How many patients per RN/LPN?

aloevera · Jun 17, 2008

medsurgrnco.----in reply to your inquiry, we as RN's do all the pts. assessments and 5 page notes on them, we do all the dr. orders re: ECG's, blood draws, etc. We attend the tx. plan meetings along with therapist and psychiatrist on each pt. after their 2 days in house, then again after 7 days in house; we do all the admits; and anyhing else that comes along during the day !!! Sat, there were 49 pts., 2 RN's, 2 LPN's (meds) and 2 MHT's....we sent 3 out to H., had 4 new admits and dealt with all the rest......very busy and interesting day, for sure...

medsurgrnco, BSN, RN · Jun 18, 2008

Thanks for all the responses. Where I work nights there are a max of 16 patients with 2 nurses, with few medical issues. We usually each do all pt care & documentation on half. If I don't have an admit, I have a couple of extra hours in the shift - after my relaxed long lunch break. And I've never had over half an hour OT. This job is so much better than all the med/surg jobs I had! The few hectic nights I've had were still much better than almost every night I had on med/surg units!

aloevera · Jun 20, 2008

medsurgco - I would gladly give meds also if I could have just 16 pts. with 2 nurses...that sounds like a great arrangement at your job...are your other duties similiar to what I stated with mine? just curious as to how other psych hospitals operate.....

kiwipsychnurse · Jun 20, 2008

usually 1:3 ratio here in New Zealand Forensic Nursing. Sometimes 1:2. I keep telling people we have the ratio's in the world.

medsurgrnco, BSN, RN · Jun 20, 2008

In answer to Aloevera's query, our patients are typically medically stable. If there are unexpected serious medical issues, patients are sent to the local hospital emergency room. Every day, nurses spend many hours in rounds with the psychiatrist, CM, and patients. And deal with admits and discharges, although most admits are done by an admit nurse who helps out however they can when not busy with admits. On day shift, one nurse usually does all meds and then they divide up the assessments equally. As in any nursing job, there's too much paperwork! I have been doing all lab draws on all patients, as I have the med/surg experience, and the other nurses say they are not good at lab draws, and I like doing them. Night shifts are really easy if there are not admits and if patients are calm. I have had less than one admit per week, although sometimes I finish up some of the work for an admit nurse who wants to go home. So sounds like your job is a lot more work than for nurses where I am.

aloevera · Jun 21, 2008

yes, our days usually fly by....we stay busy, that is for sure...but I like that, I don't like much down time, I prefer to stay busy but sometimes it gets too hectic !!

we have just hired several new nurses that are orienting for nights, we have been very short on the night shift...and a few for days so maybe we will be staffed better in the near future...I would be happy with a 1:12-15 ratio.....I like that you have a nurse just for the admits..we have a needs assessment team who sees them initially but we must still do the medical and psych assessment and hx. on each...

thanks for the info....

ScarlettRN · Jun 21, 2008

Wow. I thought my place was bad. I think we have it sweet here! I work for a state psych hospital on one of the 2 adult acute wards. We can have up to 40 patients but usually our census hovers at 23-25. We are staffed according to patient observation level. 1:1s, Intensified Obs, Close Obs and Routine Obs. Our psych techs for day shift are between 7-9 of them. One med nurse, a charge nurse, and (sometimes) a clinical nurse....so 2 RNs and 1 LPN.

I feel like a whiney baby right now, but the hardest part of my day is making the assignment for the techs! We have this lovely policy that every tech's assignment is rotated every 2 hours. They also get an hour meal break, and they take it. It has taken me 2 hours to make the schedule before!

But after listening to some of y'all, I am feeling a lot better about my staffing!

sarmedic70 · Jun 22, 2008

Wow...........where do you all work? Give you all my week........Sunday I put in over 20 hours. First of all, I was covering for one of our RNs who was on vacation and then went into my regular shift (every other Sunday I work 8 hours.......I come in at 1400 hours and off at 2300 hours........so the Shift 2 RN and I overlap for about 4 hours.........a lot of the time one of us will get pulled to another unit)........at any rate........due to issues on the unit, I didn't get off till 0200 hours on Monday................Then Wed I put in 5 hours OT due to issues on the unit (it "erupted" big time.....so TONS of charting to say the least).....On Thurs...........same thing...........5 hours OT.....as with Wed, I was in at 0600 hours and didn't get off till around 2400 hours..........so same for Thur.......another MAJOR "eruption"......this time with one of hte patients who managed to get into the kitchen (thanks to apparently a staff member NOT taking the nanno second to ensure that the kitchen was closed), then this patient got a hold of the fire extinguisher........you can imagine the "rest of the story".........add to that, several of the patients opted to go off so seclusions, physical holds, IMs et al...................more charting, et al...............Friday, 1 hour or so overtime and would have been 2 had I not been directed to come in later than normal. RN scheduled to work the night (to cover for our two vacationing night RNs) and was on the schedule was a "no show/no call"......I call scheduling to find out what happened..............make a long story short, one of the SSRN's covered that shift since she was working extra and was supposed to be working one of the other units...................Per shift (minus nights), we have 1 RN, 1 LPN (except on Saturdays when we have no LPN), and 5-7 techs, depending.................too many times we are shorted staff despite our numbers.............it's a long story and beyond frustrating. After the episode on Thur evening, I am hoping to heck something is going to change....................So, since the start of the pay period (a week ago Sat) I have put in well over 80 hours.........this includes working an extra shift (Fri) to cover for one of our other RNs on vacation................I have one more week to go for this pay period..................We have THE MOST active unit of all but yet............

Despite all, I LOVE my job........and I LOVE my patients............it sure as heck beats any ole day I worked Med-Surg..........I am also a medic and work part time for one of our counties..................it is my "quiet" job..............

Have a great weekend everybody :-)