Med Surg Nurses: How many patients do you care for? - page 4

by cheez1285

Hi all! How many patients are you allowed to care of at a time on your med surg floor during days or nights? In our hospital, on days, we go up to 6 and night shift can take up to 7. Just curious. I work at a hospital near... Read More


  1. 1
    At the hospital I left last year (in NY), a typical med/surg floor would operate like this: One RN on each end of the hall, and an LPN in the middle. Each RN would have 6 of her own patients. The LPN in the middle would also have 6 patients.

    HOWEVER, this hospital didn't "allow" LPNs to do a lot of things. According to some LPNs that worked there for years, the hospital had only recently started this "LPNs aren't allowed to do anything" business. In the past they had done lots of things. I'm not very familiar with the LPN scope of practice, but apparently there were things that LPNs were qualified to do, that this hospital still would not allow!

    Anyway, the LPN's assignment would be split between the 2 RNs to "oversee". The RN was responsible for anything the LPN wasn't allowed to do, which was basically everything except meds (Unless there were IVP or something). The RN was responsible for doing any documentation, assessments of any kind, making/answering any necessary phone calls (LPNs were not allowed to speak with doctors, lab, etc on the phone), taking/giving report, etc. So, as an RN on a med/surg floor, you were actually responsible for 9 patients! It was so stressful. Rarely, there would be an RN in the middle, and that was a huge gift! No disrespect to the LPNs, but it was just human nature to be grateful to "only" have your 6 patients. Many of the LPNs there are so experienced and knowledgeable. What a waste of their skills!

    I thank God every single day that I no longer work there.
    anotherone likes this.
  2. 0
    I am a new nurse, just graduated in may, and I was 4 weeks into a 12 week orientation taking 6 patients on med/surg with little help from anyone. It is very difficult because I felt like I was being neglectful in a way-not knowing enough about patients and then having to give report on them made me feel ashamed, I felt like I wasnt being the nurse I wanted to be-not thinking, not making smart decisions, just following orders like a robot as quickly as I could with all this pent up anxiety. I almost walked out one time when i heard that I was going to have 7 patients, I would have to assess 4 other patients assigned to LPNs, and I had no aide for the totals yet I had aides for the walkie/talkies-gee, real helpful. I laughed at my preceptor when she told me all this and I really felt like I had had enough. I was seeing that everyday each RN would never have no less than 6 patients-even 7 or 8 if someone called out. I dreaded going in knowing that I would always be taking care of 6 patients and thinking I will never feel like I am doing a competent job. So I quit and will be on a unit that will have 4-5 pts.
  3. 0
    Quote from wheekris
    I'm not a nurse yet; I graduate this summer in Maryland, but I am so glad you all are talking about this. It's interesting to hear your perspectives on how many patients are too many!!
    Make sure you ask hospitals what the nurse to patient ratio is in the interview because 6 all the time is exhausting and you will dread it!
  4. 1
    I work within the military system on a mixed hem/onc med surg overflow ward. We are allowed 4 hem/onc-ers at a time (which is a MESS if you're giving lots of chemo) and 5 med-surger-ers at a time (which is also a mess if you've got complete care patients). The standards down the hall on the pure med/surg wards is 5 patients each, but most of the time, nurses have 3-4 patients. I know that our ratios are much better in the military than they are out in civilian nursing. And even though the military has its own set of unique problems, I thank God I'm in this system and not on the outside!
    anotherone likes this.
  5. 0
    7-8 on a med/surg floor in NJ
  6. 4
    Usually 6 med surg here in GA and I gotta tell you, most days its so overwhelming you don't know whether to cry or laugh hysterically.
    anotherone, BumblebeeinNC, noyesno, and 1 other like this.
  7. 1
    Normally 5. Occasionally, if no one calls out, and the acuity is high enough, we might go down to 4 on days. We rotate turns taking 6 at night but 5 is the standard at night. Out of the 5, you're lucky to have 1 walkie-talkie. Most are q4 VS and OOB with staff only. On day shift, you normally have 2 discharges + 2 post-ops (so you really see 7 pts over the course of the day). On nights, you typically start with 4 pts and an empty -- the empty room is either filled with a post-op early in the shift or an ED admission in the middle of the night. (but, no doubt about it, that room will get filled!!)
    anotherone likes this.
  8. 0
    I can have 10 patients, and on most nights I have 8-9. I'm in ky. Very hard for a new nurse.
  9. 0
    Five on a med-surg floor...occasionally four if the patients are all high acuity.
  10. 0
    I work as a charge nurse on nights, we usually have 6 patients per nurse. When the other nurses have 6 each and we get more admissions I start taking patients. Occasionally we will have 7 each. Day shift works a bit differently, they take more patients each so their charge nurse can be a charge nurse. They have discharges and daily rounding with the Drs, so they really need a charge nurse. I find that 4-5 patients is a good number for me. Of course there are times when you only have 3 patients but they feel like 30! I'm fortunate that I work with a team that really works well together. We help each other out and no one leaves in the mornings without first checking to see if any of us need anything.


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