NYC- common Nurse to patient ratio's

**LibraSunCNM, BSN, MSN, CNM** · Apr 6, 2008

The worst ratios I've heard of are 1:12 on night shifts, 1:8 on days in NYC. Don't know how accurate or generalizeable that is.

Natingale, EdD, RN · Apr 8, 2008

Not far fetched at all, I work in a E.R. and theres 12 patients to one nurse. The charge nurse does charge, triage, ambulance triage and starts lines *because shes nice)

Day shift has more nurses than nights, its just politics which is ridiculous jmho

CalypsoRN · Apr 17, 2008

ugh that is terrible I am about the graduate and want to relocate to NYC but that can't be safe they usually have new grads work evenings and nights so how can that be true. I mean besides putting your fresh license on the line I wouldn't want a stressed out over worked new grad taking care of me at 5 am

nyforlove · Apr 19, 2008

ugh that is terrible I am about the graduate and want to relocate to NYC but that can't be safe they usually have new grads work evenings and nights so how can that be true. I mean besides putting your fresh license on the line I wouldn't want a stressed out over worked new grad taking care of me at 5 am

Don't get "too" upset...Now, I'm not defending such high ratios (but then again, I'm not about to say that hospital nursing is an "easy" job--it requires a lot of judgment, juggling, "evenheadedness," personal skills, time management and more--which is why it pays more than Dr's offices...Many new nurses leave their first hospital job within one year)....but a new nurse with so many patients can expect his/her patients to be in reasonably good health---e.g., patients awaiting surgery or who have had a "minor" procedure who can talk, walk to the bathroom, and spend time watching TV...the patients the new nurse on the med/surg floor would NOT be given are, e.g., those who are connected to ventilators, who need cardiac monitors attached to them, who need their blood pressure taken every 20 minutes, who have open wounds, nor even those who need a glucose-check (chem stick) every hour....It's safe to assume that your patients are not "seconds from crashing" as is frequently the case with patients in PACU and ICU where nurses typically only have two patients...So, don't be put off by the absoulte numbers, but consider the relative health of the patients...Good luck in coming to NYC :)

loriann, BSN, RN · Apr 19, 2008

Based on what I've seen, you typically will see ratios of 1:8-10 on med-surg type units, 1:4-5 on stepdown/telemetry units, and 1:2-3 in ICU settings.

I think the acuity of the patient obviously plays a role in the final number, but I wouldn't assume with higher ratios you have easier patients to work with. For example, on the geriatric med/surg units, if you have 8 elderly patients admitted for pneumonia, falls, etc., you will have to make sure they are turned and repositioned if they can't get out of bed, you might have some wound care if they have had surgery (ie. hip replacements), checking their electrolytes and repleting, they might be demented and require a 1:1, etc. This could be A LOT of work. The med/surg RNs where I work do not have patients on vents, you find these in ICUs. As for cardiac monitoring, some units have a tech that does the monitoring and others have the nurses do the monitoring. These are usually stepdown units where the ratios are smaller. I would suggest finding out what the nurses aid ratio is on the unit you are looking into so you can see what type of help is available to you. Also, think about what type of patient you want to work with, are you interested in cardiac, medicine, surgical, renal, etc, and see what is available in terms of openings.

CalypsoRN · Apr 20, 2008

Thanks you for the feedback... I understand that the patient ratios are different on different floors for a reason. I also know that it doesn't matter if you have 2 patients or 12 the one with twelve can have a better day/night than the one with 2 patients. But regardless of how many patients you have the greater the number the more mistakes that can be made and don't forget overall patent care. Although we are not handmaidens (or in my case soone to be a handmaiden NO OFFENSE)we get the best response from patients when we are attentive and how can you do that with 8 pts on dayse and 10-12 on nights? Don't get me wrong I am ready for the challange but there has to be a safer way to do it.:)

loriann, BSN, RN · Apr 20, 2008

Thanks you for the feedback... I understand that the patient ratios are different on different floors for a reason. I also know that it doesn't matter if you have 2 patients or 12 the one with twelve can have a better day/night than the one with 2 patients. But regardless of how many patients you have the greater the number the more mistakes that can be made and don't forget overall patent care. Although we are not handmaidens (or in my case soone to be a handmaiden NO OFFENSE)we get the best response from patients when we are attentive and how can you do that with 8 pts on dayse and 10-12 on nights? Don't get me wrong I am ready for the challange but there has to be a safer way to do it.:)

I agree, patient care suffers. I see it all the time. You feel like you are doing medication drive-bys and treated like a waitress at times. I think there are probably several reasons we have such large nurse to patient ratios...too many to list. I think the obvious one would be budgeting concerns of the facilities we work in. They simply do not want to pay for more nurses and would rather throw a tiny bit more money at the nurses working, hoping they can maintain the balancing act of patient safety and patient numbers. One more nurse to the schedule sounds better, looks better and IS better. Bottom line from every manager is always, "We are allotted 12 nurses from our budget we can't pay for 13" or whatever the number. So, nurses are left working with large numbers of patients. ICU nurses have better ratios, sicker patients.

