TEXAS nurse/patient ratios? - page 2

There seems to be quite a few of us that are interested in moving to TEXAS, myself included (preliminary stages), anyway, I thought it would be a good idea to find out what the patient ratios are... Read More

  1. by   RN34TX
    My last Med/Surg job at a big hospital in downtown Dallas was making me take 7-8 patients each. They stretched the CNA's so thin that they would only be able to bathe/change linens for maybe 1-2 of my patients and I often worked with no CNA or unit clerk at all if one called in sick.

    I also worked at a couple of the "big chain" LTAC's in the DFW area over the years in the early 2000's. I never took more than 6 patients at these long term vent facilities but the patients were almost always morbidly obese and on vents, meaning it was nearly impossible to turn or bathe any of my patients without at least two people working on one patient.

    On top of that, the families are 10 times more demanding/dramatic/abusive in these LTAC's as their loved ones have been hospitaized for extended periods of time and they get better and better at demanding and manipulating staff/administration.

    I now work ICU and PACU in southeast Texas and the 2:1 ratio is strictly enforced here. I've heard reports that other areas in Texas have ICU nurses taking 3 patient assignments which is totally unacceptable and I'd never do it.

    I'll never do floor nursing (Med/Surg or LTAC) ever again regardless of what the pay offered unless I'm so desparate for a job that I'd be homeless living under a bridge otherwise.

    I have 4 co-workers who have all worked at one time in either the Laredo area and/or Rio Grande Valley (Brownsville/McAllen/Harlingen) and all have left due to horrid working conditions and abusive MD's in those areas.
  2. by   TheCommuter
    Quote from RN34TX
    I'll never do floor nursing (Med/Surg or LTAC) ever again regardless of what the pay offered unless I'm so desparate for a job that I'd be homeless living under a bridge otherwise.
    :roll
  3. by   sjt9721
    Quote from RN34TX
    I'll never do floor nursing (Med/Surg or LTAC) ever again regardless of what the pay offered unless I'm so desparate for a job that I'd be homeless living under a bridge otherwise.

    Well...at least you have a plan in case your living situation changes!
  4. by   heath55
    I am a agency nurse in the Dallas area and can tell you that the ratios are getting worse. I am seeing alot of 3:1 in ICU this has been over the past year but those ICU nurses are still fighting just doesnt seem as hard, 6-10 Med/Surg, and the most abused units seem to be PCU's with up to 7:1 no tech and yes with drips - none of the facilitys staff by acuity. I am also seeing a high number of foreign nurses coming in to the area. There are a lot of HCA hospitals in Dallas and a few Tenets, Presby and Baylor. I have worked with several california travel nurses over the last couple of years that have asked that they be release from their contracts - reason given - unsafe practice. I only see the problem getting worse due to immigration problems, high number of uninsured patients, Texas unable to help hospitals that are eating the costs. I read recently that Texas and California are at a crisis state in dealing with healthcare costs with no solution in site.
  5. by   Hellllllo Nurse
    I have to live in Texas, unfortunately. But I don't have to work there anymore. I am a traveler now. I miss being at home w/ hubby, but working conditions and wages in the panhandle are terrible. Plus, there are just too many nurses. You can't even find a crappy, bad paying job in the panhandle.
  6. by   RN34TX
    Quote from heath55
    I am a agency nurse in the Dallas area and can tell you that the ratios are getting worse. I am seeing alot of 3:1 in ICU this has been over the past year but those ICU nurses are still fighting just doesnt seem as hard, 6-10 Med/Surg, and the most abused units seem to be PCU's with up to 7:1 no tech and yes with drips - none of the facilitys staff by acuity. I am also seeing a high number of foreign nurses coming in to the area. There are a lot of HCA hospitals in Dallas and a few Tenets, Presby and Baylor. I have worked with several california travel nurses over the last couple of years that have asked that they be release from their contracts - reason given - unsafe practice. I only see the problem getting worse due to immigration problems, high number of uninsured patients, Texas unable to help hospitals that are eating the costs. I read recently that Texas and California are at a crisis state in dealing with healthcare costs with no solution in site.
    The last job I had in Dallas (Med/Surg) before I moved down here advertised a big full spread ad in the Dallas Morning News in late 2002 as having a 4:1 ratio in med/surg units with CNA support who did everything from blood draws to foley insertions.

    Well call me a fool if you will for actually believing that and taking the job, but it really was true when I started there...for a good 6 months.

    The CNA's never had more than 8 patients each (often less) and as a result, I rarely, if ever, had to change a single bed or give a bath. Not that I mind doing those things as I do them now in ICU every day, but it was nice to have a CNA who was not streched so thin.
    They walked and turned every patient who needed it right on time and patients/families never complained about things like how long it took for someone to answer their call light or take Grandma off the commode.
    They would actually walk up to me and ask if any labs needed to be drawn at least once a shift!

