nurse-patient ratio

Shellsie · Oct 4, 2003

i work at a small hospital (45 tele/ms beds, 8 imc beds, 9 surgical, 6 icu beds) and on regular med/surg there are still alot of LPNs so they do team nursing sometimes. when its team nursing generally there are 8-10 patients with an RN, med nurse, and CNAs roughly get around 12 each. When they do primary care its 5-6 per nurse and same ratio for CNAs. the surgical unit and imc unit each have 2 nurses for their 8-9 patients and the ICU gets 3 nurses for their 6 patients

Clarisse · Oct 17, 2003

I work in a small hospital, med/surg unit. Our usual ratio 1RN8-13 patients not including covering for the LVN's patients,if we get lucky we could have 3 CNAS and 2 units secretaries in each med/surg units. But they already experimented with 1 unit secretary to cover both units, not including continues admissions and our charge nurse not even lifting a finger to help us no the floor. We get all kinds of med/surg patients from ortho,psych to onco. Just imagine all of these during 7A-7P shifts.

Clarisse · Oct 17, 2003

ruca30 · Nov 1, 2003

Days/afternoons is 1:6 here, midnights 1:8. That's the theory, anyway. There has rarely been a day where I've worked a midnight shift with less than 10 patients, or a day where I've had less than 7.

debRNo1 · Nov 2, 2003

Originally posted by Clarisse

Im in NY, mostly med med-surg busy busy unit day shift. On friday I had 10 :eek: NOT SAFE at all with discharges and admits. My unit is 28 beds and on a good day we have 4 rn's/ cna's and hopefully a ward clerk. 6-7 depending on acuity is sometimes managable. Usually Im not done with assessments and meds till lunchtime then do the accuchecks and my 1400's before I get a break somewhere around 3 pm when there tends to be a lull in the chaos.

Friend of mine works at a cardiac hospital on a med surg floor and has 10-12 on day shift, dont know how she manages that, they just sent a flyer for an open house I filed it right in the garbage can :chuckle

RN-PA, RN · Nov 2, 2003

I am not being purposely naive, but I wonder who arrived at the magic number of SIX patients being manageable by one nurse on med-surg. I have had shifts with 6 patients who were all partial- to self-cares, mostly "walkie-talkies" and yes, that was busy but manageable. But throw into the mix coverage for an LPN who has 6-7 patients, some of whom may be a new admission (RN's muct do admissions and initiate care-plans), needing to hang blood, do IV pushes, call the Dr. for any of their problems along with your own load, and there's nothing very manageable about that. And of course, you can have shifts where you have only 3 or 4 patients, and depending on their acuity and problems that crop up, you can be running all night.

I saw one of my managers on Friday (right before the Halloween-evening-shift-from-hell), and she mentioned, in regard to nurse to patient ratios that she still believes 1:6 should be "manageable". The hospital where she used to work had 1:8-9, so she thinks we have it pretty good. :rolleyes: Of course I mentioned that 1:6 is not taking acuity into consideration and she grudgingly agreed. One of our upper management nurses mentioned in a local newspaper article about nursing shortages that ran within the last year that she thought that 1 nurse for 6-7 patients was "adequate" staffing. (How about asking a patient? How about asking the nurse in the trenches? )

But again, what's the deal with this "one-size-fits-all" staffing for med-surg units? I can see a number of years ago, maybe when patient acuity wasn't so high, that 6-7 patients would be doable, but nowadays..... :eek:

MinnRN · Nov 6, 2003

I work in a large midwestern teaching hospital, 745 beds. The unit I work is a medical floor that specializes in endocrine, diabetes, and kidney problems, although we see a little bit of everything. Our staffing ratio on days and evenings 1:4, nights 1:8. Our charge nurse often takes a full patient assignment or "flies" and will process admissions. Acuity of the patient no longer seems to matter when staffing our unit, you may find yourself with 4 level 2 (low acuity) or 4 level 4-5 (high acuity) patients. Charge does try to gather staff input before assigning patients. For those of you who feel this is is a cushy assignment, I would like to add, that often we do not staff PCA's on our unit, and the Rn is responsible for all patient care along with stocking supplies, etc.:imbar

mcg02 · Nov 29, 2003

I work in a hospital in Atlanta (Decatur) Ga and our ratios vary for days anywhere from 5-7 patients with average of six and same for evenings and on nite anywhere from 6-8 with an average of 7. We have techs eacy shift 6-7 on days and evenings and 3-5 on nites depending on how many patients on floor..

