Charge Nurse Patient/Nurse ratios

[jzuba]

Hello,

I am a clinical nurse manager of a Neuro/Trauma ICU and a medical/surgical telemetry unit. We are a 254 bed medical center. I have been charged to determine nurse/patient ratio for charge nurses. We have done some tests of change in our facility to determine nurse/patient ratio for the charge nurses and the smooth flow of unit acitivies. I strongly believe that charge nureses need to take reduced patient assignments.

I would like to know:

1. How many patients are assigned to the charge nurse on your unit?

2. What type of unit and the bed size of the unit.

3. Hospital size

4. Did you do any education for staff?

Any other information that you think would be helpful is greatly appreciated.

Thank you,

Jeannine

[NCRN-29]

I am a day-shift staff nurse on a 45 bed medical surgical unit. 166 bed rural county hospital. The charge nurse on our floor usually "floats" without a patient assignment. When she does need to take patients, it is a reduced load of less than 5. Average staff nurse has 6-8 patients on day shift. It is definitely nice to have the charge nurse freed up from a specific pt assignment---I have been on both sides of the issue.

[lee1]

You are in charge of both an ICU unit and a med/surg unit with telemtry??

First know your state hospital regs

Second, look at what AACN recommends as your critical care expert association

What is the acuity of your patients

What is your knowledge/experience based RN group like. What is the mix

What is your ancillary help mix

What other support structures exist in your hospital. For example, who is transporting your patients to testing, procedures, etc. Who is taking your patients to the front door for discharge, etc. Any reason why the RN would have to leave her patients and WHO is covering them. Who is drawing labs, etc. Who is running the lab draws to the lab, etc.

Who is mentoring/problem solving on a daily basis

Who is covering meals/breaks/committee meetings

How difficult is it to get help with call outs/ vacations. etc.

Now, think yourself, if you were in the staff RN shoes how you would practice safely/ educate your patients/ enjoy your job/ appreciate your worth to the hospital

A charge nurse should be just that-----someone able to make capable decisions, problem solve, be available to help out with deteriorating conditions which may occur at any time, cover breaks, mentor staff, be someone staff respect, etc. What is the point of a charge nurse if you have overloaded them with patients and they can not see beyond their own assignment.

If you have a daily Head nurse who is present on the unit. If you have a Director who is present on the unit.

Lee

[SHAMROCKY]

I work in an 8 bed med/surg ICU at a 350 bed level 1 trauma center (a university teaching hospital). Our Neuro ICU is 8 beds also. The charge nurse on each of these units NEVER has more than 1 patient. More often than not they don't take a pt. assignment. They are usually busy dealing with staffing issues, rounding with the teams, going to committee meetings, writing staff evaluations,etc.

[begalli]

1. How many patients are assigned to the charge nurse on your unit?

None. Charge is staffed by any one of four assistant nurse mangers (day and night) or a large variety of staff nurses who choose to do charge for premium pay, staff level credit, and a change of pace. The charge nurse is not "in the count" when considering staffing and ratios. None of the staff or management that fills the role of charge nurse in this hospital -unit or floor- has a patient assignment, but they are all RN's.

2. What type of unit and the bed size of the unit.

25 bed Cardiothoracic ICU (staff of ~100 RN's).

3. Hospital size

University/teaching hospital. 433 beds. 718 full-time RN's, 628 part-time RN's; 21 full-time LPN's; 30 part-time LPN's (as of 11/04).

4. Did you do any education for staff?

Yes, quite a bit.