ED ratio across the US

Specialties Emergency


Specializes in SICU BICU MICU ED PACU Homehealth.

Hi everyone,

I am curios to know what is your ED nurse to patient ratio. Please say what city and state your ED is in + nurse/patient ratio + level of ED (I, II, III) + acuity level (high/med/low) + patient turn over rate in your 12 hr shift (eg., 8 patients per shift) if you can remember or per year if you know.

Also, how do you feel about the nurse to patient ratio you currently have

1) in terms of patient safety and satisfaction

2) in terms of your own standard level of care/ personal satisfaction from the care you have provided

Are you happy with it? Why? Why not?

Your response will be greatly appreciated!!!


Specializes in ER.

4-5:1, level III, anywhere from 7-20 patients in a shift, medium acuity

Specializes in Cardiology, ER, Hospice, Pediatrics.


Night shift

8:1 medium to high acuity in Level 2 trauma cntr.

number of pt's in 12 hours shift 18 to 24 usually.

1) not good

2) barely adequate with is poor on my personal satisfaction scale.

Specializes in Pediatric Intensive Care, ER.


Night shift

4:1 medium - high acuity, Level 2 Trauma, primary cardiac and stroke center

usually 12-14 pt's per 12 hour shift

barely safe; staffiing is always short and staff satisfacion low

becomes quite concerning when you are asigned/receive 1:1 patients and still must care for your other rooms - sometimes multiple times per shift, sometimes with more than 1 1:1 at a time

My hospital is a Level III, and we are generally 3:1 in Williamsport, PA. The acuity level is medium. I couldn't begin to count my patients. A majority of them are not in and out though. Patient satisfaction at my hospital is terrible because of the long wait times. But I think when we see the patients, we treat them pretty well. 3:1 is pretty good, and I don't think you'll get better for a medium sized metropolitan hospital. Nurse satisfaction is variable as in any case, but I think they don't realize how good we have it. Our ED has an urgent care center, so we only see class I through III type patients in the ED. The class IV and V patients go to the urgent care center. When we get vented or 1:1 patients, we try to cover each other and help one another out.

As other places, we're always short staffed, and there is never enough time to do it all. Cost cutting measures have hit our hospital as well. If someone calls in sick, we simply go short, and this can make for a long shift.

Specializes in ED.

Los Angeles

4:1, Level 1 high acuity, 60,000 pts a year.

Satisfaction is so-so. I'm totally stressed about the acuity of my assignments on a regular basis

Specializes in Emergency, Nursing Management, Auditing.

Los Angeles area, CA

4:1 Level 2 trauma center, acute stroke center, unsure of visits/year but probably around 50,000

Depending on the acuity area and turnover d/t availability of inpatient beds (we may work trauma rooms, regular ED or fast track) we may have anywhere from 2-20 patients per shift.

Patient safety is pretty decent until night shift starts at 7pm when we start getting crazy busy but losing staff and people wait in the waiting room for hours. We live in a very overpriviliged area where people expect to be seen RIGHT NOW for their hangnails and have no idea what a county hospital is like, but we also have some sick people who wait too long because our "customer service" module is basically "first come, first served." Therefore you can see where I'm going with patient satisfaction.

Specializes in ER.

VA, 1:4 or 5, varying acuity but usually medium to low, pt length of stay is average 150 minutes, Can vary from 65 patients a day to 120 patients, depending.

Patient safety is usually adequate, security however, could be better, more of a locked down unit.

Most days I feel I can provide adequate care but some days, I feel like I am having to neglect one or two patients in order to care for a higher acuity patient. I do think people in general expect too much of a "warm and cozy experience" versus emergency treatment of ill and injured. So a lot of time is spent getting blankets, pillows, drinks, food, etc, etc. I mean let a TV not work and you would think it was the end of the world.

Most days I like my job, others I don't. I am lucky in that I like 90% of the people I work with.

Specializes in SICU BICU MICU ED PACU Homehealth.

Wow! 7 comebacks! Thanks everyone! This is actually my 1st post and I enjoyed reading your responses.

My 1st ED: Chicago, IL

ratio 3:1 can go up to 4 if busy and maybe 5 or 6 if we start pulling pts to hallway (dt low bed availability or staffing). High acuity. but usually we are very organized and goal is to bring pt to floor as soon as admission orders are in. We usually bring pts to floors asap. Short staffed? call agency nurses. It's a level II inner city but as like everyED, we get everything from nothing to lots of things. We have the luxury of TV's too, so if the TV is broken - pt try to elope, sign out AMA... u get the pic. Pt's per shift normally 12-20 depending on acuity. 65000 seen in ED in 2008. 30 bed unit + 6 fast tracks. All agency RN'S LOVE our ED d/t patient ratio and complete set of monitors for every room. RN satisfaction - low turn over for staff (pretty happy).

2nd ED: Downers Grove, IL

ratio 3:1 and same as above. This is a Level I. Worked here as agency and everyone here seemed real happy about being in their ED. They have a lot of room for growth and leadership in ED.

3rd ED: Lakewood, WA

ratio 3:1 when I worked there as agency in 08. Level II. High acuity. RN Floaters in each pod to help you out.

4th ED: Takoma Pk, MD

ratio 4:1 to 5 to 6. Level II. High acuity. Other staff from what I gathered are happy about how they've grown here as a nurse in the ED bc of the craziness. 52 pt's in 8 hrs when I worked last night from 1p-9p. It was one of those days!

Conclusion: I like the 1st 3 ED's I've been in. Patient safety is our #1 priority and I started this thread bc I was curious to know how others dealt with ED that has higher nurse to pt ratio with high acuity levels. I felt overwhelmed in this most recent ED I am in. I guess this ED I'm in is not that bad compared to 5:1 and the 8:1!!! How do you survive your shift? Take it day by day?

Thanks again everyone!

Specializes in ED, Clinical Documentation.

LI, NY Level 1, three ED areas

for critical level 2 and 1s ratio was: 1:3 or 4

for level 2 and 3 it was 1:6-10

for level 4 and 5 it was 1:11

peds (level 2 and 3) it was 1:4 or 5

so stressful

now i'm a traveler

NYC Peds ER level 1 ratio 1:3 or 4 or a real 1:1 for a critical

California 1:3 or 4

I feel like I'm on vacation some days considering where I came from.

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