nurse-patient ratio - page 2

Within the last year, we restructured our Med-Surg nurse patient ratio to be 1:6 for days/eves, and 1:8 for nights. I am interested in hearing what other ratios in Med-Surg are. I work in a 400 bed... Read More

  1. by   tremmi
    Most of you have very good ratios. In our hospital it is 1:8 days, 1:10 eves and 1:12 nights with 1 aide on days , none on evenings or nights. The charge nurse doesn't take patients on days but does on eves and nights. There is a unit clerk on days but not on eves or nights.
  2. by   JB120RN
    I'm in Louisiana. I'm glad to have found this bulletin board since I am currently researching staffing levels for Med/Surg units in acute care settings. Our unit is 42beds, good mix of surgical, New CVA's, telemetry, and all medical conditions. Occasional ortho, oncology, nad female surg. Staffing is on number not acuity. We have 1:6-8 days,1:6-10eves,1:10-11nights.This includes LPN's or RN's. There might be 6 RN's or 2 RN's and 4 LPN's, no rhyme or reason. We do have 2-4 aides on days,2-3 eves, and 1-2 nights. Charge nurse- all shifts-has patients. It is often harrowing. Glad to see some are better, sorry to see some are worse.Interested in hearing where everyone is from.
    Janet
  3. by   Cindy Lou
    I live in the Hearland - Southeast Missouri. Our nurse patient ratio is not determined by acuity. Sure wish it was. We can get several intensive care unit move - outs to make more room for the ICU, but that doesn't help us. Our usual staffing on days ranges from 1:4-6, evenings 1:6-8, and nights 1:7-?. We are actually 2 zones combined and we total 39 beds. We can start a shift out staffed correctly - but throw in some unexpected ER admits, unit moveouts and Outpt surgeries that should have gone home, and your night has turned into a nightmare. On evenings and nights we have a house supervisor who will try to call in more help for us but with the nursing shortage and/or the hospital not hiring as nurses leave, we have no reserve. The hospital is constantly asking us to work doubles then come back in 8 hours and do your regularly scheduled shift. We are all burnt out, needless to say we need a day off to be with our families and to "take care of ourselves". Sure wish they'd quit calling on my one day off. Our nurse manager states, as she picks up her purse to go home for the evening at 1600, "That's all the staffing you get, so you better get busy". I've had it. Doesn't the public have a right to know. Our adminsistration also had us attend a 1/2 hr meeting, instructing us to always smile. What a joke !
  4. by   tina marie
    I have a 52 bed med surg unit: it is a mix of urology/nephrology/pulmonary. Lots of high acuity patients. Currently we use work redesign care delivery model. 7-3 shift is RN/LPN with 7 pt's, RN/UCP with 6 pt's and Rn or LPN by self with 4. 3-11 shift is RN/LPN with 8, RN/UCP with 7 and RN or LPN alone with 5. 1-7 is RN/LPN & RN/UCP with 10-12. 7-3 and 3-11 have dedicated charge nurses. Of course all of this is very dependant on how short staffed we are for the shift. Frequently the numbers are higher especially in the winter with the "snowbirds" here. Financially this will not be able to last, our ratio's will have to increase.
    The "working" nurses shortage is only going to get worse before it gets better. As a manager I am frequently on the unit filling in - all shifts, holidays and weekends. (and still required to do all the behind the scenes paperwork & projects). What do we do when there is no staff to care for the sick and hospitalized. Nobody wants the off shifts - who will take care of the patients?? I lose sleep over this scenario and wonder how long I can hold out.
  5. by   Miss Saigon
    [QUOTE]Originally posted by tina marie:
    [B] Be greatful of the staffing you have. I work on a 30 bed med/respiratory floor. We have 6 trachs, and 4 vents. Days we are staffed with 4 RN's, 2 LPN's and 2-3 techs.
    Nights we have 2 RN's 1 LPN and 1-2 techs.
  6. by   LORI O
    I am a student nursing preparing to graduate in May. I am currently preceptoring in a small hospital where the patient load is 1:4 on days. At times, we have a CNA on staff, but not always. Nights is 1:5 ratio.
  7. by   pnorcross
    I am the clinical coordinator (charge nurse with more papaerwork) for a 30 bed medical/resp unit.Day ratios are 1:5 or 1:4 for RN with covering 3 LPN patients. Nights are 1:6 or 1:5 for RN with covering 4 LPN patients.
    LPN's 1:6 with RN covering. 2 PCA on days and occasionally 1 pca on nights. We do consider accuity and may adjust staffing if needed. We have mostly 3's on a 1-3 accuity scale. after reading replies maybe i should say we have openings availabe
  8. by   YADA-YADA
    When I first read the posts I was amazed at the ratios until I picked them apart. For the most part those people who have high numbers of pts to care for have better ancillary staffing to help them.
    I have worked in both set ups. One where we were staffed with one aid for 35 pts but we only took 4-6 pts and another where we will have 2 aids for 24 pts but we will take up to 8 pts. I prefer the latter.
    There is nothing worse than trying to find another nurse to help pull your pt up in bed when she is busy too. At least having more pts but also more aids I know that stuff is taken care of for the pt. If they need me they all know i am available for them, so there not alone.
    However, by letting them lead in that area of care, turns, baths, vitals etc it frees me up to get all that stupid paperwork done.
  9. by   Sarah Shupek
    I manage a 24 bed unit that specializes in Ortho (but we get a wide mix of pathologies). Our current ratio is 1:4-5 on days, 1:5-6 on eves and 1:5-6 on nocs. We have 2 CNAs on days, 1 on eves and .5 on nocs. We are a county facility and a teaching facility. We have very little ancillary support. The RNs are responsible for all ABGs, 12 lead EKGs, PICC line insertion, about 50% of all phelbotomy (including STATS, helping out with ADLs and transporting patients. We are in the beginnings of change that will probably either decrease our NCH or dilute our skill mix. I would really like to know what kind of ancillary support other hospitals have. Please e-mail me at sarah_m_shupek@yahoo.com.