    During that time, the nurses never dreaded getting new admits like most med/surg floors simply because we had plenty of time to get everything done.

    Needless to say, after realizing how much money they must have been losing, they cut some nurses off each day's staffing grid and went from having 4 CNA/PCT's on our unit down to 1-2. (Most days 1).

    The nurses were now getting 7-8 patients each with minimal CNA/PCT help because each CNA/PCT was now taking 16+ patients each.

    When they were starting to talk about giving the nurses 9 patients each, I finally jumped ship and actually quit an entire month before my next job was scheduled to start out of fear for my license and/or losing what little sanity I had remaining.

    This was my last Med/Surg experience and this is why I made the comment about living under a bridge before ever taking another Med/Surg job! (That a couple of you apparantly got a kick out of! ) :roll
  7. by   Sanuk
    ER nurse in Dallas with a hospital policy of 4:1 ratio, but routinely get 5:1. Nurses with ICU-bound pt's still have 4:1 ratio as well. We are routinely understaffed and actually get excited if we have a tech scheduled for the shift.
  8. by   dazey71
    I work a med/surg unit in Dallas hospital with a ration of 5-6:1 on days. It can be pretty hectic, but since we can take 6 patients, we don't get post-ops.
  9. by   tx2007
    I am not a nurse yet (just an intern) but from what I see on a surgical floor we have anywhere from 4-6 pts. We have 1 CNA for 20+ pts and if we get over 25 we get an additional CNA. ICU is a STRICT 2:1 with CNA's doing all the baths and linens. We have an admit nurse who will come up and admit your pts for you if you get too busy. The most pts I have seen any nurse on our floor have is 7 and thats RARE. We do surgical and ICU stepdown on our floor. I have been an intern for 8 months and will be working there after graduation. HTH
  10. by   freestylepnoi
    I work at a Houston Hospital (North Houston), our ratios are 7-8: 1. While administrators says its acceptable to have 7:1, national standards are 5:1. The nurses are overworked and there are days when I find myself doing everything from changing bed, drawing labs, etc. Basically, I think the reason is money, most hospitals will give up great nursing care to save "a couple of bucks", Ive been working there for 2 years and when one of my coworkers complain about the ratios I usually tell them it happens almost everywhere. 6:1 i have no problem with the ideal is 5, 7 patients is a stretch, 8, i wont even begin to think about going home on time. After 7-8 with no tech, a nightmare, i remember being so behind and leaving so late..Plus to add to the problems we still have written nurses notes which amounts to piles and piles of paperwork which for some reason gets misplaced at least once a shift.
  11. by   RN34TX
    Quote from freestylepnoi
    I work at a Houston Hospital (North Houston), our ratios are 7-8: 1. While administrators says its acceptable to have 7:1, national standards are 5:1. The nurses are overworked and there are days when I find myself doing everything from changing bed, drawing labs, etc. Basically, I think the reason is money, most hospitals will give up great nursing care to save "a couple of bucks", Ive been working there for 2 years and when one of my coworkers complain about the ratios I usually tell them it happens almost everywhere. 6:1 i have no problem with the ideal is 5, 7 patients is a stretch, 8, i wont even begin to think about going home on time. After 7-8 with no tech, a nightmare, i remember being so behind and leaving so late..Plus to add to the problems we still have written nurses notes which amounts to piles and piles of paperwork which for some reason gets misplaced at least once a shift.
    Of course administrators are going to say 7:1 is acceptable, but who are they?
    7:1 is not acceptable even if you have a tech/CNA to help you but most definitely not acceptable when you don't have one to help.

    I know for a fact that the nurses at least on the post-op surgical floors at my hospital (don't know about medicine or other areas) never take more than 6 patients so perhaps you need to seek employment elsewhere.

    I know this because I work in the PACU and it affects me.

    A med/surg unit could have 16 beds. However, if there are only two RN's then they only take up to 12 patients, the other beds become closed and my patient has to remain in PACU with me until a bed opens in another area.

    I don't mind because those nurses shouldn't even be taking 6 patients, IMHO.

    5:1 with a CNA/PCT should be the absolute max for any med/surg floor nurse and even less if no CNA/PCT available.

    Your job sounds like my last med/surg job. Never again.
  12. by   freestylepnoi
    It happens, nurses call in, bad weather, as much as I want to come into work with just 5 patients, it doesnt always happened. The one positive that's come out of it is I've learned to handle 7 easily, without a CNA its difficult.

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