What do you consider to be safe staffing levels for an inpatient psych facility? We have 1 nurse for 16 patients and then two techs (our techs help with meals, smoke breaks and personal care). Sometimes this is overwhelming should anyone require extra attention...either sudden acute medical or mental episode. I believe it's just too much responsibility for one nurse but that is the "matrix sent from corporate". The state I;m in requires and "average monthly" of one staff for four patients except on nights.
Mar 16, '13
by Meriwhen, ASN, BSN, RN Senior Moderator
In CA, I have ratios on my side, so it can never be greater than 1 nurse:6 patients for inpatient.
However, having also worked outside of CA...I'd say that a ratio of 1:8 max is safe. Of course, this has to take into account the acuity of the patients. On a high acuity unit such as stepdown or ICU, or for detoxing patients (or other psych populations) who are medically unstable, more staff is needed. Sometimes even 1:6 isn't enough.
Last edit by Meriwhen on Mar 16, '13
I am also concerned about the staffing ratio. I am the charge nurse 3 days a week 12 hr shifts of a 26 bed psych unit We are allowed me, a med nurse, and 2 MHTs for a census over 19. When the census drops to 19 they send 1 of the MHTs to another unit or home. On the unit there is Adult Psych, Chemical Dependency, and a Womans Program. We are supposed to keep the men on one end of the unit and the women on the other end. There are 2 nurses stations and a long hall seperating them. One MHT is to stay on the Womens end and the other stays on the mens end. I am housed on the mens end along with the med nurse. We very seldom have a male MHT. Yesterday we discharged 6, admitted 4 new patients and had one transfer from another unit. This all took place from 3p-7p for me and 2 more pts. were admitted after I left. Administration learns who is to be discharged and begins pushing us to get the pts out so they can fill the bed. The admitting office or Care Center as they are called will send patients to us back to back. It gets so overwhelming, yesterday I refused to accept an admission at the time they wanted to send the pt. I was swamped I had just gotten 2 new patients. I was still working on discharges, answering phones, taking off orders, tending to doctors, not to mention pt needs and issues.
OUESTION: I've been told by the care center that I can't refuse to take a patient, that whenever they call I am to take report and take the patient. I know I can (since we have 26 beds) refuse to take any patients over 26. And to clarify I am not saying that I won't take the pt. at all, I am just saying "I'm swamped, I can't handle another pt right now. "Give me 20-30 minutes to take care of the patients you just sent me."
Last edit by mare4322 on Mar 20, '13
: Reason: I didn't express clearly