What's your nurse pt ratio?

lisamct · Nov 18, 2002

I work in a complex needs learning disability unit. We work short 8 hr shifts,both day shifts we have minumum of 3 staff, 1 nurse and 2 or most times 3 nursing assistants to 10 clients.night shift goes down to 1 nurse and 3 n/a's between 2 units, 20 clients.

OUr staffing does look good on paper, but in practice its still inadequate

Lisa

askater11 · Nov 18, 2002

I work afternoons on an angioplasty/ICD insertion/EPS floor. Most of patients need (B.P/groin) checks every 15 minutes x 5, every 30 minutes x 4, every hour x 4 upon arrival from CCL. When their ACT's low enough to pull we start the every 15 minute x 4, every 30 minute x4 ect. While we hold manual pressure our B.P. cuffs set every 15 minutes.

We have 2 seperate matrix's: weekday/holiday & weekend.

Weekday it's 3-4 R.N.'s, 2 secretaries until 7 P.M. then we're down to 1 after 7 P.M. we're supposed to have 3 P.C.T's but we're lucky to have 2 P.C.T's. (we usually have a N.T. work the floor and we cover all her meds and telephone the Dr. for her....also there's been a time we've had 4-5 patients)

Weekday we have 5 patients per R.N. 1 secretary that leaves at 5 P.M. 1 P.C.T. The weekend staffing is horrible. And on Saturday we do have a few patients going to ccl.

Nope we're not adequately staffed. When I first started working this floor the staffing was a lot better!!!!!!

I get out 15-30 minutes late about every 3rd time I work. Rarely do we get dinner, and if we do it's around 8 P.M.

Jay-Z · Nov 18, 2002

I worked in a combined Surgical High Dependancy Unit (usually 6 pt)/ Overnight Intensive Recovery Unit (8-9 py)

On HDU days we had 1:2 and 2 NA (Nursing Assistants), one shift leader/ runner and one clerk (office hours usually)

so 6 Nursing staff.

On OIRU days we had 1:1 with 3 NA's one clerk and 2 runners, so 13 staff, so it was alright but sometimes we could have more pateints than expected, especially when doing recovery because of overcrowded theatre lists and dealys going back to the wards:p

Nurse Nevada, RN · Nov 19, 2002

I work in Med-Surg. Here in Las Vegas on the day shift we have 8 or 9. It keeps climbing because we have the lowest number of nurses in all 50 states. It's very unsafe. Night shift has 13 patients sometimes. If anyone would like to help us lower the ratio, please come sign a petition to get it lowered at:

http://users.lvcm.com/nursenevada

California had a mandate passed through a petition and we are trying to follow in their footsteps. California nurse-to-patient ratio now has a limit set at 6:1.

Thanks for your support in signing.

Dianne Moore, RN

Genista, BSN, RN · Nov 19, 2002

Just wanted to thank everyone for the posts.

As a California RN, I want to remind everyone, that our nurse patient ratios have NOT gone into effect yet. The legislation has been in the works for several years now, complete with hearings and public forums, etc. Nothing has been finalized yet, and none of it has been implemented. I was a new grad in 1998 when the legislation was pending, and I remember trying to garner support from my coworkers and staff. It's been over 4 years, and no, we haven't seen the ratios implemented yet. We are still arguing over the ratios!!!!

In my current job, for example, we normally staff 7 patients to 1 RN on some floors of our acute care hospital on NOC shift (med/surg). And on one bad night a few weeks ago, one of our RNs had 10 patients on NOCs med/tele all to herself for a few hours. It was a night from hell for her. You can fill out assignment under protest till you're blue in the face, and it won't stop the short staffing. I know, I've seen & heard & filled out many.

For those who want to read the latest info, California Nurses Association has updates on AB394, and when we will "really" have implementation of the new ratios:

http://www.calnurse.org

Also, the problem with the CA ratios is that it is worded as a "nurse patient ratio," not RN to patient ratio, which leaves RNs open to "covering" who knows how many patients of an LVN. Don't get me wrong, I love a good LVN, but it's darned scary to "cover" huge LVN assignments. Case in point: on my new floor in the hospital, the night shift routinely staffs the floor 7 patients per nurse on one med/surg floor. We had a census of 14 the other night, with 1 RN, 1 LVN. This was normal staffing to matrix. The RN is legally responsible for all 14 patients. This is acute care folks. As an RN, I find this scary!

Ps- Dianne (aka Nurse Nevada)-

You bet I signed your petition! :roll

I hope you get even better ratios than we do!!!!

Burnt Out, ASN, RN · Nov 20, 2002

Originally posted by kona2
I am curious what skill mix others have & what nurse patient ratios are in other hospitals. For those of you who are willing to share:

What's your nurse patient ratio?
What shift?
What floor/setting?
Who else is on your "team" (ie CNA, LPN, etc)?
Are you adequately staffed, in your opinion?
Do you get off work on time usually?
Are you usually able to take a 30 min lunch break each shift?

