Are nurse patient ratio's safe with the numbers rising away?

[Aubrianna]

Are the nurse patient ratio's that are climbing it seems like monthly, even weekly to me. Are these numbers safe? Do we have a choice or a voice? We of all people (experienced nurses not me just new grad but I like to include myself) would know when enough is enough, when too much is too much but we do not regulate patient nurse ratio's.

Who does regulate those numbers the hospital or facility. I have been quoted 15 patients to me, and 32 patients to me in the same type of setting and nursing situation? Really, that big of a gap exists.

I think the nurses should be setting the standards. I hear too many times, its just not safe, I just don't feel good about this. Why in the world are nurses not in control of their profession? Are doctor's in control for the most part, sure. They space their appointments by their standards, they gauge the time they spend with each patient.

I think a nurse is the best indicator of an appropriate patient nurse ratio, who else does the job to know what is and what isn't.

I can't wait till the day the nurse has the voice that they should as an educated medical health professional with valuable insight that can only come from a nurse alone.

We need to take control. Who holds the ball when an unsafe ratio results in an incident? Who is always the responsible party. Who double checks everyone and everything anyone's done? Who is in charge of everyone and everything? I mean count in one day, how many times you are checking that another person did what they should have done correctly and while doing that taking responsibility for their actions? Our voice should be much louder.

[limey]

WELCOME to the REAL WORLD OF NURSING!!! Owners of places like the LTC, skilled nursing facilities, etc. only care about the almighty dollar they put in their back pocket. The more residents or patients they can pack in the facility, the more money they can stick in their wallet. You might as well face it now, they could give a crap less about you and the patients or residents. One thing they can never take from you is your passion for your career and the care that you give your patients. You are probably a godsend for some of the patients you care for because the owners making money off them could care less. It is so sad.

[Aubrianna]

Your so right. I just think that nurses are the ones doing the care and the one's who care? A nurse knows what is safe, not some person in an office. I guess your right, reality. I was actually told with the 32 patient load that even though my motivation for being a nurse is making a difference and KNOWING my patient, so I can treat them better. I was told I would not have time for all of that stuff, so don't waste my time doing it?? What?

I'm new and I am not sure if things are really safe or not, but I feel like I am doing what I should to protect the patients. Like you say, no one cares about what I care about.

I just think nurses need to take the active role. They should be determining patient load? Am I crazy? I spend time with my patients regardless, how can I tell if anythings wrong if I have no connection? This is really getting to me.

Nurses should be setting regulations because they put patients 1st. Now, how do you suppose we make that happen?

[DanaLPN]

I had a 33 patient load at a LTC facility once with only 2 (TWO!) CNAs on staff for each day shift and only 1.5 per evenings. It's hectic to say the least.

At the hospital I currently work it is 4:1 with a heavy utilization of CNAs. I ♥ it!

[TonyaM73, ASN, RN]

AH, 4 to 1 sounds like a dream job unless it's ICU. On med/surg we usually have anywhere between 5-7. Most of the time it is 6 or 7 to 1 nurse. It gets a bit busy to say the least expecially with admissions and discharges.

I started off with 5 pts the other day. DC #1 by 1pm, DC #2 by 3pm, a transfer to me at 4pm, admission at 4:15pm, admission at 4:30pm and 2 discharges at 6pm. Needless to say I was up to my butt in alligators! Thank GOD everyone was stable!

[limey]

Try 26 -30 pts and only 2 CNAs, plus being responsible for doing all paperwork for admissions and discharges plus (with another hair growing up the DON and Admins _ _ _ ) they decide to have us do monthly and quarterly assessments (more paperwork) on assigned residents. That tells me.. all they care about is being able to present paperwork quota to whoever. I made the decision that before I become incompetent to make my own decisions, I will have in writing that I am not to be placed in any nursing home for any reason whatsoever. Whenever my last days here on earth occur, they are to be spent at my home. Just place me in an area of the house where I can have food and water within reach, whatever necessities needed for my body's plumbing, a TV in front of me and someone or my kids or grandkids to check in on me once a day until I'm gone. I want EVERYTHING I OWN to go to my family, not some heartless, uncaring facility. I think the owners of some of these facilities should watch the TV show 'Undercover Boss'. It is great of these bosses to actually get down and dirty with their employees to understand what the business they so call "manage" is all about. It is true that for a business to take care of their customers, they must first take care of their employees. If a nurse in a facility works with their CNAs, be good to them and reward them once in a while, your CNAs will do good for you. Nurses need to have a say, since they know the resident better than anyone in administration. We need to be listened to!!

[txwildflower57]

Well, as a DON in a LTC I would like to let you know that my resident's care is #1. I make sure I see and talk with each resident each day. I also listen to my nurses and aides so I can try to make a better work environment for them. As for the paper work. I don't call the shots on this - the government does. These weekly, monthly, and quarterly reports are how the facility gets paid - oh yes and this is how you get paid too dear so you might want to pay more attention to what you are doing so you can get more money so you can have more help so you can spend more time with the residents. Just saying - that's the way I run my facility.

[TonyaM73, ASN, RN]

Oh believe me limey, I have been there and done that. I started out at a LTC with rehab and did the 20-30 pts with minimal CNAs to help. You are just as busy in the hospital with 7 pts as I was with 30 in LTC what with all of the iv medications and fluids, procedures, MD orders and other areas (pharmacy, PT, OT, ST, radiology, telemetry, etc.) calling you and adding more to your plate.

I have to say though that it is a lot nicer to be able to look up information on the computer rather than all the handwritten reports at the LTC, but sometimes more work inputting the information into the computer.

[APN Under Construction]

Nurses being the profession with the largest members, need to be there for each other. There's so much we can all do as nurses if we all speak in one voice, whether or not we are in that specialty.

[luckynurse_1234]

Agree with all of the above. I started out in LTC with 30 patients and 2 CNAs and the CNAs were so overworked and burned out they barely did a minimum. Next Med-Surg with a 4:1 ratio or 3:1 if they were recovering from spinal anesthesia. It was awesome and we were renowned for our "above and beyond care." Unfortunately we have a new nurse manager with an axe to grind so we are at a stated limit of 6 which gets a little crazy. I barely have time to get to know my patients let alone make sure they are happy with their care! I think there should be a federally mandated ratio because each individual nurse manager has an arbitrary idea of how many patients is "enough."

[LizN]

Currently in San Antonio, hospital patient ratios on MedSurg units are 6-7:1; and the hospitals are pushing an 8:1 patient/nurse ratio. Not safe!

[Zombi RN]

Are these numbers safe? Absolutely not.

Do nurses have a choice or a voice? Well, do you have a union?