Quote from carm4502
Patient ratios would be great if they had some means of validation. The ratios are applied across a facility so a ratio of 1:4 sounds great until you take out the 1 for 1:1 patient care for each ICU patient, the 1:2 for all the HDU patients, the staff off-line doing professional development or other non-clinical duties and what are you left with? anything from 1:8 to 1:12. The next step the Government wants to take is to include in the ratios all non-clinical staff (the nurse managers Directors etc.)for a facility. Where will that leave nurses and their precious ratios? Ratios are fine if based in fact and are constantly evaluated and validated by Nurses.
I've worked with old-style dependency scales, been involved with a Trendcare trial, and worked with the Victorian ratios, and the latter are my preference by far.
The description above is an inaccurate portrayal of the ratio system - the 1:4 applies to general wards in A class hospitals (in Melbourne that's The Royal Woman's, The Royal Children's, Royal Melbourne, the Alfred etc).
ICU's are staffed 1:1, HDU's are staffed 1:2 etc, and there has never been a suggestion that non-clinical staff are counted in the numbers. In fact, ACN's are specified as being supernumary, so a twenty-bed unit in a A class hospital has five clinical nurses, plus an ACN, plus a Unit Manager, Clinical Support and Development Nurse, plus any non-clinical nurse specialists.
Also, the ratios are supposed to be a minimum
safe staffing level - the night-time ratio in A hospitals in 1:8 (including ACN), but most wards on my hospital staff 1:5 or 1:6, depending on acuity.
One key advantage of the ratios is that it is a transparent system - any one can come on and see if there are enough staff for the shift. This has meant that this morning, for example, I was able to close three empty beds because admin weren't able to replace a sickleave, and without that we'd be working over the ratios. No need to involve admin, get approval from my NUM - we don't have 1:4 so those beds are closed until the PM.
It's also supposed to be flexible - you can deploy those five nurses any way you like among 20 patients: team two nurses with ten stable patients, have a 1:1 special, whatever works for that shift on that ward.
The ratios have meant that Victoria hasn't got a nursing shortage, and we're not giving them up!