Nurse/Patient ratio in the ED?

[jlan79]

I'm looking to go into ED nursing and I was wondering what is the typical nurse to patient ratio on a relatively busy day. The program I interviewed for mentioned 7-8 patients and I thought it was a lot, especially in ED. Is that a lot? Or am I being unrealistic?

[Robublind]

Wow those ratios sound lovely.

Per our union contract our ratio is supposed to be 6 patients to one nurse.

On average I'd say we run about 7-9 patients each

and on most bad days (which are pretty much every day) we have up to 15 patients each.

YEP 15!

I think you guys need to talk with the union rep about this. 15 is unsafe for the pt and your license.

[sapphire18]

I think you guys need to talk with the union rep about this. 15 is unsafe for the pt and your license.

I agree. I would never accept an assignment of 15 patients in the ER. I don't even understand how that is possible.

[emtb2rn, BSN, RN, EMT-B]

I agree. I would never accept an assignment of 15 patients in the ER. I don't even understand how that is possible.

Agreed. Totally unacceptable. Even in fast track.

[Esme12, ASN, BSN, RN]

15:1.......I have worked in some of the busiest departments in the country and while I have had really bad shifts, 15:1 is unsafe and unrealistic. I have also worked for Union facilities and I know of no Union that would support this. I'd be filing some grievences

[GleeGum, BSN, RN]

I'm very curious to know what states you are in. Are these state mandated ratios or department imposed ratios? How do your departments pay for the extra nursing salaries? Were you always at those ratios? If not, how did you get to good ratios? (And i mean those lovely ratios os 1:4, etc.) I am now in a Level 1 with ratio max of 1:10 (main level 2/3 and 3) and I've seen 1:6 in the level1/2 area. It's insane.

[jbsul]

Usually in my department we do a 4:1 ratio. This does depend on patient acuity and can change during the shift. If a patient is very critical nurses may go to a 2:1 or 3:1 depanding on staffing. Also in our rapid medical evaluation area 6-7 patients is not uncommon. These patients have less acuity and require less resources.

[emtb2rn, BSN, RN, EMT-B]

Manager does staffing based on average census. It's been unusually busy the past few weeks, so we've been getting additional staffing. Yeah OT!

[brainkandy87]

For these people that have 10:1 and 15:1 ratios.. did they tell you these ratios when you interviewed? I'm not sure I wouldn't stop the interview and say "not interested, thanks for your time" if I were told 10:1.

[That Guy, BSN, RN, EMT-B]

4:1 unless.

Until a trauma, Code or some other variation of **** hits the fan...

[Frizbeeboy]

Fast Track is 5:1, Main ED is 4:1, and both can go up by 1 if it is busy. I dont understand how people could safely do 8:1 or 10:1. I am wondering what type of ancillary help these higher ratio's get. My facility has the nurse doing much of the care. Techs do transport/ekg's/occ. phlebotomy/some VS/some personal care. I know other places have techs doing a lot more which would make a bit higher ratio possible.

[CrashED]

It completely depends on the environment you are working. My ED is broken into 4 parts, fasttrack where the ratio is 1:9, Acute where the ratio is 1:4-5, and Critical/Trauma area has a 1:2 ratio. In fast track or minors it is completely acceptable to have a 1:8 ratio as these patients are normally triaged to be qiuck see and sends.

[Frizbeeboy]

yes I agree that in a fast track setting 8 to 1 isnt a big deal. However I feel like some of the people here are alluding to main ed pts with that kind of ratio which seems quite challenging. Not to say it wont happen here and there on some ridiculous night. It should not be the norm. It also does depend on the staffing mix and how much support staff is there.