What is the maximum number of patients per nurse?

[Info(RN)matics]

Worst Case Scenario:

1. What is the maximum number of patients per nurse on your Medical/Surgical floor?
   
2. Which shift?
   
3. Which state?
   
4. How often do you find yourself in such a situation?
   

Background:

When our nurses explained to our DON that it was not only unrealistic, but also unsafe for one nurse to take care of 12+ patients with minimal help on the night shift, he said that we were much better off than many other hospitals. Is that true?

[Carrie_MTC]

I'm a new grad nurse with 2 months experience in home health. I was offered a position on a 60 bed med/surg/tele unit. 3 weeks of training, and patient ratio is normally 6:1. It's night shift. Is this too much for a new nurse? I was told CNAs will do VS, I&Os, and personal care.

[felineRN]

wow...

the norm on my unit: 4 pts per nurse on stepdown

6 (normally) per nurse on med/surg with 7 about 50% of the time d/t constant capacity alerts in ER (we are main Lvl 1 trauma center in our area)

Virginia

Oh and this is for day and night shift

(side note: Most of our patients consist of medically unstable psych, IV drug abusers, sickle cell, or total assist SNF pts. Thus, the acuity of these people is insane imo.)

[gcupid]

I'm a new grad nurse with 2 months experience in home health. I was offered a position on a 60 bed med/surg/tele unit. 3 weeks of training, and patient ratio is normally 6:1. It's night shift. Is this too much for a new nurse? I was told CNAs will do VS, I&Os, and personal care.

3 weeks of training is not enough....3 months of training is sufficient...

and dont get the wrong impression. CNAs may do vitals, I&Os, and personal care but you are still responsible for making sure these things get done.....and with a high patient ratio like 6:1 on a telemetry floor it's highly unlikely that you will have an aid [:down:during night shift (which is more likely to be understaffed, especially when it comes to ancillary help)] that will be able to handle every brown code or every other personal care duty...

My advice would be to continue to work in Home health while learning skills on the telemetry floor...Work out a schedule that allows you to keep your foot into home health just in case you find tele a little too stressful or not rewarding...

[Tess Sweeney]

What are the written standards at your institution? The other question is acuity level? I'm sorry you felt unsuported by our DON. Tess

[0402]

We have 4-5 pts on days and up to 6 at night. 35 beds and 4 techs during the day, and usually 3 at night. Though the ratios aren't bad, I would say the one issue I've seen is that the charge nurse pretty much always carries a full load, which complicates things for us, IMO (at times, we really need to have that resource but it's hard for him/her to help us when his/her pts are really demanding). We do have a unit secretary 24 hrs a day, which is really nice.

[Ellekat]

We usually start out with six, although it's supposed to be four. We'll have 4 nurses and two aides for 18-24 patients. We've had up to 15 admissions on one shift with just three nurses (and that obviously means we've had many dismissals, too). Yes, we are an acute floor-our patients come from the physician's offices, the ED, and PACU. If you complain, you're more or less told you're easy to replace and that you're obviously just not "good enough" for the facility. I was told I am too old for the job.

[ASparks]

I am really surprised to hear such high nurse-pt ratios. I'm looking at the work conditions for nurses across the nation. I'm really concerned that nurses do not have work conditions that allow them to give the care they want to their pts.

http://www.surveymonkey.com/s/6653VJJ

[NursKris82]

1. Nights- 5 pts typically, max at 6. Days- 4 for days, max at 5.

2. Night shift

3. Michigan

4. 6 pts about 50% of the time for me.

I don't know how you could actually give safe care to many more than this, espeically if they are acute care pts. : /

[destin3g99]

Wow, reading this makes me feel spoiled. But, sadly I still feel like our patients get crappy care on some days. Of course a lot of it depends on aquity. You could have 3 heavy patients and be busier than 6 quiet patients.

I work days on a 50 bed med/surg unit

max 6:1, usually 3-4 techs on the floor doing all baths, bathroom, bedpans

Floating charge nurse who don't do any bedside care, just works at the desk

We did go to 7 once, charge nurse had 5. We had a bunch of float nurses leave at 3 and got no replacements to take their place from 3-7p.

Night shift gets the same # pts and same # techs as days.

RNs do vitals at the beginning of the shift. Techs do vitals the rest of the day, all blood sugars.

They are supposed to do all I&Os, but most of the techs don't enter them into the computer

We do very rarely have to do one bath if techs are very short staffed. We also do sometimes do our evening vitals if techs are short staffed.

Our patients turn over quickly. Some days I have an entirely different group at the end of the shift than what I started with. That's a lot of D/Cs and admits.

[destin3g99]

Oh, our average is 4-5 pts.

[cp1984]

we have no more than 4 patients on the day shift...occassionally we have 5 if understaffed, but we always have a resource nurse that has no patients and 3-4 techs. on the night shift usually no more that 6 (occasionally 7, again if understaffed) and we have at least 2-3 techs overnight. 12 patients is a lot and NOT safe at all!

[MsbossyRN]

7 acute care pts, nights with NO aide...happens very often NOC shift in Va.