surgical step-down unit staffing ratios??

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    i'm looking for feedback on staffing rn ratios for surgical step-down units. we currently have 3:1 without pt care techs and we "borrow" a secretary from our meg-surg "sister" unit to help enter new orders but sometimes we are on our own without any additional help. we order and stock our own supplies as well as tidy up and clean common areas. our pt's have cardiac monitoring with drains/tubes and pain relief of several varieties and require bathing and ambulation. administration is trying to increase the ratio to 4:1, what is the general consensus about this arrangement?
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  3. 16 Comments so far...

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    What are they giving you in return? A person from materials to stock your shelves and a FT secretary? If you had help, as in a CNA or two to help and a secretary, IMO it would be reasonable. But without any other support? It seems rather high.
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    we have borrowed secretary at times but we generally have 3:1 without any ancillary help. Is this normal or are we average?
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    Odd around here. Even as small as our hospital is, we have a FT secretary and someone to stock our shelves. My previous hospital was a 50 bed med/surg unit and we never stocked a thing and had two secretaries.
    Who answers your phones when they are ringing off the hook?
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    we do and it makes us crazy to run and answer a phone when we are in the middle to speaking to a pt or their family.
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    You need another job or a union, that is ridiculous to have to answer phones and stock shelves what happens if a patient is having a problem? I am on a med/surg oncology unit and our ratio is 6:1, sometimes 7:1 on day-shift and that can be crazy but we do have aides and a unit clerk.
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    Thanks for your reply. We have noted our compliants with management but to no avail...
  10. 1
    I work in a step down unit with many protocols. Our staffing ratio is 5:1, and if census is low we have no secretary or nursing assistant. We do all the paperwork, phlebotomy, and are required to obtain our own vitals at one on the four hour intervals. In addition, we have to enter our own I/O's. Drips, drains, secretarial and CNA work. Our shift ends at 645 and cannot get our work done in time. We are there for 14-15 hours a shift. If we have 10 patients we have 2 nurses, and that is the staff, period!! There is no one to help with call lights and no code buttons in the room. We hang cardizem drips, amiodarone drips,insulin,etc. Healthcare at its greatest!!!
    SCraigRN likes this.
  11. 0
    Dear Kentucky,
    That sounds unusually unfair and unsafe. I have contacted many other step-down units across the country and yours is the worst so far. Everyone of them has techs and secretaries with ratios between 2:1 and 4:1. You need to get some help there!!!! Thanks for taking the time to respond.
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    I work on a stepdown/floor unit, so our ratios vary depending on the # of stepdown pts... On day shift you can be 3 pt's/1 RN (with 2 SD pts), 4:1 (1 SD). On rare low-staffing occasions we may get 5 on day shift. On night shift we do 4:1 (2 SD) or 5:1 (1 SD). We have 2 CNA's for our floor, 16 pts to each of them, and 1 full-time secretary. We also have a free float charge RN on day shift and on night shift the CN has 1-2 pts.


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