nurse-patient ratio - page 6

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   Scavenger'sWife
    GADS...The posts about ratio are so varied and mostly BAD! I used to think my hospital was tough, but now I think we are more in the better category. I work on a 42-bed med floor, occasionally get a surg pt. We have Marquette tele which we carry pagers for that beep us with lethal rhythms (as determined and set by the programming RN). We also carry cell phones so the unit clerks, docs, families, etc. can get their phone calls to us w/o the RN having to come to the desk. (We can also call out to other units in the hospital such as to pharmacy or lab) We also wear tracer badges that light up a signal over the patients' door when we are in the room. RNs light up green, aides light up yellow. Call lights flash yellow. Our pagers also beep or vibrate when the patients we are assigned for that day put on the call light.

    Ratio is RN-Aide to 6-8 (sometimes 9, rarely 10) patients. RN-LPN-Aide get 10-12 patients. We work a lot of "triads" which means RN-LPN-Aide who are always together. (Scheduled together) We do get to pick who we want on our triad when we set it up. We also have "Nurse Technicians" who are Aides with an additional 40 hrs training to do things like put in foleys, assist with sterile procedures, do simple dressing changes, etc.

    We usually have a "float RN" who does not take patients, but does the admits, makes phone calls, takes off orders, goes with pts for tests if they need to be accomp by an RN, etc.

    We are looking into establishing a permanent Charge RN position, as currently the charge does patients also. In the new position, charge will not take a pt load. They are still ironing this out. Prob be 2 months before it happens.

    We work 12 hour shifts, 7 to 7. We always have a unit clerk for phones, docs orders, etc. We also have a pharmacist on the floor during the day shift.

    We also have "Professional Nurse Coaches", which I think is a temporary "new idea" from admin...they are supposed to oversee the staff and try to defuse problems, look for ways to improve, and even do hands-on if it's a really bad day. Some of the coaches are really great at this, some are not. Our nursing supervisor is usually nowhere to be seen.

    Sorry such a long post....I guess it really doesn't sound bad here, even though at my hospital, the floor I work on is referred to (jokingly, I think) as "Bosnia". It is very busy, usually high acuity. We used to do acuities, but now it's as someone else said, "butts to beds". Only exception is doctor-ordered 1:1 - then there must be an aide to sit with the patient at all times.

    Anyone want a job??? E-mail me! regnursein99@yahoo.com
  2. by   rebelwaclause
    22 bed, smaller hospital. 1:4 ratio at nights (usually). 1 CNA/1 - 2 LVN's depending on census.
  3. by   preciousnurse
    Hey Deespoohbear. Where do you work because the setting sounds IDENTICAL to mine! Is it in the Shenandoah Valley?
  4. by   deespoohbear
    preciousnurse- I am in northeast Indiana, south of Ft. Wayne.
  5. by   BBFRN
    I work 7p-7a on a 30 bed Trauma Med/Surg floor, and we're doing 7-8:1 right now with Telemetry (no Telem Tech), usually 2 Pt. Care Tech's, and 1 secretary. We usually have 1 RN (charge), and the rest of us are LPN's. This really sucks! The bad thing is that we're phasing into a Step-Down unit. We're only losing 2 beds, and it looks like the ratio will be the same, except all pt's will be on Telem., and we'll have a Telem. Tech. I am scared! I don't feel it's within my scope of practice to take care of pt's on cardiac drips, and we are going to lose what little RN night staff we have. I wouldn't want to be the only RN on a Step-Down unit.
  6. by   Luv cats
    I work in a 60-bed hospital on a 26-bed Med-Surg floor. Ratio is 1:13 (depending on census of course) for 1 RN charging and 1 LPN passing meds. Our staffing plan is 5 for the entire floor (1 aide for the entire floor). Our floor does it all except ICU status or OB. Ortho, Peds, Psych, surgical, medical, extended ED, etc etc...
  7. by   Tweety
    Originally posted by ohbet
    If staffing is dangerous doesnt the buck stop with management?

    True, but when you make a mistake and go to the state board, they will look at you stern faced and say "you accepted the assignment, you made the mistake, give us your license for xxxx amount of time..." I've seen it happen to a coworker when she made a med error in direct relation to having 11 patients and no aid.

    But yes, it is a management problem.

    The ratio on my facility varies, on med-surg it's depends on how many CNAs are on the floor, a day nurse may have to take 7 patients with his/her own CNA all to themselves, or nights up to 9. In neuro med surg, we go from 6 up to 8, mostly six or seven, with two aides on the floor.
  8. by   Tweety
    Originally posted by ohbet
    If staffing is dangerous doesnt the buck stop with management?

    True, but when you make a mistake and go to the state board, they will look at you stern faced and say "you accepted the assignment, you made the mistake, give us your license for xxxx amount of time..." I've seen it happen to a coworker when she made a med error in direct relation to having 11 patients and no aid.

    But yes, it is a management problem.

    The ratio on my facility varies, on med-surg it's depends on how many CNAs are on the floor, a day nurse may have to take 7 patients with his/her own CNA all to themselves, or nights up to 9. In neuro med surg, we go from 6 up to 8, mostly six or seven, with two aides on the floor.
  9. by   vikiboop
    I work on a 44 bed med-surg unit. Our current ratio is 1:6 with occasionally 1:7, rarely 1:8. That is a big improvement over the 1:8 a year ago. I can go home @ the end of the day feeling like I did at least an acceptable job caring for my patients now & our patient satisfaction rates are going up. I feel there is still room for improvement but we are lucky to have a manager who does care about this. Don't use acuity either.
  10. by   welnet66
    I work in a 650 bed teaching hospital. Our nurse/pt. ratio is1:5 or 6 on all shifts. Na's are a bit scarce but they are beginning to hire more.
  11. by   majrn
    From Indy area, work at a 125 bed suburban hospital where ratio is 1:4 on days, 1:5 on eves and 1:6-8 on nights. One or two techs for days, one for eves and one for nights. No secretary on nights and charge takes pts all three shifts. The unit I work on is a medical/oncology unit, 18 beds, chemo and hospice, ecf pts. Its really not to bad. Days and eves often have lpns in order to do pod nursing.
  12. by   takararose
    an RN on days usually has 6 pts with IV covers, 7-9 on evenings and same for midnights, sucks doesnt it? sometimes i will only get 4-5 but that doesnt happen much....as well as sometime i get 7 pts with 5-6 covers
  13. by   NS_RN
    I work on a 34 bed medicine unit with RNs and LPN's. We are in the midst of changing things a bit, but as it stands an RN and LPN paired together would have 6-8 patients on day shift and an RM alone would have 3-4 patients on days. On nights we have 4-5 RN's on and the assignments are split...so 6-7 patients each. Usually 2 LPN's on nights who do the bulk of the "care", glucs,vitals. RN's give meds..LPN's do not in our institution.

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