Med/ Surg Patient to Nurse Ratio

  1. 0 I work a realitvly small KY Hospital. We have two acute medsurg floors each with 33 private beds seperated into 4 wings. There is a central desk were the unit secetary answers lights and enters orders. Each wing has a small room with a counter, med cart, computer, shelving full of supplies, patient fridge, icemaker... you get the picture. Each wing is designed in such a way that you may not see any other nurses that day. I was recently speaking with another nurse who had returned home from travling these past 7 years. "I ask him how are the other hospitals? Did you like them?" He looks and tells me straight up that in the 8 diffrent facilitys that he worked at across the country, our small facility had THE highest ratio he experienced. I was amazed and I wonder.. is that accurate? What are your ratios?

    Here is where i work: 8:1. RN, LPN.. whatever. 8 patients, 1 license... unless your the unlucky nurse of the day that gets the wing with the extra room.. then its 9:1. So, that is 33:4. .. it could be all RN or 3 LPN and one RN... but that doest matter because each wing has everything you need.. you don't really see your coworkers.. your nurse aide can make or break you in terms of care. aide ratios are 8:1 from 7am-3pm.. then they drop to 16:1 . No charge nurse.. no IV team, admit/discharge team.. whatever kinda teams we don't have 'em. we do it all. Oh and the rounding with a purpose.. was just implemented..
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  3. Visit  pilpusher} profile page

    About pilpusher

    pilpusher has '7' year(s) of experience and specializes in 'Medical/Surgical'. From 'Mayfield, KY'; Joined Dec '09; Posts: 2.

    28 Comments so far...

  4. Visit  Super_RN} profile page
    0
    We generally have no more than 7 patients per nurse. I work night shift, so our ratio is higher and the only time we have a LPN is when they're floated in. There are none scheduled on our floor at night. We don't have an admission team / IV team / etc at night. Our charge nurse takes patients, just like the rest of us. If there is an admission, we do the assessment and computer stuff and the charge nurse does the orders and the rest of the chart.
  5. Visit  kat7ap} profile page
    0
    At my med/surg job we have 5-6:1 with about 1 tech per 15-16 pts

    At my rehab job we have 8-9:1 with about 1 tech per 10-12 pts
  6. Visit  Super_RN} profile page
    0
    I forgot to add we have one STNA to approx 8 patients
  7. Visit  doubleplay} profile page
    0
    We have 5 patients at night, no tech, no unit clerk and really no charge nurse. We do all the admissions also.
  8. Visit  SeattleKid09} profile page
    0
    We have 4-5. Seems like very little but my hospital does not have a med-surg intermediate unit so we're getting a higher acuity of patients on a regular basis.
  9. Visit  NursKris82} profile page
    0
    High acuity med- surg tele: RN 5:1 typically, max 6 for nights and 4:1, max 5 for days. CNAs typically have 8-10 pts and max out at 14.
  10. Visit  RN/CM} profile page
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    I am an RN on a busy med/surg floor. We have 10 private rooms and 14 semi-private rooms on our floor. We have anywhere from 9 to 12 or more patients per RN, depending on how many RNs are scheduled for the day. We also have LPNs and CNAs.

    Most of my days are VERY busy!!
  11. Visit  Piki} profile page
    0
    I cannot imagine having 9-12 patients on a med-surg floor! Yikes. I work surgical/tele med-surg, typically on days we get max 5:1 patients, sometimes only 4 (but you know you will get the first admission). Eves it is sometimes 5:1 or 6:1, and nights it is never more than 7:1. We often turnover half the floor in a single day (22 beds), we get a lot of admissions and discharges. Typically there is one aide to 11 patients. Once in a while there is only one aide(one aide only after 7 p.m. thru 7 a.m.).
  12. Visit  NJNursing} profile page
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    Our staffing used to be 1:5-6 and very rarely 7, but they just changed the guidelines so we're going to be 1:6-8 and very rarely 8. One patient really does make a big difference and we're all up in arms about it. We will get 1-3 aids on the floor and our floor holds 36 patients - 30 semi-private rooms and a 6 bed stroke unit which are private. I also work nights. Day shift almost never goes above 5-6 per pt. We have a secretary 24 hours too.
  13. Visit  Wondergirl0905} profile page
    0
    I'm on a surgical-tele floor at an academic medical center. Our patients have pretty high acuity at times. We also receive overflow of medicine, trauma and neuro patients. Our floor has 4 pods with 2 nurses on each pod and 1 LNA. Our ratio is 1:4-5 for the RNs and 1:9-10 for the LNAs. We have a charge nurse during the day with no assignment (unless someone goes home sick and there is no flex RN available to cover) and the charge nurse at night takes an assignment. We also usually have one of our nurse managers around from 07-2300. We do our own admissions and discharges - which could be every single bed on the day shift. We have unit secretaries between 0700-2330, and then the RN does all the transcribing for new admits during those off hours. We have a phlebotomoy and vascular access/IV team 24/7. I feel pretty spoiled when I hear about some of the ratios out there, including the OP's!
  14. Visit  lab211} profile page
    0
    It seems to me from the responses, the nurse to patient ratio is dependent on the location, availability, acuity, risks, experience, finances, management, and the circumstances (which is really in a a nutshell, those that I just mentioned).
    Let us ask ourselves, do you honestly feel that staffing practices put patient safety as the number 1 priority? Do we leave work each day feeling good about ourselves and our employer? And what about California with their mandated 1 nurse to 5 patient ratio, practical or paranoia? At my institution, there is really a nursing shortage...for experienced nurses. New grads are in a tight job market right now. Nursing school teaches us the "ideal" but not the real world. Every nurse know this. Then why is this the approach? I know I am throwing quite a few questions out there. Just like everything in life....finances dictate practices.
  15. Visit  NJNursing} profile page
    0
    Quote from lab211
    It seems to me from the responses, the nurse to patient ratio is dependent on the location, availability, acuity, risks, experience, finances, management, and the circumstances (which is really in a a nutshell, those that I just mentioned).
    Let us ask ourselves, do you honestly feel that staffing practices put patient safety as the number 1 priority? Do we leave work each day feeling good about ourselves and our employer? And what about California with their mandated 1 nurse to 5 patient ratio, practical or paranoia? At my institution, there is really a nursing shortage...for experienced nurses. New grads are in a tight job market right now. Nursing school teaches us the "ideal" but not the real world. Every nurse know this. Then why is this the approach? I know I am throwing quite a few questions out there. Just like everything in life....finances dictate practices.
    No, staffing practices put the almighty dollar as #1, not patient safety. Our hospital is having this problem right now. Lets see how many pts we can pile on the nurses without killing people, causing a mass exodus of nurses and before the nurses break down.......

    a 1:5 ratio is fantastic, of course unless you work in ICU/CCU/PCU - then it's overkill. California has the right idea. But for med-surg, I think 5 patients is ideal to give really good patient care and give each patient really dedicated time. I agree, there is NO nursing shortage here in the northeast. New grads can't get jobs and many hospitals are on a hiring freeze. I agree that nursing school is nowhere NEAR real life nursing. Why do they do that? Because their goal is to prepare you for the NCLEX, not the real world. My professors would often tell us that our TRUE education would come in the first year or nursing and why they really push students to do med-surg for at least a year before specializing. When I was a new grad and went right into a speciality I thought, for what? But when I went from the specialty to med-surg, OMG, I had like NO skills. All of my med-surg stuff from school was lost for a while and time management? Non-existant.


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