Questions for all Med surg nurses

Specialties Med-Surg

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I have a question for all Med surg nurses. What is your nurse to patient ratio? Do you have cna's all the time (do they get called off), what is your hppd? If your facility has a pediatric unit do the nurses only take pediatric patients or do they have pedi and adult. Do you have phlebotomist? What do the charge nurses do and how is your admission and discharges done?(admit and dc nurse or floor nurse). How are your hcap numbers? Any of the above information would be greatly appreciated.

TheCommuter, BSN, RN

102 Articles; 27,612 Posts

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Welcome to Allnurses.com!

Your post has been moved to the Medical-Surgical Nursing forum to generate responses from nurses who work in this area. Good luck to you!

Sassy-RN

85 Posts

Nurse to patient ratio can be 3-5 on days 4-5 on evening s and 5-7 on nights ( strictly surgical floor).

We do have have phlebotomists but all PICCs, central lines and ports, we draw.

It depends on who the charge is if they help with admits and discharges.

Our PEDS unit is only PEDS.

I do not know about the HCAPS score. ( and don't care! I am bust caring for patients!)

PG2018

1,413 Posts

Specializes in Outpatient Psychiatry.

Where I worked the shift was supposed to be staffed with two RNs, one LPN, and one CNA per 15 patient unit. That would equate to 5:1. However, in reality if someone was on vacation, sick, had a sick kid, didn't feel like coming to work, etc then they weren't replaced. Also, my shift had two LPNs and me (RN) so I had to do all admission assessments, IVP therapy, central lines, PICCs, and ports in addition to managing my own patient load as well as admin duties of the shift. To make matters worse, I had a CNA for about four months of that year. The point here is that regardless of staffing ratios they "correct" number of employees won't always be present.

Something to think about...

Specializes in LDRP.

What is your nurse to patient ratio?

ideally 5:1. More often than not it is 6:1. Sometimes we are 4:1, but expect tons of admissions. I personally have gone up to 7:1 on very busy nights and some other units have gone up to 9:1 which I feel is absolutely unsafe.

Do you have cna's all the time (do they get called off)

I work nights and we usually have at least one aide for our 22 bed unit. Ideally we have 2 and probably a couple times a month we have none. Dayshift usually has 2 aides and a unit clerk, sometimes only one aide. They will cancel or float an aide if our census is low (less than 11).

what is your hppd?

sorry not sure what that stands for!

If your facility has a pediatric unit do the nurses only take pediatric patients or do they have pedi and adult.

our peds unit takes patients 18 and below as well as adult patients with pediatric problems (the only example i can think of is young adults with congenital heart defects) They certainly don't take random med/surg overflow.

Do you have phlebotomist?

we do have an outpatient lab with phlebotomists, but we do all of our own blood draws on the floor. Our aides are trained in phlebotomy as well so we have some help, but I usually have 6 blood draws in the AM and I do at least half of them on a normal day.

What do the charge nurses do and how is your admission and discharges done?(admit and dc nurse or floor nurse).

The charge nurse is usually the most senior nurse on and takes a full assignment. Since we have a lot of new grads I get the pleasure of doing this often on night shift. We are responsible for placing new admits in beds, putting together the assignment schedule for the next shift, being the resource person for the other nurses (answer questions, help out), going to a once a shift staffing meeting with the other charges and the nursing supervisor, and communicating and unit issues with the sup/manager. All for a measly $0.75/hr bonus.

admits and discharges are done by the floor nurse taking care of that patient.

How are your hcap numbers?

I am proud to say pretty good! We are at least on par with the national average in all areas and above average in many. Most of the comments are positive and we have the best scores in our hospital (we are tied with OB).

Lev, MSN, RN, NP

4 Articles; 2,805 Posts

Specializes in Family Nurse Practitioner.

What is your nurse to patient ratio?

Our nurse to patient ratio is supposed to be 1:5. Sometimes I start off with 4 patients and get an admission, but often I start off with 6 patients. Do you have cna's all the time (do they get called off) We always have CNAs, but they sometimes get floated to other units that are short or have to sit with patients requiring constant observation.

what is your hppd?

Not sure what that stands for...Hospital population density??

If your facility has a pediatric unit do the nurses only take pediatric patients or do they have pedi and adult.

My adult med surg unit takes patient age 16 years and up. Every once in a while I have a teenaged patient. We do not have a designated pediatric unit.

Do you have phlebotomist?

We do not have a phlebotomist. We have vascular access team (VAT) nurses who access ports and insert PICC lines. All nurses and techs are trained in phlebotomy. I do all my own draws and IV starts. If I can't get a stick, I call the charge RN or one of the VAT nurses to see if they are available. Our policy is 2 sticks per person and then someone else has to take over. At night, there is a "resource nurse" available to help with IV starts and lab draws.

What do the charge nurses do and how is your admission and discharges done?(admit and dc nurse or floor nurse).

The charge nurses assign admissions to rooms, go to bed-boards meetings (where they figure out staffing and census), handle customer service issues, help out whenever they can, and make the next shift's assignment. They sometimes take on 2 or 3 patients if we are short nurses. We get ED admits, OR admits, and 23 hour ambulatory surgery patients who are not full admissions. The floor nurses admit and discharge patients. The charge nurse helps with admissions.

How are your hcap numbers?

Our HCAHPS scores are TERRIBLE!

Lev, MSN, RN, NP

4 Articles; 2,805 Posts

Specializes in Family Nurse Practitioner.

Double posted

bamaguy1989

47 Posts

What is your nurse to patient ratio?

usually 4 to 5 patients per nurse and a charge nurse with no patients on day shift only. Night shift has same ratio but charge has patients always.

Do you have cna's all the time (do they get called off)

Supposed to have 2 CNAs if we have at least 16 patients but we are short staffed right now because of one being on maternity leave. They have let us keep an extra nurse when we have only 1 CNA so that the nurses have about 3 to 4 patients each

what is your hppd?

We have a staffing grid that we go by. I know that if we have 16 patients we can keep 4 nurses and if we get to 20 patients we can keep 5 nurses. This is on night shift. Day shift is the same except when they have >16 patients they also can have a charge with no patients. And they always have a HUC(secretary). Night shift never has one.

If your facility has a pediatric unit do the nurses only take pediatric patients or do they have pedi and adult.

Adults only on my floor

Do you have phlebotomist?

Lab comes to draw all labs unless they have a central line, where the RN will draw from it

What do the charge nurses do and how is your admission and discharges done?(admit and dc nurse or floor nurse)

IDK what day shift charge does but night shift charge checks the crash cart, makes patient assignments, answers phone/call light, helps others when available. On weekdays there are admission/DC nurses that may be there until usually around 10pm. One of them works until midnight sometimes. No admit/DC nurse on weekends.

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