ER staff to patient ratio and acuity

[sreynolds]

We have a 37 bed emergency department. We are always 4:1, and 2 lucky nurses each shift (who still have a zone of 4 to run) gets to do trauma and resuscitation as well for the entire shift. I'm curious how it is for the rest of you. I had 4 level 2 patients in my zone for over half my shift....2 were pediatric patients on droplet precautions who required Q 15 hour vital checks, one was there for chest pain/arrhythmia, and the tech brings me a stoke alert who I had to stop what I was doing and take to CT. Is this a common theme in ALLLLLLL emergency rooms so I need to just suck it up? Or is this a bit much? I did t get any support when I approached my charge nurse about my concerns. She said there was nowhere else to place the level 2 patients except in my zone since I had rooms open up after I discharged my patients.

How is it at your emergency room? Is this just how it is!!??

[Lev, MSN, RN, NP]

We have separate adult and peds sides, and I only work adult. We are not a trauma center. However, we have a lot of codes and high acuity patients and any nurse can get those patients. Usually once you get a cardiac arrest or vented patient, you won't be sent any more patients until that patient is settled. Our ratio is 1:3-4. People with the 3 room assignments are supposed to be floats too. The main ER is a mix of 2s and 3s with a couple 1s scattered throughout. The 4s and 5s are treated in the fast track area. Late at night, sometimes the main ER will start seeing 4s and 5s since the fast track area will close.

[PAEMT]

We have 8:1 (or 9 or 10) ratios. Sometimes if you get a code or vented patient the float nurse will take over care for a bit. If your lucky your ratio goes down when you have a critical.

[turnforthenurse, MSN, NP]

We are either 3:1 (acute side) or 4:1 but that depends on staffing. Lately the charge nurses have been good at not loading up your rooms when you have a critical patient.

But to answer you question, it is like that at some places, unfortunately.