Med-Surg Topic of the Week .... Nurse to Patient Ratios

jax · Nov 17, 2004

1:4 on days, 1:5 on evenings and 1:10 on nightshift. No nursing aids. Secretary for the day and half of the evening shift. One RN team leader for each shift who has no patient load. We are a 48 bed orthopaedic unit.

RNPATL, DNP, RN · Nov 17, 2004

Your unit sounds wonderful. Ortho patients are pretty heavy, so I would imagine that a lighter ratio without aides probably helps out a lot. However, sometimes having an aide can really be helpful.

allnurses Guide · Nov 17, 2004

Two RN's (or one RN and an LVN). Ward Clerk from 6:30 a.m. to 10:00 p.m. most days. One or two CNA's. Our ratios are 6:1 max all the time due to California ratio law and that will change to 5:1 in January.

steph

SweetnurseS · Nov 17, 2004

I work on a 20 bed med/surg floor where we have one charge nurse who works days 6:30 to 3 mon thru friday. We work 12 hr shifts. Our patient ratio varies depending on the census. Usually we have around 15 patients most days. Our average is 3 primary staff with atleast 4-5 patients each. I've never had more than 6 patients and with most of them being ambulatory. No CNA's. We have only one LPN full time on days and nights has 2. RN's are responsible for signing off their charts if a RN didn't have that patient in 24hrs. We also have a unit secretary who works 8 hrs, 2 per day. Night shift has 3 nurses working most nights, sometimes 2 if the census is down. Most of the time if we are busy and happen to be short staffed usually we get a float from either OB or ICU.

General E. Speaking, RN, RN · Nov 18, 2004

I work on a 28 bed med-surg floor. We have 10 pedi beds and use them as MS overflow when the pedi census is low. We work 12 hr shifts. This is the only hospital I have worked at where the night nurses have the same amount of patients as day shift. Five or six patients each. One charge nurse w/o patients. During the day we have 2 aides at night they have 1.

Too bad I can't hack night shift.... :crying2: More money for less work.

pnkprincess · Nov 20, 2004

The floor I work on we do team nursing. Either an RN with and LPN or an RN with a CNT (certified nurse tech, a nursing student with at least one semester under their belt). The teams that contain an RN and LPN take more pts. usually 6-8 sometimes more when census is up. The teams that have an RN with CNT are not suppost to have more than 6. Basically because the student can't pass meds which means the RN has to do the IV and po meds, along with making sure that the CNT is doing their job right since they don't have a license.

starcandy · Nov 20, 2004

We have modular nursing on my floor. On afternoons the ratios are 2:7-8 . This is a team of RN and one PCA or the RN has 4 patients alone. Modular nursing is when you have a set assigned group of patients regardless of acuity. I think this sucks sometimes when you have a heavy set and someone else is playing games on the computer.

live4today, RN · Nov 20, 2004

Two RN's (or one RN and an LVN). Ward Clerk from 6:30 a.m. to 10:00 p.m. most days. One or two CNA's. Our ratios are 6:1 max all the time due to California ratio law and that will change to 5:1 in January.
steph

That info makes me want to move back to Cali come January! :) Which hospital would you recommend? Any travel nurses in your area?

schroeders_piano, RN · Nov 20, 2004

Too bad I can't hack night shift.... More money for less work.

I almost let this comment go by, but I can't.:angryfire I used to work Med/Surg on the night shift. Just because is it night, it does not mean it is less work for the nurses. I find it funny that a Med/Surg unit had to have a 1:5 ratio for the day shift, but one minute past 7:00 p.m. it is alright to have a 1:8 or 1:10 ratio. I realize that a patient's status change, but not that quickly. I have been reading throughout these boards about nurse retention. One of the reasons my Med/Surg unit couldn't keep nurses, was the day shift kept telling us how overworked they were and how we, the night shift nurses, didn't do anything all night. These statements were coming from a dayshift staff that had 15-20 patients. 3 or 4 RNs, 3 CNAs, a ward clerk, and case management nurses who covered lunches and breaks. Night shift had 2 or 3 RNs or LPNs and that was it. Sometimes we would get a ward clerk until 11 p.m. or we might get a CNA, but not always. The night shift also had to do the daily "chores" of the unit such as cleaning the nurse's station, checking the crash cart, restocking the rooms, etc. I was suppose to squeze this in between assessing 10 patients (or all of them if I was working with a LPN), passing meds, providing hygiene care, helping patients ambulate in the hallway (because dayshift was to busy) and doing doctor rounds with that one doctor that waits until 10:30 at night to come and see his patients. I don't normally get on my high horse, but for some reason this comment rubbed me the wrong way today. I will just apologize now to the people I might offend.

Schroeder

nursbee04 · Nov 22, 2004

Too bad I can't hack night shift.... More money for less work.

Oh my...

Wanna hear about my night last night? I was the only RN plus three LPN's. We got five admissions. I had a pt I had to call and get a bolus for b/c his BP was bottoming after IVF @ 150 all day, a pt recieving blood, a toddler /c a terrible SpO2, a postop colon resection, a pt /c sepsis, two chest pains, a pt in DT's, a LOL in CHF /c MSC, got another postop emergent colon resection, a pt in traction to be prepped for surgery, a pt /c CRF and COPD, a pt that had to have emergency transport to a cath lab, three low Hgb's I had to call and MORE blood products to give, a pt /c an ammonia of 190 and SO confused, elevated cardiac enzymes I had to call, not to mention all the total care patients we had on the floor. BTW, none of the LPN's are allowed to do IVP or hang blood, and we don't have aides or a ward clerk. We do EVERYTHING for our patients. Do you think one person on my crew last night had a spare second to take an extra breath?

Why can't all shifts respect the hard work we ALL do and agree that ALL shifts are hard?

I will say it ONE MORE TIME: JUST BECAUSE IT IS DARK OUTSIDE IT DOESN'T MEAN THEY SLEEP.

Off my soapbox now, didn't mean to hijack the thread.

Tweety, BSN, RN · Nov 22, 2004

I'm disappointed to hear that you think 7-8 is a decent ratio for night shift. But that's probably because I've recently went back to a floor with those kinds of ratios and am seriously struggling. I don't necessarily feel unsafe, but feel overworked, especially with the paperwork. I'm getting better but 8 patients is too much.

I could provide most excellent care for 6 patients max.