Day Vs. Night Ratio?

Specialties Med-Surg

Published

  1. Does your patient ratio change from shift to shift?

    • 17
      Yes, and it should.
    • 6
      No, and it should.
    • 13
      Yes, and it should not.
    • 14
      No, and it should not.
    • 1
      I have other opinions and will explain in detail.

41 members have participated

Does your nurse to patient ratio change from day shift to night shift? Do you think it should? Do you think it's fair if it does or doesn't?

Ours doesn't. Max 6 patients on days, max 6 patients on nights. While I don't think night shift should have more than 6 patients, I would like day shift to be capped at 5 patients. I wouldn't say that it's not fair that we have the same amount of patients on day shift, but I still feel it's easier for night shift to handle 6 patients vs day shift.

I am a new grad (4 months in so far) so take this for what it is worth. Both days and nights are very busy on our unit. I work a medical tele unit in a 900 bed hospital that takes 5 both days and nights. During days, we have a UC, charge with no patients, unit manager, CNM, techs with a 9-1 ratio and doctors on the floor. Nights we have a charge who often has to take 2 patients if we had anyone on call before she can call that person in, 12-1 ration for the techs, no UC, no docs on the unit, no manager, etc. Days typically starts with 5 patients, but very often they are discharging patients and having patients off for lengthy tests, so they frequently do not have 5 on the floor all day. We almost always start with 3-4 on nights and are all the way to ratio by morning. I do 1-2 admits almost every shift. I think it's a little telling when we fight to see who gets to start with 4-5 rather than 3-4. My nights are so much easier typically when I start with 5 rather than 3-4. I have done admits and discharges and I find admits to be way more time consuming. ER tends to send unstable patients in pain and I often wind up tied up in a new admit for 90+ minutes. At least once a week one of the nurses is calling response on a new admit and they often wind up leaving for the Unit before they ever get settled. Waiting on a doc to call back at 0300 when your patient is in afib w/rvr with nothing by po lopressor ordered is stressful.

I think both are very busy. Personally, I like the flow of nights - fewer tests, docs, families, etc. Nights do have 24 hour chart checks, careplans and a few other daily charting requirements that days don't have to deal with. I don't think we should have more than 5 on nights, but 5 on days seemed like far too many when I precepted there. I don't know if with more experience it wouldn't have been quite so overwhelming (I really didn't have my time management down at all before I switched to nights).

We got 1:4 be it night or day.

Specializes in RN.

I work noc, I do understand the "busy-ness" that is dayshift. However, to assume that noc is easier across the board is naive and not safe. There should be what I would call "micro-managing" in place. What I mean by that is; acuity must be taken into account, are the pt's 1-2 assist, behaviors-are they on the call light all the time?...we get admits on noc shift also. How about when E.R. sends an admit to the floor at 6:55, or even 6:15 and dayshift didn't have time to do anything except get some vitals? (happens often).

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