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  10. by   ClariceS
    I currently work as a staff educator and relief charge nurse on a 40 bed floor that has ortho, surgical, burn (post BICU), and telemetry patients. Last year we were able to prove the need for increased NCH and now our ratios are 1:4-5 days, 1:5 evenings, and 1:6-8 nights. We have up to 3 UAP on days and usually 2 on nights. We are responsible for all phlebotomy and ADL's. We don't staff according to acuity but keep track of it every shift and were able to use that information to prove our need for increased NCH. We have access to Physical Therapists on days for some of the ambulation. On days, we have a Respiratory Therapist dedicated to third floor (three unit areas about the size of ours) and on the other shifts they are split throughout the hospital. We do all our own ECG's.
  11. by   NoelaniRN
    Oh my. Some situations sound like a dream come true and others I can relate to. I work on a 32 bed Med/Surg/Peds/Tele unit with just about every mix possible. We usually have 6-9 on days per RN or LPN sharing a CNA with the lead nurse taking a full load and being responsible for helping the floor and precepting new nurses on days. Evenings it's 1:7 or 8 with 1-2 CNA's for the floor. Nights is about the same as evenings and sometimes staffed the same as days (go figure). Most days I wonder how we make it without any real bad stuff happening.
  12. by   Dayannight
    Our hospital has a 22 bed surgical unit and 26 bed medical. We use 12-hr shifts. Staffing on days is 1:5-6, nights 1:6-8. The charge takes a patient load as well. On days there are 2 CNAs for 12 - 14 pts, nights, 1 CNA for 10 -12 pts. The CNAs really make a difference, God bless them!
  13. by   Jenny Mills
    On our 29 bed unit it depends on the amount of CNA's work--
    Days 1:6 if they have a CNA to team with
    Days 1:3/4 if no CNA

    Evenings there is only one CNA and the ratio is 1:4/5

    NOCS with one CNA 1:6/7

    We have high acuity in our teaching hospital with a high turn over rate. Portland OR

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