Nurse to patient ratio

  1. I was wondering what the average ratio is for nurse to patients for the night shift. I work in a tele unit but we get everybody! I am expected to care for 8 patients that run the spectrum of complexity. We are getting killed everyday! I was also looking for research to show our manager how dangerous it is to staff based on census and not on acuity levels. I really feel like I am a reactive nurse vs a proactive nurse. I have only been out of school since may. I was a paramedic prior to this and thank god I have those expierences to draw from! Thanks!
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  2. 11 Comments

  3. by   CaLLaCoDe
    At my hospital in central california rarely do we have 6 patients or severely rarely seven...most nights 5 at max. I am certainly concerned for your patient's welfare with such numbers...even I having been a nurse for over a year and a half would be overwhelmed with such an awful ratio such as yours; especially on Tele where you can have positive cardiac enzymes, chest pain r/o MI on another; pulling a hemaquit on still another and a confused client and add another 4 patients.....wow !umpiron: please tell me where you're located.
  4. by   Lacie
    I have to agree. When I was a NCM of a Telemetry unit we did base our assignments on acuity level. Staff never had more than 5 pts max and less if thier pts were more critical or unstable. I would be very concerned with asking a nurse to attempt to care for 8 on a unit such as yours also. On occasions we may get so short due to call ins whatever but that was rare. Then I also would be out of my office taking patients myself majority of the time. I wouldnt ask my staff to do anything I wouldnt do myself.
  5. by   Tweety
    8:1 on night shift, trauma med-surg. Too high in my opinion.
  6. by   RGN1
    Ours is 7:1 for the night staff, mostly elective surgical patients. Although I have to say they very rarely get up to their maximum, it's usually 4 or 5:1. They will also do early admissions for theatre times up to and including 09.00.
  7. by   cheshirecat
    Ours is 16 pts to 1 RN and HCA. We never stop the whole shift. Our ward is a surgical ward. We used to have only 2 RN and 1 HCA for 30 pts, but thankfully they decided to give us the extra HCA.
  8. by   AliRae
    I don't think it really counts, because I work PICU. We're 1:1 or 1:2, both days and nights. Very rarely when we have a lot of overflow from the floor, I've worked 3:1 (and even that makes me head spin!)
  9. by   BGgirl
    Wow, you guys make me thankful for our low patient ratios even though the nurses on my floor tend to take critically ill pts with multiple health issues. We're 4:1 on nights at the max but we usually start out with 3 and end up with an admission.

    We've had other nurses from different floors float to our floor that take 6 patients a night and say they'd rather have their 6 patients then our 4. I cannot even imagine taking 8 patients by myself. That sounds too unsafe.
    Last edit by BGgirl on Dec 27, '06 : Reason: spelling
  10. by   all4schwa
    ours is 5:1 on nights. we're considered advanced care and float to other advanced care units, but I believe other floors carry 7-8 on nights.
  11. by   HappyNurse2005
    labor and delivery/high risk antepartum:
    active labor 1:1. maybe one labor and one cervidil induction. or 2 cervidils.
    antepartum side 1:2 to 1:4 at night. depends on staffing, census, etc
  12. by   pickledpepperRN
    Telemetry ratio is 1:5. This means stable patients with continuous cardiac monitoring.
    Step down is 1:4. These are unstable, potentially unstable, or requiring technical support such as a ventilator, hemodynamic drip, or frequent interventions.
    The ratios must not be averaged so no RN may be assigned more than five on nights. If days is busier then day shift needs to add staff, not take staff from night shift. Patients are sick at night too.

    Our ratios are the maximum number of patients that may be assigned to a nurse at any one time:
    Ratios Home Page

    The Linda Aiken study in JAMA showed that for each patient over four assigned to a registered nurse fatality due to 'failure to rescue' increased by 7%. The study is attached.
    So for if your nurse has seven patients your chance of dying increases by 21%.

    The regulations as required for a hospital license in California:
    http://www.dhs.ca.gov/lnc/pubnotice/...ation_Text.pdf
    Last edit by pickledpepperRN on Jan 26, '07
  13. by   blondegenes
    I urge you all to check this safe staffing site as an extension of American Nurses Association;
    http://www.safestaffingsaveslives.org/default.aspx

    I have some questions about the specifics of the proposed legislation to limit nurseatient ratio myself, but I urge you to take the poll and back the ANA and any other organization that is working toward nurse/patient ratios that will not burn out nurses and risk patient care.

    I am currently working acute med/surg on nights 7pm to 7am (which really means I'm in half an hour early and clock out half an hour later due to change of shift report, and my patient ratios have been as high as 1:7.
    If our patient ration goes down to 1:4 we have to do total care, including CNA stuff and unit secretary things.
    Because we have a unit secretary who spends much more time playing video games than she does inputting orders and doing her job, we have been penalized by only having her onboard until midnight any given night.

    Again,,put your questions to the ANA, read the specifics,
    take the poll and support legislation that favors treating nurses well.
    The federal government is doing lots of studies on why they lose so many hospital nurses each year, and why so many leave the field altogether,,,let them know exactly why!

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