My usual nurse/patient ratio is anywhere from 4-6 patients per RN AND we are to assess and do IV pushes for 3-4 patients that LPNs have. This doesn't even count by the time we get admits..

I work 7am-7pm on pulmonary/med/surg

Sometimes we have 2-3 NAs to split 38 (when every bed is full)patients.

NO I DO NOT THINK WE ARE ADEQUATELY STAFFED!!!!!!!

Most of the time it is 7:30 or 7:45 pm before I am able to leave...

I usually am able to eat lunch.....but somedays:rolleyes: :stone

Bluebarn · Nov 20, 2002

I work the 3pm-11pm shift on a Med/Surg floor that also includes pediatrics. Our ration is usually 5:1 or 6:1.

Approximately 1 CNA helps with every 10 patients. The RNs do some assessments and IV pushes for LPNs. A unit secretary enters many of the orders.

I feel we are adequately staffed about 60% of the time.

Lunch brakes are closer to 15 or 20 minutes in length.

I leave an average of 30 minutes late every day. Charting, of course, is what keeps me late.

rebelwaclause, ASN, RN · Nov 21, 2002

Med-Surg,

Small hospital (20 bed) in California

1:4

Usually a LVN (me) for RN to cover.

Shevalove · Nov 21, 2002

LTC care 32 Patients, 7-3 shift has one RN, 3 CNA's, Evenings had 1 RN, 2 and a half CNA's, third has one RN and two CNA's. NO MED TECHS

I spend almost the whole shift handing out meds. I feel they don't get the attention the deserve from me, but the CNA's at my facility are awsome

Zee_RN, BSN, RN · Nov 21, 2002

Intensive Care Unit. (18-bed community hospital setting).

Ratio: supposed to be 2:1 but can easily be 3:1 (of course, manager says this 'rarely' happens...right).

Ancillary staff: sometimes an aide...depends more on their availability than on our need. We had 17 patients yesterday, all ICU, and no aide. None were available (all our aides are in school). Unit Secretary most of the time until 11pm unless census is low. Charge Nurse does not take a patient assignment. We are not responsible for lab draws (except central line), EKGs or ABGs.

WHen we are not full of Telemetry or Med-Surg patients who can't get transferred out (no empty--read that "staffed"--beds), it gets nasty. They drop our RN staffing but don't increase our ancillary staffing--so we could still have 18 patients and no aide.

Most of the time are staffing is 'adequate.' Not necessarily wonderful but adequate. Sometimes it is downright scary. This weekend I had my two ventilator patients and was watching another nurse's two ICU patients (one ventilated, one crazy 302 patient--she was off the floor with her THIRD patient at a two-hour long bleeding scan) and had to take a stat transfer from the floor too....that's five ICU patients, folks. WAAAAAY not safe.

fieryrn · Nov 21, 2002

I work all shifts..usually 7-3 or 7a. We have one CNA and one secretary on 7-3 shift , then no one after that. I work LDRP. we staff 4 nurses, 3 for the LDRP and 1 for the NBN on days. We have 13 beds. I am usually there at least 30 past shift change catching up on my charting. I do charge, precept, and take a patient load. Yesterday was horrible.....Just me and another nurse and preceptee....started off busy...called in another nurse at noon....got worse...should have gotten off at 3.....preceptee and I stayed till 2000...we had 8 admissions including 5 laboring ..no lunch...no breaks.....Is this typical? No, but also this senario happens regularly. I work overtime most weeks....My hospital has recently implemented a new program where we can no longer be posted overtime....but may pick up empty slots and make double our base rate of pay...nice...but all are wondering how long the new incentive will last. Also, rarely do we get breaks....and they are spent on the floor as is our lunch break...because the unit will be left uncovered otherwise. As you might imagine....lunch is rarely without interuption.

Nurse K-Bear · Nov 22, 2002

LPN- med/surg float pool large city hospital about 40 patients per floor most nights 3-11 shift

RN's 6-7 patients cover LPN's (blood, pushes, out of ordinary problems, first anitbiotic etc) or charge nurse covers LPN

LPN's 7-8 patients

CNA's usually12- 20 patients each

usually one LPN the rest RN charge nurse usually does not take pt

Usually no break or just enough time to use the bathroom. utter chaos!

Depending on wich floor I am on. Sometimes I just pass meds. start IV's, treatmens or do labs. Most times I take a full assignment and do good team work with the RN. (The barter sytem)

Now I work at a different hospital on the pediatric service 15 beds for general and intermediate units, where I float to a clinic or when I take an assignment I usually have 2 babies and 2 older children. RN's usually have higher acuity patients and usually have 2-3. Much less stressful with my new job!! I am so glad they gave me the chance!!