Are your Nurse to patient ratios changing

eriksoln, BSN, RN · Oct 27, 2009

Sicker patients and more of them to take care of is the norm. No secretary or CNAs on nights. Welcome to the future of nursing. We are nothing more than a line on the hospital expense report.

I feel that way a lot of times too. Facilities being very obvious about how they consider nurses debts not assets. But, call off or not allow yourself to be available and.............wow, they don't know what to do with themselves. You'd think since we are simply a debt.........they'd be happy.

vivicaq · Oct 27, 2009

Is the trend any different in magnet hospitals?

*ac* · Oct 27, 2009

Magnet here.

Don't get me started.

Mollypita · Oct 27, 2009

I work in a 320 bed, non union hospital. Over the summer our matrix just magically "changed" to increase the patient load- no explanation, nothing. We only knew because it was posted on a clipboard for the charge nurses to see. It makes a big difference on night shift, which I work. I'm curious what has happened at union hospitals? Any differences? I'm staying where I am for now, but I definitely look forward to the day when there's a nursing shortage again...

nurse grace RN, BSN · Oct 27, 2009

magnet is no different

ObamaRN08 · Oct 27, 2009

I work for a magnet hospital, and it is no where near as bad as what you all have written. Our ratio is 1:3 in our stepdown, and 1:4 in med-surg, however is is not uncommon to only have 3 on medical. We have rapid pt turnover, we may discharge 2 and get 2 admits, but we have an admission discharge nurse everyday but sunday and she does all the teaching too. Its a 32 bed unit. We were recently having a staff shortage and when staff complained that they were getting 5 pts to 1 RN they hired travelers to help out until our orientees were all trained. We have patient care assistants each one takes 8 pts. and we have 2 unit secretaries during the day and 1 at night. We also have a unit tech that fills our carts with supplies everyday and helps strip the rooms after discharge. I love my facility. they listen and try very hard to keep us happy. they know that happy nurses make for happy patients. we share in leadership, the staff interviews applicants, We have a say in nearly all unit decisions. We have problems as every workplace does, but nothing major... Granted it is a For-profit hospital, and I think that probably makes all the difference in the world. When nurses on my floor complain, I can't help but ask them if they realize how spoiled we are. We have got it much better than I think they realize. I wish all of you could have the same experience. I love my job and I enjoy being there. Not every hospital is horrible to their nurses. Some places spoil them!!!

Ayvah, RN · Oct 27, 2009

Obama, that's pretty amazing. Our med surg unit is 1:6 days with us doing about half our own admits, and we do our own discharges, and all the education. I didn't even know discharge nurses existed! I'm curious, are you in a state with mandatory ratio laws, like CA?

ObamaRN08 · Oct 27, 2009

No I am in Indiana, nothing is mandatory. we will sometimes get nurses that come from places with 1:6,7,8 pts and when we tell them we only ever get 3 or 4 they nearly keel over, when we tell them we have an admission discharge nurse they say I think i died and went to heaven! lol

vivicaq · Oct 28, 2009

In some places managements does not want to acknowledge that nurse to patient ratios have gone up, sadly patient acuity has also gone up. I would hate to see someone injured before something gets done. Nurse to Patient ratios need to be signed into law. Enough of this crazy mess.

Mollypita · Oct 28, 2009

ObamaRN, that's fantastic!!! If I worked there, I wouldn't complain either!!!!!!

nursenewbe · Oct 28, 2009

I work in a nursing home that had 1 nurse to each floor and about a month ago they dropped a nurse. So now one nurse has 40 patients on nights, and she has to count two med carts, give report to two nurses. For the past week, I have been getting off from work at 9:00a. It has really begun to **** me off. Around 8a, I begin to get cranky because my body is shutting down better yet my brain is shutting down from all the critical thinking that I do all night long. It is crazy out there. All of the staff nurses are quitting. This seems to be happening nationwide. I also work in a hospital, where if they can do without the techs they will make it happen. This hospital makes the charge nurse take patients and be in charge which is utterly impossible. I am a new nurse and after a month I am already having second thoughts. I detest the idea of staying at work until 9a when I am suppose to leave at 7:30a. I am so frustrated, I really don't know what to do.

ChristyRN2009 · Oct 28, 2009

I work stepdown and we have 1 RN to 4 patients. They staff for it, and we are constantly checking to make sure all nurses have 4 patients. If more than 3 nurses have an open bed, we get "the frown" from management. Nevermind that safer patient ratios are 1 to 3, it is and always will be 4 and although we have a free float charge RN, she/he can and is supposed to take up to two patients before calling anyone in. At least 1 RN per shift is put on call on average, lately more, but they get called in frequently too. I was told at the beginning of working there that for our unit we should have 2 CNAs/PCAs at night, 3 during the day. We have since added more beds, but still only 1 PCA at night, 2 on days. They stopped pretending that they would hire more PCAs for nights. I was also told that technically we could have 2 secretaries at night if we had enough patients. We always have enough, and we NEVER have 2 secretaries at night and usually only 1 during the day too.

So the changes I've seen is that where they used to at least pretend that they were trying to get more ancillary staff, they've dropped the facade. And even though the charge taking 2 patients has always been unit policy, it wasn't really encouraged or enforced and now it is.

There have been other changes lately not related to staffing though that make it suck a little more to work there every time. You can just feel it getting worse, and I feel a little crispy around the edges as I face what's going to be a difficult winter anyway.

I've heard this hospital is not the best in my area, so I feel like its time for me to start looking for another but I'm stuck by personal situations that can't tolerate a break in income.