RN,BSN

nursenatalie, ADN, RN · Dec 9, 2003

Our floor has ratio of 1-5,6 on days and 1-7,8 on evenings. The big difference comes in with the CNA's...day shift is allowed 2-3 and we (night shift) dont get a CNA until we have 15 patients on the floor...it is very hard to deal with 7 post-op patients with no CNA and never a unit secretary!!!

NurseStyles · Dec 15, 2003

I work on a med/surg/tele/peds mixed unit. Usually for days, we have 1:6-7 RN or LVN with a CNA for each team of 6-7 patients.

PMs is about 1:4-7 RN or LVN with the CNA ratio being 1:6-12

Nights is about 1:6-9 RN with the CNA ratio being 1:11-16

Days has a charge nurse who covers the LVN

PMs has a charge nurse usually with no patients, who covers LVNs sometimes no charge nurse

Nights--no charge nurse, no unit clerck

WE have auxillary staff to perform all RT functions, all labs, ECGs etc on all shifts.

Our average census is about 20

NurseStyles · Dec 15, 2003

Originally posted by RN-PA
I am not being purposely naive, but I wonder who arrived at the magic number of SIX patients being manageable by one nurse on med-surg. I have had shifts with 6 patients who were all partial- to self-cares, mostly "walkie-talkies" and yes, that was busy but manageable. But throw into the mix coverage for an LPN who has 6-7 patients, some of whom may be a new admission (RN's muct do admissions and initiate care-plans), needing to hang blood, do IV pushes, call the Dr. for any of their problems along with your own load, and there's nothing very manageable about that. And of course, you can have shifts where you have only 3 or 4 patients, and depending on their acuity and problems that crop up, you can be running all night.

I saw one of my managers on Friday (right before the Halloween-evening-shift-from-hell), and she mentioned, in regard to nurse to patient ratios that she still believes 1:6 should be "manageable". The hospital where she used to work had 1:8-9, so she thinks we have it pretty good. Of course I mentioned that 1:6 is not taking acuity into consideration and she grudgingly agreed. One of our upper management nurses mentioned in a local newspaper article about nursing shortages that ran within the last year that she thought that 1 nurse for 6-7 patients was "adequate" staffing. (How about asking a patient? How about asking the nurse in the trenches? )

But again, what's the deal with this "one-size-fits-all" staffing for med-surg units? I can see a number of years ago, maybe when patient acuity wasn't so high, that 6-7 patients would be doable, but nowadays.....

Our LVNs do admissions, hang blood, call doctors, they do everything except IV pushes and piggybacks, and central line care. I wonder if this is legal, I guess I should check with the LVN scope of practice. The charge nurse just cosigns the charting.

busyrninva · Feb 3, 2004

Where do you work ? I would be willing to move if thats the ratio and the thoughtfullness that administration is willing to provide for the nurses.

WOW!

Originally posted by ruby mcbride
I work at a 175 bed hospital. We recently had a consulting team evaluate our patient:nurse ratio. It basically is 1:4 for day shift, 1:5 for pm shift and 1:6-7 for night shift. We have aides on days, pms and nights. They also vary as to acuity status. It is a good system, and most of the nursing staff feel they can live with the numbers. The charge nurses have the final say in staffing. If they feel they need more staff (based on influx of admissions or patient condition) they can request more staff, the same if the patient census goes down, they can send people home low census/on-call. It seems to work pretty good. Other nurses that come to this facility to work feel we have very good staffing. Good luck.