nurse-patient ratio - page 7

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   NS_RN
    Originally posted 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.
    Oh, and I must add that the staffing levels I work at now are the best I've ever had in my 12+ yrs of working medicine. I remember 2RNs1LPN for 28 patients from 1500-0700!!! And on a 35 bed unit, the assignment on nights would be 17pts for 1RN and 18 for the other!!!Imagine!! What I do now (if I am with and LPN 6-8 pts, alone 3-4 pts) is gravy compared to anything else I've ever done.
  2. by   laurako
    I work on a 34 bed Med/Surg unit. Ratio is 7:1, on days and nights. On days, the total number of nurses never exceed 5. NEVER more than 2 RNs, then the 3 LPNs. with one RN as "charge". As soon as 4 nurses reach 28+, the "charge" takes up to 6. No regard for acuity. Never more than 3 CNAs for 34 patients. I was happy to read staffing is better in other places. Cause I have about had it.
  3. by   susanmary
    24 bed medical-surgical-telemetry unit. Days & evenings 1:6 (3 aides); nights 1:12 (two aides.) Charge nurse (guess who?) has full patient assignment.
  4. by   BeeStrong
    I work on a 22 bed oncology unit in central Oregon; days usually 1 RN to 4 or 5 pts; eves 1:5 or 6; nocs 1:5-7 with Charge Nurse days and eves no pt load; nocs; Charge Nurse takes up to 4 pts; days and eves have ward clerk; none at noc; aides are 3 on days, 2 on eves, one or 2 on nocs; generally very reasonable staffing compared with back east where I worked it was very bad; if we were lucky enough to have one aide on days, they would usually pull her to be a sitter somewhere and we would be left to do all baths, meds, dressings,procedures, toileting, etc. etc.; also gving chemo, blood, etc. acuity didn't matter; just the numbers. I think west coast is much more enlightened than east coast. And attitudes are better too. We have float nurse to help with admits and iv starts, ostomy nurse on days, pharmacist on the unit on days, and Resp. , Phys Therapy and Occup/speech therapist during the week on days. When we have sick calls managemnt will generally try to get replacement even if they have to get agency. I feel very lucky to have found this hospital. I will never, ever work on the east coast again. No way.
  5. by   pam156
    I shudder to read about low acuity patients... have had may crump on me and require dilgent care to assess their apropriateness for my unit. We need to have time to watch all of those under our care carefully. This is a great format, I admire all of you out there! Thanks for sharing!
  6. by   KindRN
    I work in a small town hospital and we don't consider acuity, but I think our ration is pretty good. Days and PMs have a 3 to 8, which is usually 1 RN, 1 LPN and 1 Aide, but it could be a variety of any of them. On NOCs we have a ratio of 1 RN and 1 LPN to 10-12, or it could be 2RN's.
  7. by   wjeff
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  8. by   wjeff
    I worked at a nursing center last weekend where,I had to give medicine to 60 residents.I gave meds from 4:30 pm to 10:30pm.
  9. by   Jaaaman
    Wow! thats a lot of patients to pass out meds to. I work on a cardiac/telemetry floor in North Texas. 1:4 on days. 1:5 on nights. Charge nurse does not have a patient load. We also have a unit clerk on days and nights.
  10. by   tuni813
    I am A DON at an acute care hospital of 224 licensed beds. We usuallly have a census of 230-260, really! Our units are all 36 bed private rooms. Except of course the ICU/CCU are 16 bed units and mother baby are 12-14 bed units, but all private rooms.
    Med Surg 1:6 , Telemetry 1:5, and ICU/CCU 2:1 all RN staff.
    We also have 3 CNA's on day shift and 2-3 on night shift.
    We have 2 unit secretaries on days/1 on nights per unit.
    Telemetry has 1 Monitor Tech 24/7 per unit.
    We also have housekeeping 2-3 per shift per unit.
    Nurse Managers 1 per unit.
  11. by   Daisy
    I work in a small rural hospital .On the day shift we average 1-5 or 1-6 but sometimes what difference does it make. We don't have enought support help to help us. Our unit is 30 beds and we average 2 CNAs. They can only be assigned 8 or 9 patients and if you tax them beyond that they complain and quit. Administration does what they can to keep them but forgets the needs of the RNs to care for the patients . I will do anything I can to care for the patient even if it includes filling water pitchers and passing trays when need be, but when this is included in our every day work the real work of the RN suffers. We have a charge nurse but I have never seen her administer patient care or fill a water pitcher. The doctors have even been complaining but that will go nowhere. Take away some of my task work by providing adequate support help and I can really coordinate patient care as my job description says.
  12. by   dadrn
    Reading these responses is horrible. I can better see why there is such a shortage and why it is getting worse. I work on a 24 bed med/oncology floor, military hospital hospital. We do use an acuity system but most of the people don't use it the way it was designed.
    Still, the ratio is around 1:4on days and 1:5 - 6 on nights. That sounds like heaven compared to some ot the mail but I tell you its not. We also have CNA's. But we do everything, iv's labs, ekgs, etc. We do give chemo, 1st dose is usually given in the clinic. But this is a teaching hospitall for doctors. Imagine that the average length of experience for the military nurse on this floor is probably less than a year; we get them brand new. We are just now getting some civilians, but most don't stay for long.Just imagine that, even with only 3 or 4 patients, you're still so busy on most days, 12 hours feels easily like 16 -18.
    And we do get the other types of patients, from psych, to surgical, to ortho.
    I do think the best way to avoid the stress is to talk about it. That's what I like about this website. I'd love to hear the stories. E-mail me. I don't get on much but it makes me feel so much better when I read these stories.
  13. by   RN-PA
    On our 3 Med/Surg units with 25 to 30 beds apiece, our nurse to patient ratio used to be 1:4-5 on days and evenings, and 1:8 or more on nights (they had horrible staffing problems for a while). Within the last few months, it's been 1:6-7 on all shifts. No acuity is figured into our assignments and we can get everything from peritoneal dialysis to chemo to total hip/total knee replacements, to continuous epidurals for various surgeries (all gastric bypass, some joint replacements, nephrectomies, to name a few.) We get 1 PCT (nurses' aide) for 12 to 14 patients, have 1 Unit Clerk for 28 beds, and transport stops at 5:00 p.m.

    I recently had a night with 6 patients, 5 were complete care, 4 were admitted with "change in mental status", 5 were confused, and 1 was getting peritoneal dialysis q4h. Tonight, I had 7 patients, 1 I had to transfuse 2 units PRBC's and then platelets on my shift, and 1 was complete care with gastric tube to low gomco suction, jejunostomy with tube feeding, PPN, Lipids, and she vomited 600 cc's which I then had to call the Dr. twice about. The topper is that when I was trying to place an IV pump on an IV pole with a PCA pump, the pump slipped out of my hands (they are very heavy) and hit my patient who'd been sitting below me, in his left abdomen. I was mortified! Fortunately he wasn't hurt-- I wrote up an incident report and called his doc, apologized profusely to the patient, and was so thankful it wasn't worse. Anyway, the rest of my patients weren't too bad-- Partial cares, thankfully, but on Med/Surg you can have an easy night with 6-7 patients and a horrible, license-threatening night with only 3 patients, all depending on their acuity.

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