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Discussion

Another ratio question

I'm just learning the details about CA's laws about hospital, licensed nurse to patient ratios. If someone has time to humor me and explain that'd be great!

On my tele (pseudo med-surg) unit in PA RNs take 5-6 patients on days and 6 on evenings. That's the goal anyway. Lately we haven't had the staff to manage that, and it's become acceptable for us to take up to 7 patients on these shifts. Like many places, we just don't have the resources (RNs) to meet the demands of the hospital census and the "ideal" RN-patient ratios go by the wayside. Granted, it's NOT the safest for the patients and not safe for us nurses. How do CA hospitals manage to keep the mandated ratios? Is the RN shortage less severe there, do hospitals turn patients away if there aren't enough RNs on staff. I admire the safe numbers you all maintain but just can't imagine how it really works.

Thanks!

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Strong, effective ratio laws are a critical factor in helping to mitigate the effects of the

nursing shortage. California, which adopted the first ratio law in the U.S., and Victoria, Australia, offer two good case studies.

Wow, thanks for this link...we have to do a project on a subject of our choice and my group chose "Why there is a shortage..."....this will help immensely!!

  • Author

Yes, thanks for the great link! I plan on printing it and sharing it with as many people as I can. I totally see the benefits of better ratios.

So now I'm trying to imagine...

Say your med surg unit has 35 beds. There are 30 patients at the start of day shift and 6 nurses, 5 patients apiece. What happens when someone's admitted to the ED and needs a spot on your unit before anyone is discharged or transferred? That would mean someone would have to take a 6th patient. Right?

Or does your unit always staff with the assumption that the unit could be full on any given shift and so there'd always be enough RNs?

I'm trying to picture how it all works.

Where I work we make staffing decisions for the next shift two hours prior. So the census at 1pm determines the number of RNs who'll work the 3-11pm shift. If we get tons of admissions at 7pm, oh well, you suck it up even if it means having 6-7 pts on a tele unit.

Again, thanks for anyone willing to humor me and explain how it works for you.

Where I'm working, if the ED has a patient to transfer and there is no nurse to care for that pt. (all nurse's on admitting unit are fully loaded with 5 pts), that pt. sits in the ED until a space can be found, or more staff can be called in. It can back up the ED quite a bit, with all the holds taking up beds, but we are not asked to take a higher load than we can handle/ratios mandate.

Hope that makes sense.

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