Staffing ratios in isolation units

[GHGoonette, BSN, RN]

I was involved in a debate with our Hospital Manager today, and the subject was staffing ratios on pediatric wards. He informed me that a ratio of 1:16 was the norm, and frankly, I think he's talking through the back of his head. We were referring specifically to isolation units; the kids not critical, but pretty sick nonetheless. Parent present round the clock. Would you guys be comfortable with this kind of ratio?

[WSU_Ally_RN, BSN, RN]

Oh my goodness, NO! I work in a PICU at my hospital, and we only have 1 or 2 kiddo's, depending on how sick they are. When I have floated to the general care floors, they try to keep it to 3 or 4 pt's per nurse. I think maybe occasionally, if really short staffed, they might get 5 pt's per nurse, but that's rare... No way is 16 pt's per one nurse safe!

[NotReady4PrimeTime, RN]

Absolutely NOT!!!!!! Peds should never be more than 1:6 on nights with parents present. 1:4 on days at most, and isolated kids 1:3. Kids are at extremely high risk for falls, entanglement, loss of IV access, wound contamination, suffocation... all sorts of hazards the average adult isn't likely to get themselves into. Ask you manager what your area's legislated day care and classroom ratios are (look them up first so you're not the one talking through the back of your head) then ask him how caring for children who are ill, in hospital and in separate rooms can possibly be considered safe at 1:16. Bet he can't answer you.

[GHGoonette, BSN, RN]

Thanks for your responses! Unfortunately, this is in South Africa, and although the unions are getting the ball rolling on mandated ratios, hospitals are still getting away with murder as regards staffing. I'm referring to a for-profit hospital here, and the bottom line is definitely profit!

I've read comments on AN in which the "nursing shortage" is cited as a reason for hospitals understaffing, ie, there is no nursing shortage, but health care companies are trotting it out as an excuse for cutting staff in order to increase profits. While we have a crisis in the large State hospitals as regards staff shortages, this is not the case in the private, for-profit sector, yet I've heard representatives from the big corporations say that their staffing problems were due to the "nursing shortage".

As you say, I need to get all my ducks in a row before I take this further. Thanks again for your input.

[umcRN, BSN, RN]

What?? thats crazy, I've talked to a friend of mine who used to work on our hospitals peds unit and she said she had 2-3 pts during the day and 3-4 at night. I couldnt imagine trying to BABYSIT 16 kids never mind give meds, keep ivs in, treatments, procedures, feeding if the parents arent there, constant monitoring for kids that are headed downhill, thats nuts!

you often rarely see that kind of ratio for adult med surg, I would think kids would be considered much more needy