typical nurse/patient ratios?

laurakoko · Oct 18, 2004

Dang! ALLLE...I want to move there....

We have 7, always 7, no more, no less, no acuity ratings. If the census drops, where a few nurses have under 7, they send someone home. We have 1 aide to 10-13 patients, and a "free charge nurse". Meaning if all the nurses on the floor are maxed at 7, the "free charge" takes the remaining. I work on a med surg floor, the acuity is PHENOMENAL.

Typical day...34 bed unit, avg census..28. For 24-28- 4 nurses, (each with up to 7pts, 2 RN, 2 LPN) 1 RN-charge. 2 aides, 1 unit secretary. If census goes up to 29, and above, charge nurse takes all admits, up to 6, and that is then the unit limit! If census fluctuates, for every discharge a nurse gets, an admit is to follow, when the room is ready.

The evil number is below 24... then all nurses are maxed with 7, and the "free charge" gets the rest. It bites. Oh, and did I mention, NO REGARD TO ACUITY.... even though it IS written in policy.:angryfire

harley_fan · Oct 18, 2004

I think we have awesome staffing. It is based on acuity. I am on a medical unit and on days we have typically 3 patients. On days that we are short staffed it is 4 patients and if we have "heavy" patients then we may get assigned 2. We usually have 1-2 aides during the day also. On evenings we can have 3-5 patients along with 1-2 aides. On nights the pt load can be from 4-6. These of course are all based upon acuity. When reading some of these other posts it definitely makes me appreciate my unit/staffing!!!

allele, LPN · Oct 18, 2004

Dang! ALLLE...I want to move there....

LOL! We have a couple of positions open!! On the toughest shift though, 3-11!! Like I said before though, I NEVER take these ratios for granted! I know things are pretty bad at a lot of hospitals. We've got our own problems though. The pay isn't great, the politics suck, and certain shifts are quite cliquey, etc. Same thing a lot of hospitals go through. I work for another hospital part time that I found through an agency, the ratios are ALMOST as good, and it's a REALLY pleasant place to work!! They're out there, the perfect job for you!! Try working for an agency if you're comfortable with it. You can 'try out' other places of employment, you may find your dream job!

live4today, RN · Oct 18, 2004

cheerfuldoer, when you've had 6 to 7 pts on days, did you have an aide? on our floor the staff have 5 to 6 pts and it is tough. there is usually 1 to 2 aides on the floor. the management staff is telling us that other hospitals that have fewer pts/nurse do not have any aides. i cannot imagine having even 4 to 5 pts without an aide.
with the discharges, then admissions coming right back at you, it is almost impossible most days for the nurse to do any baths. between all the meds., turns, vital signs, mobilizing and ambulating, drsg changes, and unforseen occurrences, i just cannot imagine being responsible for baths, too.

yes, we had aides. the aides had over eight or ten patients a piece, sometimes more. even with the aides, it was a madhouse. :uhoh3:

i've worked where the nurses were assigned a max of five patients on days without aides. crazy for sure. :rolleyes:

patients today are sicker, often younger, more demanding, and most of their visitors try to run over the nurses. it's hard to do our jobs when we have negative interruptions from disrespectful and rude people. :angryfire

lee1 · Oct 18, 2004

There are state regs for hospitals you can even look them up in your local library. In NJ the state reg states that there is to be a minimum of 1 nurse to 6 telemetry patients. There are however, no regs for straight med/surg patients not on a monitor, which the State ANA is trying to lobby for mandatory ratios.

ICU is 1:3 if you can believe that although the AACN recommends only 1:2 as the minimum.

lee1 · Oct 18, 2004

and the state regs state it must be based on acuity

nuttyRN · Oct 18, 2004

Hi all,
I ask this question mainly out of curiosity - what is the usual nurse to patient ratio on a typical hospital floor? I was in hospital a couple times the last few months (prostate infection, later an abcess that was positive for staph). Anyways, I had a couple complications here and there, one of which was kidney spasms.....at 0330 in the morning! It seemed like it took a long time for the nurse to get the morphine shot ordered, didn't think of it till the next morning about the same time, this time it was bladder spasms. Anyways, while trying to walk the pain off, I went by an eraser board, and noticed the nurses were assigned SIX rooms (2 per room) on overnights, where during the day it was always four rooms. Is this pretty typical? Considered high or low? I'm a MR/DD caregiver, worked assisted living homes and group homes both, with much lower ratios. The idea of me going up alone against 12 group home residents (granted, most hospital patients are much more cooperative) would simply give me the willies.....:imbar
BTW - so far as I know this was a regular floor, no special care (one nurse did mention they have a lot of prostate cases tho) that I'm aware of....naturally if it was ICU or something the ratios would be much different!
Tom

