word while at work (quiet) because you know what is going to break loose if you say it. Good luck in finding what you want to do.:spin:

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