How many patients do you have as a Psych. RN?

Specialties Psychiatric

Published

I'm a new grad who applied for an RN position in a psychiatric hospital. My duties would be to chart, doctor's orders, admissions and discharges. I will have 20 patients, but I'll have another nurse administer medications, and MHW help and interact with patients. I would do a quick "check-in" with patients to assess their affect, but other than that the manager said that the RN doesn't interact much with the patients since the RN is responsible for 20 patients. Does 20 patients sound resonable? remember, I don't administer medications. I will be in charge of the unit and if anything happens it is on me. So does that mean I could lose my license if a patient gets hurt e.g. committs suicide due to lack of observation by a MHW?

Thanks.

In California it is MAX of six...twenty...that is scary, how can you do your rounds and take care of 20 people? With potentially suicidal patients...20 is way too many in my opinion.

Can you elaborate? Are you doing meds and VS and all direct care for 6 patients? Or do you have aides, a med nurse, a clerk, other staff?

What shift do you work? And do you work Psych?

Thanks!

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Specializes in Psychiatric.

When I worked inpatient, we worked a 26 bed acute adult/15 bed geriatric unit. I worked nights and we usually had 1 nurse per 10 pts, and a total of 4 techs, 2 per unit...I can only echo what the others have posted...I love psych and won't do anything else! :) Good luck!

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OP, where are you?

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Wow - I can't believe the ratios some of you work with - how do you form therapeutic relationships, and work through issues with that many patients?

On my unit we have a mix of nurses and youth workers. As a nurse I have direct care responsibilities for 3 patients and med/nursing responsibilities for 3 more. However our model of care is that nurses are the front line workers - we do all the groups, individual talk times, sit with the patients during meals, deal with families, do safety planning, run recreational activities, manage crisis etc... as well as the admissions, orders, meds, careplans, nursing care. For safety reasons I need to know where all my patients are all the time...no way I could keep track of more than 4!

On nights the nursing ratio is 1:7 and there is a youth worker overnight as well.

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Specializes in Psych.
In California it is MAX of six...twenty...that is scary, how can you do your rounds and take care of 20 people? With potentially suicidal patients...20 is way too many in my opinion.

The most I ever had as a student was six and I felt like I was sprinting on those days. Twenty patients means you have 3 minutes per hour to devote to each one. I can't even imagine how you have time to read their charts, do their assessments, update their charts, AND manage all the inevitable 'stuff' that seems to start happening simultaneously (e.g. as you're in the middle of figuring out why someone's blood sugar is too high, someone else becomes agitated and is escalating, and whoa...naked guy just went running down the hall...)

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Wow, things are certainly different in the USA compared to Australia. I am a new graduate in a government hospital, a 25 bed adult inpatient unit. On average I would have 4 - 6 patients, generally around 5, for whom I give medications. We have cleaning and kitchen staff to hand out meals, clean etc, but we do everything else.

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Specializes in Adolescent Psych, PICU.

We have up to 27 patients. On day shift we have 2 RNs (one is charge and the other is med nurse) and 3-4 mental health techs. At night (which is when I work) we have 2 RNs and 2-3 techs. I find it very adequate and feel safe with our staffing ratios for my unit.

I have to say though that I do NOT work on an acute unit. We rarely have a patients who are suicidal and they are not violent. We do not have medically unstable patients. I work in a locked RTC with teen boys (sexual offenders). If they become violent we ship them out to the acute unit.

Sometimes a nose gets broken or a fight between 2 boys breaks out or there is a therapeutic hold, any suicides are 1:1 and at night they sleep in the hall so we can watch them all night. We have NEVER had a patient kill themselves or attack a nurse.

I feel very blessed to have my job and love it :)

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Specializes in Psych.

Holy Cow! 20 to 1????? I work on a 26 bed adult acute care unit. On the day shift we have 4 RN's, 2-3 MHW's and 1-2 PCA's, about the same on eves, nights has 2 RN's and 2 or 3 PCA's. We pass our own meds, chart, go to team meetings, and actually usually get to spend time with our patients (altho the paperwork is getting WAY out of hand). I don't know how you do your job with 20 patients, but from reading the other posts, it sounds like your situation is not so unusual. I'll keep my job, thanks.

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Holy Cow! 20 to 1????? I work on a 26 bed adult acute care unit. On the day shift we have 4 RN's, 2-3 MHW's and 1-2 PCA's, about the same on eves, nights has 2 RN's and 2 or 3 PCA's. We pass our own meds, chart, go to team meetings, and actually usually get to spend time with our patients (altho the paperwork is getting WAY out of hand). I don't know how you do your job with 20 patients, but from reading the other posts, it sounds like your situation is not so unusual. I'll keep my job, thanks.

Is this Psych?

I'm so frustrated that the OP hasn't come back. I guess she took the job and is too busy. :lol2:

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Remember, although I'm responsible for 20 patients I'll have a med nurse and 2 MHWs. My responsibilities are admissions, discharges, dr's orders, answering the phone, blood draws, and supervise the other staff on the unit. My only concern is if it is manageable for a new grad. Orientation is twelve 8-hour-shifts. I will also be floating to different psych. units.

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Remember, although I'm responsible for 20 patients I'll have a med nurse and 2 MHWs. My responsibilities are admissions, discharges, dr's orders, answering the phone, blood draws, and supervise the other staff on the unit. My only concern is if it is manageable for a new grad. Orientation is twelve 8-hour-shifts. I will also be floating to different psych. units.

Lion09, Do you have any response to my posts? Did you take the job? How's life going for you?

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

The worst day I ever had in the hospital, I arrived on the unit to find that we were staffed with two CNAs and me. I had 16 patients on the floor and two admissions waiting in the ER that would put us up to our capacity of 18. I couldn't delegate anything - meds, charting, admission paperwork, nothing. I later found out that my nurse manager had deliberately staffed the unit like that (it wasn't an emergency situation due to call-offs, etc.). I told her that if she ever left me staffed like that again I would refuse the unit - and I'm pretty easy going and adaptable.

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