Bottom line is money. It's like the idea of a national healthcare system. It sounds great to everyone, but nobody wants to pay for it. Maybe some of this will change as the baby boomer generation gets older and we are forced to deal with crazy numbers of sick patients. Of course, now I'm heading into a political rant so I will save that for another day. Sorry if this sounds so negative. I really like being a nurse, but it's difficult.

fawnsternurse · Apr 21, 2008

Wow... Thank you everyone for feedback. I have been a nurse for 19 yrs in various areas but havent truly worked on a traditional med surg unit in many years other than a stint at Duke (patient/nurse ratio was 1:5) Now I work on a medical unit and I am not even going to share what the patient /nurse ratio is because you all will think I died and went to Nurse Heaven! LOL

This whole topic burns me as well because 1 +1 = 2! Nursing shortage = increased errors, increased decubitus (which insurance companies do not want to pay for anymore if hospital aquired) and countless other things. Can't they see that if you continue to work nurses short, nurses will continue to leave the field of Nursing and there will continue to be drastic errors? Working short impacts good nursing care and more importantly safe nursing care. We are not robots!

And for the poster who described us as "handmaidens" , I do sometimes feel like that especially working down in the South where it is still so very patriacharial.We are told to make lists of meds that need renewal and give them to the Docs. I constantly feel like I am holding their hand to assist them in getting their job done. Worst yet I have to also remind the pharmacy when my patient who has been there forever needs the next dose of vanco. Gosh forbid I dont and pharmacy leaves for the day and I dont have my 1300 vancomycin. As if I dont have enough to remember I need to remind other personnel what their job is too!

Aggggggggg

nyforlove · Apr 21, 2008

We are told to make lists of meds that need renewal and give them to the Docs. I constantly feel like I am holding their hand to assist them in getting their job done. Worst yet I have to also remind the pharmacy when my patient who has been there forever needs the next dose of vanco. Gosh forbid I dont and pharmacy leaves for the day and I dont have my 1300 vancomycin. As if I dont have enough to remember I need to remind other personnel what their job is too!
Aggggggggg

That's an interesting--and accurate--observation: A co-worker expressed a similar sentiment, stating that the RN is coordinating the patient's care throughout the hospital and has to know a bit about everyone else's duties, e.g., contact Pharm for a missing med, remind the doc to renew the wrist restraints, inform the respiratory therapist that an ABG is due, let the unit clerk know that the new arrival hasn't been entered on the computer, and--my personal favorite--reminding the MD and Anesthesiologist that surgery is scheduled for 6 a.m., but there is NO consent-to-surgery in the chart. I am fortunate that the colleagues in my workplace are terrific people and coordinating these things is not (too) much of a burden, but I've heard horror stories of places where the other Depts get nasty when you're just doing what you're supposed to do by alerting them to outstanding items.....

bsrn0523 · Apr 23, 2008

i worked med-surg days on li where the ratio was 1:8, not going to lie, it was tough, even with great staff.

maximaxi · Apr 13, 2009

[qu

ote=fawnsternurse;2759593]--------------------------------------------------------------------------------I work in a Chicago hospital now its 1: (4-6 pts) on a telemetry floor. On nights its Up to 1:9

pts. Which anyone working tele knows that's a horrible,& yes it does affect pt. care. That's if you don't add a dishcarg,admission,transfer,blood transfusion, cardiac drip, stage iv wound changes,of course no lunch/bfst1 Dealing w/crazy families, jerk off Dr.s. & of course every 100yr old is a full code... (no comment)

I recently spoke with a recruiter in this area and was told that 12 patients to one nurse was a common ratio in the Northern NJ and NYC area. IS this true?

If so this is awful!

And they wonder why the nursing shortage!

Can you someone please address this and tell me this is not so?

(med surg)

I passed this info on to the nurses I work with and they were furious to hear this. :madface: