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 many other states are trying to pass similar laws. But it sparked my curiosity as to the average nurse-patient ratios in other states? What are the ranges of patients an RN sees on the unit/floor?
In California the ratios are as follows:
ICU, CCU, NICU/PICU, PACU, L&D, and ER patients requiring "intensive care:" 2:1
Step-down units: 3:1
Telemetry, Pediatrics, ER, Antepartum/Postpartum: 4:1
Med-Surg: 5:1
Psych: 6:1
*The only exception is a local or state declared emergency.
I became an RN after this law was in place for some time, so I really would be interested in the experience of others.
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...
Specializes in Oncology; med/surg; geriatric; OB; CM.
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....
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!
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.
Illinois, nights, tele, on a floor where other floors' RRTs come to us if they don't go to ICU, ICU transfers come to us, and we get all MIs, CVAs, and GI bleeds. Six to seven patients a night with two CNAs.
Med/Surg is where they screw you. I used to have 7-9+ at night. Now in peds, we're usually 5:1. (Day or night.)
An important thing to remember though is ratios without laws in place generally don't cover breaks. So when I go to lunch, I carry my phone or someone is covering 10 patients, their own and mine.
... An important thing to remember though is ratios without laws in place generally don't cover breaks. So when I go to lunch, I carry my phone or someone is covering 10 patients, their own and mine.
I do not understand this...I have read often on these boards how nurses have not time for breaks or lunches, yet they get docked for it....am I reading correctly that if the ratios are made into law then one can by law take the break?
I wonder if having a union does help in this situation of patient overload. I baddly need a job, but I am not that desparate yet to start at a LTC Facility. I feel is abusive what they do to their nurses.
How can we; as nurses, get organized nationally to complain about this? Better yet, how can we make sure to have the patient and their families on board with this without jeopardizing jobs (Corporate is not going to like this one bit, but yet these CEOs earn a ton of money)?
Give me a piece of paper and I can start collecting signatures outside my grocery store.
I work Oncology in upstate NY and we have 4-6 patients on nights(2-3 PCAs as well.) We never have more than 6(our floor will actually cap admissions to avoid worse ratios.) When I worked in Central Texas, we would have up to 8(also Oncology.) 8 patients didn't feel safe. We never capped admissions there. And we also only had 1 or no CNA on nights and did our own blood draws, etc. My current place has phlebotomy, clinical support, etc.
I'm in Ohio at a Magnet Hospital. Medsurg/tele unit with 57 beds.
Day shift-7a-3p is 1:5
Evening shift 3p-11p is 1:6
Night shift 11p-7A is 1:7
I am not sure why our unit does not have the same ratios as our tele floors
Day shift-7a-3p is 1:5
Evening shift 3p-11p is 1:5
Night shift 11p-7A is 1:7
ICU, CICU, NCC, PACU & L&D
Day shift 1:2
Evening shift 3p-11p is 1:2
Night shift 11p-7A is 1:2
Open Heart Recovery
Day shift 1:1
Evening shift 3p-11p is 1:1
Night shift 11p-7A is 1:2
Open Heart Step Down
Day shift 1:4
Evening shift 3p-11p is 1:4
Night shift 11p-7A is 1:5
Psych
Day shift 1:5
Evening shift 3p-11p is 1:5
Night shift 11p-7A is 1:10
OR is 1:1 always
ER is 1:4
I have been looking to find the ratios from California, to see if it talks about the different shifts. Does anyone know if it mentions the different shifts?
Do you know the difference between Med/Surg Tele vs Tele unit??? I was told in a staffing meeting Health Bill 346 for Ohio that Med/surg Tele is different than a Tele unit. I have worked on a "tele floor" and am currently on a med/surg TELE floor. I don't see any difference yet the ratios are different. Any input??
Never mind... I just realized the difference. The drips that can be administered...
RN1Each
22 Posts
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...