RN to patient ratios

  1. I will be graduating in May (God willing) and have been doing med-surg clinicals at our 300-bed hospital. This hospital uses team nursing and on the med-surg floors, the ratio is 1 RN/1 LPN/1 CNA to 10 pts. It's doable, I guess, but I would find it frustrating to not get to know the pts better. When it gets busy--as it did the other day--the RN doesn't see some pts past the initial head-to-toe. Is this the standard on floors? (I know the ratios are lower in higher-acuity settings.) I love med-surg but will need to find a specialty where I'll have the opportunity to get to know pts and their families better. That's my favorite part. Thanks for any insight you pros can offer!
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  2. 10 Comments

  3. by   neygray
    That ratio is much higher considering what I'm used to. I am now 'taking a break' to be a Mom, but I was working at a Level 1 Trauma hospital with 650 beds and the general ratio was 5-6 per nurse(be it RN or LPN) with occasionally 7-8 if you had call-ins and was unable to find replacements. But, the techs(CNA) averaged 10-14. Lpn's were not hired for the Critical Care Units, but worked everywhere else including EC and they had their own pt load with a RN 'buddy' in case they had a drug that they couldn't initiate but could monitor, which in that particular hospital was only IV drip vasopressors, cardiac, and chemo. Even with assistance from other staff, 10 sounds high and not very safe to me even with lower acuity. There have been some nights that I had a few high acuity pts and the stable ones did have to be put on the backburner, which to me is not a good thing and leaves you going home thinking that you did not serve all of your pt's as well as you should have and question that you did all that you could.
  4. by   catlady
    I used to work on a urology floor where it was 1:10 ratio with no LPNs or NAs. I didn't stay long.
  5. by   Antikigirl
    I worked at one hospital that would give one RN (no guarentee of CNA or assistance of any kind) day shift 5-8 pts, swing 6-10. Lets just say I didn't work there long!!!

    Now I work for a facility that does 3-4 days, 4-6 swing...not sure about noc but higher I know. BUT our facility makes sure there are enough CNA's to help (even if they have to book agency!!!). That is much safer and the quality of nursing care and nursing satisfaction on pt and staff ends are great!

    I won't work for a facility that demands more...5-7 is my max and that is with help! 3-4 without!
  6. by   AuntieRN
    Our ratio is: 7a-7p 1 RN to5 pts, thats with a charge nurse who has no patients and a CNA who is responsible for 1/2 of the floor. 7p-7a is 1 RN to 7 pts with charge nurse having her own assignment and 1 CNA either to half the floor or the whole floor depending on census.
  7. by   Genista
    My 1st job as a new grad I worked swing shift and had 6-10 patients with 1 CNA per 12-15 patients, no charge nurse at all, but we did have a tele tech/unit secretary. My current job (also swing shift) I get 5 patients and 1 CNA per 14 patients, a charge nurse with no patient assignment (but no unit secretary either). We don't have many LVNs at my current unit, but in the past I have worked with LVNs.That could either be great or horrible depending on the LVN. Technically, you are responsible for all their patients, and some LVNs are fantastic, so this makes it a breeze. But I have had days with weak LVNs and it made my 10 pt load really feel like 10 patients all of my own! Good luck with the new job.
  8. by   DeLynn
    I've only been a RN for 5 months, so I don't know if it's just me or my floor, but i'm feeling like I have too many pt's to take care of. Here's the stats:

    Med/Surg/Tele floor 3-11 shift
    5-6pt's per RN or LPN
    MAYBE 1 CNA for whole floor (32-beds) usually only on from 3-7 then no one.
    1 charge nurse
    And the RN's have to cover the LPN for pushes etc.
    Is this too much or am I just overwhelmed because I'm new?
  9. by   ArmyKitten
    For Med-Surg/Telemetry floor:
    3-6 pts per RN/LVN, up to 7 on nights
    CNAs take 3-10 patients (depending on census)
    Charge nurse will usually take a patient or two
    Unit secretary except at night and weekends
  10. by   Rach101
    Wow sounds like very high patient ratio's.
    In New Zealand its maximum 6 patients to one nurse on any med/surg ward. Mental health wards are no more than 4 and specialised wards such as haematology have maximum 4 but more usually 2 or 3. There is 1 health care assistant for every 10 patients.
  11. by   geekgolightly
    i've been whining about our ratios but some of you have it worse!

    we are tele and we take five. if we are lucky we get one CNA to 22 patients, and there is no transport team. we also staff two to three LPN's (depending on who floats to us) so we cover their blood and pushes and initial assessments and data bases.

    i want out. i feel its too much.
  12. by   RGN1
    Where I am now we usually have 1:5 with no other cover - though most of us will help each other out. The nurse in charge usually has no patients, occasionaly 1 or 2 if there is an excess number of patients to staff.

    Here's the scary thing for you USA nurses though, the care assistants also have their own patients (1:5 again) with the nurse in charge - or more usually one of us (whose already up to their eyeballs) doing their meds or theatre runs!!! They admit patients & everything, care plans the lot!

    Now we do have excellent HCA's (some I'd trust more than other trained staff to spot a problem) but at the end of the day they are not trained nurses & I think they should be in a supportive role under the RN's direction because if they did make a mistake the nurse in charge would be accountable, even though they have no choice but to allocate them because that is the management's policy. It stopped me applying for a senior nurse position when it came up!

    We have no LPN's, there used to be the equivalent, called enrolled nurses but that training has ceased & there are very few of them left now, the vast majority did their conversion course.

    We have to do the whole lot for our patients from washes to beds, meds to dressings, vitals to documentation.

    However, this is still way better than the job I left where, on a very busy, acute medical ward it wasn't unusual to have 1 trained & 1 care assistant to 12 patients at the top end of the ward, & 1 trained, 2 care assistants to 16 acute medical elderly patients at the other end, with 1 nurse/sister in overall charge!!!! Again there were no LPN equivalents.

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