Hi, I work in a small (<80 beds) community hospital in New England and we have been challenged to find out what other hospitals have for nurse-patient ratios. Our hospital has hired an outside consultant to come in and tell us what we SHOULD be working with on each shift on our Med-Surg unit. We don't feel safe working with the ratios that the consultant suggested. I would love to have some feedback from anywhere and especially New England. Please tell me the size of your hospital, the M/S unit you work on and the ratios for each shift. Include factors such as having a unit secretary, nurse's aides, etc. and if possible, the model of patient care you follow, ie primary nsg, team nursing, etc. Also include whether you have telemetry, pediatrics, chemo patients, etc. that impact acuity. Thank you in advance.
Dec 5, '98
My surgical unit has a ratio of 1Rn for 6 patients. we have a 30 bed unit of all types of surgery. We also have on day shift 2 practical nurses and a secretary on days and evenings until 8:30. We have no aids, we have housekeeping people to clean ,do beds and move patients from rooms. We have porters who take patient to or andfor tests etc.
Dietary staff hand out trays and water jugs.
Our or seems to go non stop 7 days a week. Our patients are more acutely ill and patients that used to go to ICU postop don;t.
On the 12 hr night shift we have 10 patients and from 3:30 to 2330 we have an 8 hr RN and 1 RPN. We are busier than ever in my 21yrs of working!!
Dec 5, '98
I work in a 700 bed hospital in Maritime Canada. I am on a 36-bed general surgery stepdown floor. We have 5-6 patients on days, 6-7 on evenings and team 18 at night. Like you, our OR goes all day, all night every day...at any one time we have a number of patients on constant care...a secretary every day and weekday evenings...DOSA and ER admissions constantly....a 12 bed SICU to which we have a revolving door somedays !!!!
Most days we are able to just cope...a few days we do even better, but more often lately, we are not coping well at all....the patients are sicker than they have ever been . Those who used to be in the unit are now on the floor. All in all, a very frustrating experience !!!!
Jan 23, '99
I work in a 260 bed hospital in Michigan . Our oncology/renal unit is 30 beds, ortho/neuro unit is 30 beds, med/surg(primarily postop types ranging from gyn to immediate postop fem/pop, thoracotomy,e tc) is 46 beds. We work on a team system. RNs and patient care assistants. Day shift for oncology /renal unit has 1RN and 1 PCA for 6-7 patients, night shift has 1 RN and 1 PCA for 9-10. Mainly postop unit on day shift has 1 RN/1 PCA for 8-9 patients and 1 RN/1PCA for 11-12 patients. Ortho/neuro unit on days has 1 RN/1PCA for 10 patients and on nights. 1RN for 15 patients. Typically share 1 PCA between two RNs at night. Have unit secretaries from 7a-7p. RNs do all clerical duties after 7pm. Use a team system. No LPNs. RNs expected to do assessments, admissions, IVs, meds, teaching, planning, orders, MD rounds/calls, documentation. Converted to this team system from an all primary system in 1995. Sure hope your consults are not Deloitte and Touche!
Jan 24, '99
Hi, I work in an er in Cleveland, Ohio. we have a 3:1. Our CCU/ICU nurses have a 2:1 ratio, and SDU nurses (with telemetry or without) have a 4:1 ratio. I beleive the nightshift, post surgical, cancer, and medical floors have a 7:1 ratio. Not sure about days?
Jan 27, '99
I work in a 750+ bed hospital on Long Island, evenings, on a 43 bed medicine unit. Our best evenings have 5 RNs on the floor, 4 PCAs (NA who can do vs, phlebotomy, ekg), 3 SCAs (aides for transport & housekeeping), 2 sec'y (1 leaves @ 7pm), & a lead RN. Usually though it's 4 RNs, 3 PCAs, & 2 SCAs. I've also ran a 10 bed swing medicine floor with just myself, 1 PCA and a sec'y.
Feb 8, '99
I work on a gen medicine unit 21 patients. ratio is 5-6 pts per nurse.. usually have 4 nurses but sometimes they give us 6.. no secretary at night..we also are given 2 aids at night.. they are allowed to do blood draws, straight cath, enemas.. etc. as well as vs and turns .. day shift has a PCA.. and usually 4 nurses and 2 aids, secretary...
we really have it made considering that they also pay very well..bonus if you work extra shift also..
Mar 14, '99
I work in a 30 bed medical/telemetry/renal floor. Over the past several years we have experienced Process Redesign. Currently and I do say Currently, because they are always changing our current method. On our floor we have the telemetry, but the monitor watchers are down stairs so we have to carry phones so they can contact us. We can see the monitors, but can't print out strips. Oh well. We can also have 1-2 ventilators, but aren't suppposed to try and wean them. Usually have several long term care trach patients, some cva's, copd, pnuem.,and your basic confused aggitated tie um down in the bed patient. We now work in 3 teams. No charge nurse. You take complete care of your 6 patients in your team. that's D or E. CNA's
D- 3-4 E has 1-2 for the floor. Secretary's
D-1-2 E has 1-2 for the floor. We have no float pool anymore. No staffing office. Nurses must call other floors to see if they have extra or must call nurses at home. CNAs do VS, turns, pass out trays, answer lights empty linen and trash from rooms. This doen't work so don't try our methods.
Mar 16, '99
Hello to all,
Please note that the administrator of this web site, bshort, has created a new Forum entitled "Nursing/Issues/Concerns and how they affect patient safety and care".
Some of the discussion in this and the previous forum from which it was created is being highlighted in Nurse-zine (19,000 subscribers).
We also have the attention of ABC's 20/20.
Correspondence with the ANA, state nursing associations, legislators, AARP and other relevant organizations has been suggested and e-mails, etc. have been sent.
I urge you to join us in our efforts to improve nurse/patient ratios and increase the number of LICENSED personnel at the bedside, for the safety of our patients!
Mar 19, '99
Hello, I am Charge RN on a 23 bed Med-Surg unit in upstate NY. On a daily basis we have 4 nurses and 1 CNA. We practice the primary model and find it works best. The "suggested safe Nurse-Patient ratio" is 4 patients/Nurse, does this ever happen? NO, its generally 6-7 pt. on day shift 8-9 evenings and 10-12 on the night shift. Administration seems to think that we should be able to do this with out any problems.Our Nurses are burnt out, tired of doing just the basics. We dont even have time to do teaching anymore. With pt. going home sooner these days they desperatly need good teaching . I do truely love being a nurse but latley a Wal-Mart greeter seems more appealing than the daily frustrations we have been facing.
Mar 20, '99
PLEASE!!!!!!!!!!!!!!!!! Do more than post here about your inappropriate staffing ratios! Didn't you read the post just before yours? Send your observations and errors that may have been caused, or treatments you were unable to give due to poor staffing to firstname.lastname@example.org. If we want the media to alert the public to how todays healthcare pratices affect the quality of care, we have to let them know whats going on!
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