What is the nurse-patient ratio where you work? - page 4

So I recently learned on allnurses that California is the only state that has mandated nurse-patient ratios. I was honestly shocked and found it educational how hard fought a battle that was and how... Read More

  1. by   DedHedRN
    With most California hospitals only hiring nurses with acute care experience it leaves new grads with little choice but to work at these LTC facilities. We need to work too. Even if the conditions are deplorable.
  2. by   DedHedRN
    My facility offers insurance at rates so astronomical no one working there can afford it. The entire facility has kids on medi-cal. Now that's the real joke.
  3. by   needshaldol
    The Ca hospital that I work for has hired new grads the last 4 years. And lots of them, all full time. That does not mean they are getting full time work but they are working. But I believe we had a contract with the University and now it is done with so I have a feeling we are not going to hire new grads for a bit. If working at a LTC gives you experience go for it. And maybe you will be good at it and enjoy it. We sure need good nurses there!
  4. by   jrbl77
    I work on a combo med/surg- tele- rehab unit at a small hospital. Our census has been low- less than 10 lately. sometimes we work with 10 pts and 2 RN's, may have 1 cna, depends. The problem is getting all these pt up and down to the bathroom etc. they are often 2 person assist. My last shift, I was giving 2 units of blood to one pt,needed to stay in pt room for 1st 15 min.When my other pt's called and needed to go to the bathroom-Well? you can only do one thing at a time. This is a 12 hr day shift. Oh and on the weekends, we have to do all the resp trts.
  5. by   crbetts
    Here in rural Missourah, I work in a 24 bed telemetry step-down unit with usually a 4:1 ratio on nights, and no aide, tech, etc. So we do EVERYTHING for our patients. I do understand it is worse other places 5:1 or 6:1, I'm not sure if that's with a tech or not.
  6. by   needshaldol
    JRB, if we have 10 patients we have two RN's and no cna whatsoever. It can be very difficult esp since our acute hospital med surg is starting to look like a skilled nursing. All these old folks being kept alive when nature needs to take its course. I took care of 88 yr old who is a FULL CODE and demented, feeding tube, blood transfusions, etc. etc. What is wrong with this picture? To top it off, he is contracted and hard to turn and they want us to get him up with a lift for every meal. Give me a break. His "every meal" is a feeding tube constantly being infused. And the family refuses a foley. And he cannot be without oxygen. And I am running around crazy smashing up cholesterol meds to push into his feeding tube? Makes no sense.
  7. by   Syrenia
    Quote from wannabe2008
    In California, there isn't a ratio of nurses to patients in long term care. Instead there is a ratio of "direct care staff to patient". AM is 5 to 1, pm is 8 to 1 and noc is 13 to one. The ratio includes nurses+c.n.a. to patient.

    One nurse with three CNA could be taking care of 32 on the pm shift. BUT! The ratio takes into consideration nurses in the building, not nurses on the floor. So if a nurse is working in an office of your facility(actually officially scheduled to be there) at the same time you are on the floor, that nurse affects the ratio so you could be assigned even more patients.

    An example is the MDS coordinator sitting in his/her office. He affects how many patients the nurses on the floor are assigned. I know this because I am an MDS coordinator as well as ADON in a SNF. Monday through Friday, they count me into the ratio even though I don't work on the floor. On weekends, the am superviser affects the ratio.

    Depending on the size of the facility, the DON can also be counted as direct care staff so that would affect your patient load.

    It is very interesting reading and I recommend any LTC nurse in California go online and read it.

    At least this is what I read at the California Health Department website yesterday.
    Well isn't that just convenient for LTC facillities! It "looks" like they re staffing way better than they actually are. Nurses shouldn't work like that. If they couldn't find anyone foolish enough t work like that, then they would have to staff better to attract and keep them?

    It's not a matter of foolishness. It's a matter of that being the only jobs out there. No matter what I think about the staffing in my facility, those residents need care, and I have to pay the mortgage. Maybe residents' families should stop grousing about the bill, and start insisting on better staffing ratios!
    Last edit by Syrenia on Aug 31, '12 : Reason: added what I was trying to quote in the first place :)
  8. by   Vmwcna83
    I work in IL on acute rehab unit and we have no ratio.. Depends on how well we are staffed.. Lately it's been 2 cnas w a full house 15-16 patients a piece.. Very crazy and unsafe.. I wish we did have a set patient nurse ratio..
  9. by   Vmwcna83
    Wow 30 patients!! That's crazy
  10. by   RN1Each
    Upstate NY Tele unit. Overnights I usually have 5 or 6 patients. One night I had 7.
    One aide for the entire 42-patient floor (if we're lucky...), no LPNs (they work the day shift.)
    I do ALL vitals, hang IV antibiotics, hang blood, transport patients to the commode or bathroom, do admissions after 2am (when our admissions RN leaves), chart histories and upcoming procedures for the morning shift, etc. etc. etc.

    California has 4:1 mandated Tele, AND $90K+ per year for RNs? Rethinking my former comment about being overpaid...
  11. by   TheOldestNurseOnUnit
    Our med/surg/oncology floor used to be no more than 6:1 at night.....now we're 8:1 most nights with the option of going as high as 10:1 which scares the life outta me......oops...I forgot....suburban Chicago hospital....
    Last edit by TheOldestNurseOnUnit on Aug 31, '12 : Reason: additional information
  12. by   Platypus
    I work in LTC Administration in Philadelphia. Our nurses are 38:1 - IMO way too many patients for the nurses. There are 4 CNAs, but still the med pass alone on day shift is grueling. Add to that Tx, calling docs, notes, keeping track of CNAs restoratives/ADLs, appointments...It is crazy! I have tried to get it improved, but corp. says we are not budgeted for it. One thing is for sure, you will always have a job - but it is very stressful and exhausting! I love the residents, and I love the people I work with - the amount of work is drudgery though!
  13. by   ValdezRN
    I work in the rio grande valley-deep south texas. One facility had a regular 3:1 ratio in ICU. Charge nurses had a full assignment. 8:1 on the medical unit. 5-6:1 in ER (with icu patients). In another facility I would frequently take two fresh open hearts in one shift (with no aide and no secretary), and ER was 5-6:1. My current faculty is kinda like a rehab hospital but it had a full functioning ICU. Again, 3:1 in the ICU and 5-7 on the med/tele unit. I would gladly welcome California's ratios but I agree LTACs need a long way to go.