What is your Nurse to Patient Ratio

We have 30:2 staff.It's very difficult handle in this situation.

Med/surg units 10:1 days and eves, 12:1 nights. On the respiratory unit (ventilator patients) where i often work, 4:1 days and eves, 5:1 on nights, but can be 6:1 on any shift if short staffed.
We have CNAs, usually similar ratio to nurses on Med/surg, 5:1 up to 8:1 on resp. unit. No secretary on nights, none on days or eves when they're off or call out.
Hectic to say the least. And they wonder why Press Ganey scores are poor....the staff is blamed.

I hate the fact that the acuity of nurse/pt is note weighed but numbers are always more important! I understand that mgt has it rough because they need to fit a square block into a round hole and try to get it as close as they can. Money has no grace when it comes to actual pts, but just FTE, number of actual pt days, etc. Just upsetting to see that we and our pts are hurt because we work for "for-profit" organizations and that fact will never change. You can say not-for-profit, but just look at the insurance bill or the hospital care bill. You'll quickly change your mind!

I want to work where you do! Our *ICU* has a 3:1 ratio. I work on a primary nursing acute medicine floor, so we have no techs and, like you, have to be ready to care for whatever comes through the door. The recruiter told a bunch of us that the ratio was 4:1 on days, 5:1 on nights. After a month and a half, I see that it's clear most days are 5 patients and it's not unusual to have 6 (no tech, and some pretty serious acuity). Very frustrating! The tech stuff tends to be what can keep you in a room for an hour at a time. Nights are more often 6:1, but it would be really unusual for it to go higher than that, so that's a relief. I start on nights next week, hallelujah. If my joy is misplaced, all you night-shifters, please don't tell me, I'll find out soon enough.

Oh, if only management thought as you do!

I wk d/s on a full-service med/surg unit: GI, Onco, Tele (Cardio), Resp, Hospice, pre & post-op's, Ortho, Psych... yea I think that's it!

Typical = 1:6. but over this last week I had 1:7. And if I dc home 3 & I started with 6, I usually get back 3 more new admits & IMC transfers. So, at the end of my shift I may have had & charted on as many as 10 patients!

Our CNA ratios are much better then most facilities 1:14 & sometimes 1:18 if we're short-staffed.

And BTW I agree about the accuity vs care... some total cares are = to 2 or even 3 patients! And med lists.. geeze! It's not unusual to have 3-4 pts w/numerous po & IV meds and antibiotics. All these factors should be considered!
~MJ

Days is usually 5 patients and 1-2 nursing assistants. Evenings 5-6 w/one aide. Night shift (oh,glorious nightshift) is 8 patients with one aide. Forget about your pee break! Med/Surg/Oncology Unit.

Oh, the sad point is you can end up having a heavier load with a high acuity and the other nurse has a cake walk. I sincerely believe in using a acuity tool. I used it as a charge nurse on a previous 31 bed unit before. Works well.

I work night shift on a med-surg/tele/neuro floor. Our nurse to patient ratio is 6:1 and the day shift ratio is also 6:1.

Our charge nurses really don't look too closely at acuity, they do the assignments more based on blocks of rooms, trying to keep you in 3 rooms that are next to eachother (all of our rooms hold 2 patients). If there are a bunch of empty rooms at change of shift, then everyone gets assigned 5 patients plus an empty bed, with the understanding that you will most likely get an admission from the ER or maybe a transfer from the ICU.

Also, our hospital staffs the floors with a lot of LPNs. When our med-surg/tele/neuro floor is full or almost full, then we are allowed to keep 6 nurses. It is not uncommon for us to have 4 RNs and 2 LPNs. We do not do what I think is called "team nursing". Instead those LPNs are assigned 6 patients, just like the RNs are each assigned 6 patients. There is some rule that says in a 24 hour period a hospitalised patient must be cared for by an RN for 12 hours, so an LPN can not give change of shift report to another LPN. So, that is often what our charge nurses focus on the most. If the day shift had 2 LPNs and 4 RNs, and now the night shift will also have 4 RNs and 2 LPNs, the charge nurses sometimes find it a bit tricky to make everyone's assignment. The charge nurses try to find out which patients require a lot of IV push meds or require a blood transfusion, so that they can be assigned an RN, but it doesn't always work out that way.

When we are lucky, we get to keep 3 CNAs/PCTs. But sometimes our large floor only gets 2 CNAs/PCTs, especially 11p-7a.

my last shift, which was day shift 12 hours, I had 9 patients (all at one time)! Everyone else had either 8 or 9 as well. Then I had 2 discharges, and got 2 admissions or transfers right back. And these were patients who had a high level of acuity . . .not icu level of course, but not just hanging out in the bed and self care.