What is your nurse-patient ratio?

Specialties Med-Surg

Published

I'm a new grad RN about to start on a med-surg floor. I was told that on days I will have 4-5 patients and on nights 7-8. Does this sound normal/manageable?

Specializes in Emergency Nursing.

In our ER, an RN is responsible for 3 patients. Any RN with 3+ patients will have an LPN to fill the extra patient load or a Non RN (EMT-P, tech) to assist.

I've come to realize that nurse:patient ratios alone don't say much. I work at a level 1 trauma center. we have over 1200 beds in our hospital. needless to say it's kinda crazy sometimes. Overnight we usually have 4-5 patients. Sounds great, but we almost never have a tech, definitely have never had an lpn, and sometimes have no secretary. we also dont have phones or a doctor on the floor. so if something is going on, you go sit at the nurses station, page the doc covering your patient, wait for them to call you back, if its more than 15 minutes you page again and continue to wait. it's a huge time waster. so when youve got 2 agitated sundowners on bed alarms, 2 incontinent patients with Q2hr turns, trachs, g-j tubes with continuous feedings, ppl on q2 ivp dilaudid for uncontrolled pain, q2 accuchecks for pts who came from the ED in dka, up with assistx2 on golytely for their am colonoscopy... no tech, no secretary, 30 min to get a hold of a doc sometimes... 4 patients no longer sounds dreamy. Our floor is primary care, which is great in theory... but probably a contributor to super high turnover we're experiencing.

I'm a new grad RN and I work Med/Surg and I work nights. We have a patient ration of 6:1 and sometimes 7:1 if its really busy.

Specializes in Certified Med/Surg tele, and other stuff.
I've come to realize that nurse:patient ratios alone don't say much. I work at a level 1 trauma center. we have over 1200 beds in our hospital. needless to say it's kinda crazy sometimes. Overnight we usually have 4-5 patients. Sounds great, but we almost never have a tech, definitely have never had an lpn, and sometimes have no secretary. we also dont have phones or a doctor on the floor. so if something is going on, you go sit at the nurses station, page the doc covering your patient, wait for them to call you back, if its more than 15 minutes you page again and continue to wait. it's a huge time waster. so when youve got 2 agitated sundowners on bed alarms, 2 incontinent patients with Q2hr turns, trachs, g-j tubes with continuous feedings, ppl on q2 ivp dilaudid for uncontrolled pain, q2 accuchecks for pts who came from the ED in dka, up with assistx2 on golytely for their am colonoscopy... no tech, no secretary, 30 min to get a hold of a doc sometimes... 4 patients no longer sounds dreamy. Our floor is primary care, which is great in theory... but probably a contributor to super high turnover we're experiencing.

No secretary??:eek: or phones? Holy crap! to sit by the phone is crazy!!

Wow, we have FT secretaries plus the CN that does all the discharges,education and puts out fires, answers phones, does the admit and med rec. We have vocera as well, plus a CNA for every 10 pt's and our nurses complain!

Specializes in Surgical/Stepdown, Home Care.

I work at on a post-op surgical floor in Camden, NJ. Our ratios are 1:6, no matter the shift, with 3 techs for 30 beds.

Specializes in ER, progressive care.

I'm on a progressive care unit and our ratios are 1:4, sometimes 1:5 if we are short staffed. Our med-surg unit has a ratio of 1:6 or 1:7 if they are short-staffed.

Specializes in MS, ED.

OP, it really depends on the floor, your coworkers, staffing, and admission criteria. I worked on one general surg floor that was anything goes on nocs - head injuries, odd rhythms, ortho, trauma overflow, post-op onc patients, etc. Ratio 1:6-8, more if short. It was like a warzone...no unit secretary, techs pulled to sit or to float (leaving you with one tech for the whole floor or worse, no tech at all, totally unmanageable) and you had to pick up / transport all your ER, PACU admits and patients needing diagnostics. I survived and it taught me a lot; namely: if I see something like this ever again, I won't take the job. Period.

My current floor is also general surg, has more stringent admission criteria, a unit secretary and more techs (most of the time), but we regularly have 8-11 patients each on nocs. I literally run the entire night. I'm so tired and broken that I'm planning to leave as soon as I can find something else. If I could tell you anything, it is to take care of *yourself*. Make this job a learning experience - see and offer to help with or do everything you can - and when / if that time comes that it's not a fit for you anymore (like me!), you'll be ready to move on. Good luck. :)

As an LVN on a Med/Surg floor we have 1:5 nurse to patient ratio days and nights. Most days have a secretary but not during nights and one CNA for the whole floor and if the census drops they get cancelled. It may be because I'm new but I'm running up and down the whole hospital everyday. Oh and did I mention we don't have pharmacy at night but one house supervisor that fills new meds for new admission and no central supply only house supervisors do that. As LVN we have an RN cover our IVPB and IVP meds

I was handling total cares of 4 patients in nursing school so I would say your ratios are manageable. In ltc it was 1:30 for me and I do say that was a little overwhelming when there were a lot of treatments. Hospitals around me have the same ratios you are talking about.

Specializes in Orthopedics/Med-Surg, LDRP.

We are ortho-neuro and it can be 1:4-6 on days, 1:5-7 on nights. Aides depends on staffing and 1:1s throughout the house. We always have 1-3 aides for a 35 bed unit. We nearly always have a secretary and have mobile phones. However the acuity is high and even with great staffing, it can be rough.

No secretary??:eek: or phones? Holy crap! to sit by the phone is crazy!!

Wow, we have FT secretaries plus the CN that does all the discharges,education and puts out fires, answers phones, does the admit and med rec. We have vocera as well, plus a CNA for every 10 pt's and our nurses complain!

Wow!! Where do u work? 40 bed general med Surg- RN 1:6; LPN 1:6; CNA 1:10-15( depending on staffing) we do all of our own admits (with RNs admitting LPN pts d/t "scope of practice" - GA law), D/c's, education, med recs, IVs, ect.. After 11p, there is no secretary and we still r on paper charting!! I need to find some where else to work!!! Lol

Specializes in Transitional Nursing.

Acute rehab. We have 5:1 ratio. 29 bed unit with 4 aides

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