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Cheryl. you dont want to know. When I was a new grad the census on my floor was 40. 3 RNs and 2 CNA and a clerk on a good day. If the floor was not full to capacity rest assured that the ER/ICU would be calling to take care of that. And to top it off we were not told until we finished orientation that we only had one weekend off a month.
1:5 is standard med surg ratio by law in California where I work. It can be okay, or it can be too much. It depends on the acuity of the patient. Sometimes you have a few patients that have soooooo much going on, and it is barely manageable unless your other patients are easier. Also, it depends on ancillary staff...do you have a nurses aid, a charge nurse who can pitch in maybe pass a med here or there or help with an admission? When I was a new grad, I took 6-8 patients on med/tele pm shift.ON a bad night we would have up to 10 patients. It was very challenging and stressful. I had to take direct admits straight from the doctor's office with active chest pain on med/surg/tele! :-( (Why didn't they go to the ED first?!) Personally, I think 1:4 for med surg would be more manageable, but you never see that ratio EVER on med/surg. I always loved it if I had one or two ambulatory patients who were stable, because you know you're going to have another one or two who are on isolation, needing Q 1-2 Hr frequent pain med IV, complicated dressing change, ambulation, frequent suction, a million piggybacks every hour, TPN, accuchecks, etc. I think 1:5 is as good as you'll get. But it isn't always easy. Depends on what is going on with the 5 you have! Good luck!
a 1:5 ratio would be perfect. Our day ratio is 1:6 and nights are 1:7. There have been occasions where I had only five patients and what a big difference it makes. Unfortunately, I feel as though as healthcare continues to change, we as nurses will be having an increase in our nurse/patient ratio :-(
I'm on a med-surg floor and we do 1:5 days and nights. Our acuities have gotten higher so sometimes it can be pretty tough, but I am counting my blessings that we don't have to take more than five a shift. Ratios need to be federally mandated (in my opinion) because it is safe for both the nurse and the patient.
1:5 could be reasonable, or it could be hell. On my old unit, 1:5 would be a breeze with a certain group of patients, but it would be torture with another group. Our acuity was very very high though. We were stepdown/med surg. And our primary specialty was neuro...so that is part of it.
That said - days 1:4 or 1:5 was normal. Nights 1:5 or 1:6 (sometimes 1:4 or 1:7)... I was only 1:7 once and it was hell. We had everything short of a vent being used as a vent on our unit that night (we took vents but only for CPAP/BiPAP on patients with a mask delivery apparatus). Seeing ratios of 1:7 or 1:9 frequently? Makes me very very very glad I'm no longer a stepdown/med surg nurse.
Our "specialty" is supposed to bed GI illness, GI surgery, Bariactric surgery, vascular surgery. Now we are getting TONS of medical patients. Employees are dropping like flies. 1:5 on nights is good. We are so short staffed right now, that it was 1:8. With me in charge with 6, then an admit to total 7. The acuity of many of these pts is far beyond what these ratios allow us to take care of.
MANY orders are being missed, or carried out 4+ hours after they were written. It is a SSE waiting to happen!