Can someone please explain this to me in plain english.

[TylenolPlease, BSN, LVN, RN]

Quote

Licensed vocational nurses (LVNs) may be counted to meet the ratio requirements. LVNs may constitute up to 50% of the nurses assigned to patient care on a unit unless RNs are required pursuant to the hospital's patient classification system.  Psychiatric technicians may also be counted in the ratio but in psychiatric units only.

I understand it, but then don't understand it.  For example:

Emergency Room:  Fast Track -----> More than 15 patients at a time sometimes 20.

Does this mean that LVNs cannot care for more than 1/2 of these patients alone?  Should there technically be another LVN on the floor or RN?

In the Emergency Room Psychiatric Department when there are (4) patients assigned (2) sometimes (3) needing total care; -----> Does this 50% apply to this too?

Thank you!

[Nurse Beth, MSN]

The # of RNs is driven by the number of patients.  With a nurse-patient ratio of 1:4, 40  patients require 10 nurses. Half of those nurses can be LVNs, so 5 LVNs.

Here's the regulation:

According to CA regulation, in the ED, an RN may care for no more than:

1 critical patient (defined as a patient requiring constant bedside care and/or frequent interventions)

2 semi-critical patients (defined as a patient requiring frequent interventions, such as medication administration or monitoring)

4 non-critical patients (defined as a patient requiring intermittent interventions)

I hope this helps. 

[TylenolPlease, BSN, LVN, RN]

Nurse Beth said:

The # of RNs is driven by the number of patients.  With a nurse-patient ratio of 1:4, 40  patients require 10 nurses. Half of those nurses can be LVNs, so 5 LVNs.

Here's the regulation:

According to CA regulation, in the ED, an RN may care for no more than:

1 critical patient (defined as a patient requiring constant bedside care and/or frequent interventions)

2 semi-critical patients (defined as a patient requiring frequent interventions, such as medication administration or monitoring)

4 non-critical patients (defined as a patient requiring intermittent interventions)

I hope this helps. 

Hi Nurse Beth,

So just to clarify.  If there are "40" patients in the ED (Fast Track) does this rule above still apply?

Thank you!

[Nurse Beth, MSN]

TylenolPlease said:

Hi Nurse Beth,

So just to clarify.  If there are "40" patients in the ED (Fast Track) does this rule above still apply?

Thank you!

Yes, it applies. The law (nurse-patient ratios) does not change based on the number of patients. There's no separate provision for Fast Track.

[TylenolPlease, BSN, LVN, RN]

Nurse Beth said:

Yes, it applies. The law (nurse-patient ratios) does not change based on the number of patients. There's no separate provision for Fast Track.

Hi Nurse Beth,

Wow!  It amazes me on what our Hospital's get away with.  SMH, and they wonder why human errors occur; being out of compliance contributes to these errors..... 

Nurse Beth, Thank you for the clarification.  

 

 

[Tired nurse]

How is it nursing homes get by with using LPNs on units with med Surg post op pts those pts need RNs. Most  are not IV certified? I personally have refused to work those units as a travel LPN. The ratios are to high usually 1-15. Not worth the risk!