I work on a neurological floor, so we deal with ALL sorts! I have only once had to take 7 patients on a night shift, and these pts were all A&Ox4. We are a telemetry floor too, so if you are the RN with tele pts you don't ever have more than 4 pts. Most of the time a "typical" night's assignment is 5 pts.

geekgolightly, BSN, RN · Oct 19, 2004

I am on a neuroscience floor, with telemetry for our stroke patients and continuous monitoring for epilepsy pts. We are considered to be a step-down unit and we are well-staffed. Sometimes we have 3:1 sometimes 5:1 depending on acuity. Neuro patients are a handful at times, but I;m glad that we have the right staffing for our job. We also have PCT's who do our blood draws, baths, ADL's etc.

After coming from a step-down neurotrauma unit with max load of 7:1 with multiple trachs, total cares etc etc wherein we did ALL work except baths (and sometimes that, too), I feel incredibly lucky to have this new job.

Haunted · Oct 19, 2004

In California, Ahhnold voted for the nurse ratio law, which means that on a med/surg floor we can have up to 6 patients, in January it will be 1:5. Non union, non contract hospitals have eliminated CNA's so they can justify administrations HUGE salaries. Also, LVN's make up 50 % of the ratio, which means that as an RN, I have 6 patients as primary, which means I do all vitals, bed changes, baths, feeds and respond to call lights, deliver food tray's, help ambulate to the bathroom etc. I am also covering for my LVN with assessments, IV's and PRN IV pushes. So, technically, I am responsible for 12 patients with no CNA. Many nurses there wrote emails to administration concerned that the lack of CNA support would have a negative impact on patient safety and workplace injury. The response? "If you don't like it, there's the door!". Many of my colleages have been at this hospital group for 10 + years and would lose pensions, benefits etc. and are ill prepared to shop around for another job. I myself was fired for complaining and have gone thru all kinds of crap joining a registry, failed my drug screen, had to be immunized ( MMR , who knew?) etc. Ratios make sense and I feel it allows me to spend more time with the patient, but lack of support staff is a recipe for disaster. And my nightmare continues....

lifeisbeautiful · Oct 20, 2004

In California, Ahhnold voted for the nurse ratio law, which means that on a med/surg floor we can have up to 6 patients, in January it will be 1:5. Non union, non contract hospitals have eliminated CNA's so they can justify administrations HUGE salaries. Also, LVN's make up 50 % of the ratio, which means that as an RN, I have 6 patients as primary, which means I do all vitals, bed changes, baths, feeds and respond to call lights, deliver food tray's, help ambulate to the bathroom etc. I am also covering for my LVN with assessments, IV's and PRN IV pushes. So, technically, I am responsible for 12 patients with no CNA.

I am in CA, too. Interesting what you said about the Nurse/Patient ratio. I say this because I know several nurses that are still taking more than 6 primary patients. Also, there was an article in the newspaper the other day that said, Nurses Refuse To Care For Patients. Basically, the article was saying that there is a nursing shortage and that that Nurses need to take more patients, but they are refusing. To me, I feel that people who are reading that article and are not familiar with the nursing profession would interpret that article as saying Nurses Are Lazy and Refuse To Work. Well, what the article neglected to state was that the reason that the nurses are refusing patients is because they are already overwhelmed as it is! It is a safety issue. No nurse that I know wants to put his/her license on the line just so the hospital can take more patients. Hospitals are closing left and right in Southern CA. Already overcrowded hospitals are being completely swamped. It comes down to a much needed healthcare reform. Hey, that would make a good thread, huh? :)

laurakoko · Oct 20, 2004

When I read about the nurse/patient ratio laws, I was like, ahhhhhh, finally. Then I read the posts of the elimination of ancillary staff. That BITES. (But somewhere in the back of my mind, I knew it was too good to be true.) CNAs are a vital and necessary part of nursing care! I hope one day the government, corporations, insurance co, will figure out healthcare is about HEALTH and the PATIENTS, and not all about money making. However, it does make me feel ok that one day also, the people helping make these $ decisions, will inevitably be patients themselves! When they don't get their meal tray (and they have been starving after being NPO from a test,) and their nurse is CODING another person, maybe they will realize CNAs are pretty important.

Oh, and what is happening to all the CNAs in CA?!?!???????????????

Nurseboy1 · Oct 20, 2004

Hi all,

I work on a 31 bed Renal/pulmonary unit with a six bed stepdown.

Our daytime ratio is 1:4/5 on the floor

Our nightime ratio is 1:5/6

The stepdown ratio is 1:3 at all times

Ben