reasonable staffing? i'm not sure.
3 nurses and a tech for 16 patients really isn't all that bad (but not great, either).
what does "ortho stepdown" mean? is this like an icu stepdown for ortho patients? or is it fresh ortho patients?
if this is a type of icu step down for orhto patients, then no, i don't think the staffing is reasonable. icu stepdown should be 4 (maybe 5) patients per nurse, and in my experience is an rn job.
if, however, it is more of a stepdown from recovery room, caring for postop ortho patients, it might be ok.
however, it really does depend on what state you are in. in many (most?) states, lpns are limited in their ablility to give blood (often the rn has to hang it, though the lpn can monitor it), central line care, iv push meds. with post op ortho patients, there will be a lot of blood transfusions and iv push meds. it is tough to be the only rn and have to run up and down the hall hanging a bunch of tranfusions, checking off pcas, and giving ivp pain meds for those who don't have them, plus take care of a full load of patients.
so if he is going to be the only rn, working with lpns where he has to cover much of their work (depending on state law), then he really shouldn't be taking a full load.
in some states, lpns take an iv therapy course and can then do almost everything with an iv that an rn can do. that helps quite a bit.
in some units, the lpns will do some of the rns po meds (or somehow trade off tasks) to balance what the rn has to do for them.
again, it really depends on the laws of the state you are practicing in, as well as the unit culture. if everyone works great together, 1 rn, 2 lpns, and an aide could probably be a great staff for 16 post op ortho patients. especially if some of them are a few days out.
now, as for the "new" charge nurse position, he really needs to tell his supervior that he won't take on that role without orientation first.
i've been in that position before, and i've held my ground. i've insisited on orientation before being put in charge, and i've gotten it. thing is, the charge nurse is responsible for all that goes on. coworkers come to you with problems, ask you for guidance. they will chart "spoke with charge nurse." it is important to have orientation as to how the facility expects the charge nurse to deal with situaitons, and to know where the reasources/answers are.
oops, sorry, just re-read your post. no, 1rn, 1 lpn, and 1 tech is not acceptable in an acute-care setting. neither is 1 rn and 2 lpns on a post ortho floor. these patients can be heavy, and are not moblie on their own. it often takes two staff members, sometimes even three, to move them.