I live in Ocean Springs, Mississippi and work at Ocean Springs Hospital. We do 12 hour shifts, 7a-7p and 7p-7a. On both shifts, the ratio is supposed to be 1 nurse to 4 pts. We have 29 beds on my unit. However, this ratio goes out the window whenever it dang well pleases at times. They do try to stick with this, but what often happens is:
7 nurses will be scheduled for the day, but you will start with 20 pts and only 5 nurses ( because 2 nurses will have been called off for the day, with 1 of those remaining "on call" ). Now, all of the sudden we have a huge influx of admits, say 8 admits. They'll call in the 1 nurse on call, but that still didn't solve the problem now did it? That will leave some with 4 pts and some with 5. Sure, they could float nurses from other floors, but it seems that each floor operates under this same staffing mode so that no floor will have a spare nurse. This example happens about 1/2 of the time I work. And at times, depending on if people have called in sick or whatever, the ratio will get bumped up to 5 and 6 pts per nurse. Mostly, though, it only goes up to 5 half the time, and the rest of the time we get our coveted 4:1 ratio, which isn't all that great anymore considering how acutely ill these pts are nowadays!
As for our CNA's, we have 2 per shift.