ER patient ratio & ancillary staff question.

[Hrtnurse14]

Hi,

I am wondering if people could share what the nurse to patient ratios are in their ER's and also if they have ancillary staff ie Techs, EMT's, Medics, LPNS, CNA's etc and what they do. The facility I am at the ratio is usually 3 or 4 to one nurse unless we get hallway patients. We have tech's but they only draw blood, EKG's, and some wound care. Occasionally we have a CNA for transport. I am fairly new to ER and am thinking of seeking another position but am not sure what an "ideal" ER set up would be and if there is even one. Thanks for the input!

Hrtnurse14

[mommatrauma, RN]

We have a set amount of nurses and ancillary staff, but thats the only thing that is set...Our ratios depend on acuity..and because the ER is ever changing in can really vary from shift to shift...As for our ED techs...all are IV certified. Our techs can, transport, vital signs, ekgs, blood draws, IV insertion (both adults and peds), cpr, set up chest tubes, stock, crutch training, wound irrigation, and I'm sure there are other things I am forgetting...They are a great help and compliment to the nursing staff.

[EDNICENURSIE]

At my ER we are equipped with a 15 bed ED, we have anywhere from 4 to 7 nurses at any given time, we usually have at least 3-4 hall patients, we have one Paramedic and one aid ( if we get the aid at all). Our hospital opened up a cardiac intensive care unit and performs anywhere from 15-30 cardiac caths a day ( most of those pts present through the ed) and they do about 30 open hearts (CABG and valve replacements) a week. an average day at my ed we see and triage anywhere from 80-120 patients with 15 acute care medical beds ( one of which is a psych solitary room) and we have 2 minor care beds. lately we have had to hold our admissions to wait for beds to open up on the floor and most of the time we are on condition because all of our ed beds are used up for admissions. i would like to think that its very different every where else but i am sure that its all the same.

[ANN2WATER]

Our situation is like mommatrauma's. We have a set number of RN's and tech's. Patient acuity and census is extremely variable, as it is in all ER's. That's the nature of the beast.

It's the quality of the people on your team that seems to make or break the day.

We have an 11 bed ER in a rural area, which sounds like gravy to some...but, consider a job where you are creative, often self-sufficient, and always ready, literally, for anything. There is no urgent care center where we live (rural eastern Maryland) and the geographic area we serve is quite large. Ergo, anything, at any time.

We staff, on a good day, 2 RN's 7a to 11a, then add an 11a RN, then a 3p RN, then 2 7p RN's. There is usually 1 tech on 7a, and one 7p or 7p to 3a. There is a secretary (with nerves of steel) on 7a, and one on 7p. That's our "usual", and our ideal; of course, it's certainly not the daily expectation.

Ann, in Maryland