How is your staffing ratio

Specialties Psychiatric

Published

So last weekend I had 14 patients to just myself and 2 techs. I hear this weekend will be the same. There are 15 for tomorrow. Now I have been a nurse a long time but this seems a bit much. Some of the patients are medical too as well as being psych. Would you consider this unsafe too or am I getting cranky in my old age?

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Our unit holds 14 pts. Depending upon the acuity & medical comorbidities, it can definitely be extremely overwhelming. I also have two techs unless we have 1:1 pts. We currently have 11 pts. & 4 techs due to having two 1:1 pts. I started off on a hospital med-surg unit with anywhere from 4-7 pts. so 14 has definitely been a challenge. Good teamwork & co-workers can make all the difference.

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In deed good team members can make all the difference. I have 2 wonderful techs that totally rock.

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That seems unsafe to me. Tonight I'm carrying 8 + an admit which was overwhelming with 1 tech.

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I'm curious about others thoughts on the ratios I am about to face... I am a new grad starting at a state psych hospital. It is a pretty big facility with several units- the unit I am going to work on has approx 20-24pt, with 1-2RN and 1 LVN and 2-4 aides. I have experience in psych (I was a mental health tech), so I felt comfortable in taking this job.. But I am worried about these ratios.. When I accepted the job, I don't think it really clicked what those ratios would be like (or look like). I am still in orientation (we have only been out to observe the unit once- they do a long 2 week orientation).

Is this abnormal for a state psych hospital? I am going to stick it out... but I have a gut feeling that this isn't what I imagined doing as a psych nurse.. =/

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Specializes in Forensic Psychiatry.

I started work at a State psychiatric facility forensic department in July as a New Graduate RN. I'm a float pool staff, so I generally fill in on units that are understaffed on RN, LPN or Tech positions. Some days I work in an RN capacity (chart, transcribe orders, assess medical complaints, assess behaviors, collaborate with other staff), some days I work as the LPN and do both med passes alone for 18 - 24 patients (which no one enjoys doing because the patients have a zillion meds each, some of them have to be crushed, some of them can't be crushed, some of them can't be crushed but we have orders to crush them anyway, and each patient has a preferred way of taking their med and if Its not done correctly the med will be thrown at the med passers head :wacky:... seriously I triple check everything and I still leave praying that I did everything right), or as a tech where I do constants all night for patients on behavioral precautions (and pray I don't have to do any assisting to the floor because it's just me on a 1:1 and my constant is a 300 lb 6'9" MR/DD patient that enjoys assaulting anyone that tells him 'No', especially women and brags about it).

The usually numbers are SUPPOSE to be: 2 RN, 1 LPN, 4-6 Aids (depending on constants). However some days it is - 1 RN, 0 LPN, 4 aids... and that just freaking sucks for 18+ patients, because as RN you'll have to Charge & do meds and sometimes sit on a constant for a bit so your aids can use the bathroom ect. That's a bad day.

When staffing is good and I get to do the RN work, I love my job and it's everything I hoped psych nursing would be. When staff numbers are high enough that the unit can be run safely and I can really attempt at building good rapport with my patients and not worry so much about whether I'm making a decision that could end up with me or one of my staff getting assaulted or fret all shift about messing up meds then it's amazing. It is possible to build some great therapeutic relationships with patients. When staffing is bad and I have to do meds for 13 hours (that's my average shift), or I'm placed on a 1:1 constant with a patient I don't know, or even worse, have to do all 3... then I seriously consider stabbing myself in the throat with a flexie pen.

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We're 1:8 - 1:10 at very most.

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Thanks for the feedback justkeepdriving. I'm hoping things turn out good. The staff seems really great, and everyone has been nice. I was a mental health worker prior to getting my RN, but in a much different setting. =) Hoping I can make it in this new environment.

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I guess the psychiatric floor are different but I currently work in a psychiatric ER with a ratio of 1:6. But we have a Tech, a psychiatric attending and about 4-5 security officers on duty. It can get pretty busy especially when there are very sick patients, restraints and all. As Valnoslo mentioned, it is alway good to have a supportive staff. That makes a lot of difference.

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Specializes in Psychiatry/Mental Health.

I work in consult-liaison/psych emerg, but at the 22 bed child/adolescent floor I float to we are at 1:5-6 fully staffed (which is hardly ever the case). We also have 3-4 child and youth workers on the floor to assist with activities and behaviour management.

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wow im lucky I work in a crisis intake we have 1rn and two lpn's and usually 3 to 4 techs per shift with an average of 6 to 8 patients per shift

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Psych ER here in Canada 1:6 ratio max usually and on inpatient CAU 1:5 on days and 1:7 on nights. Only RNs, no other classes of staff other than 4 security officers. It can get pretty intense sometimes. 14 seems like too much in your case. I worked short-staffed a couple times 1:15 and that was ridiculous. No time to do psychotherapy or behavior management, just say hi and dish out meds :S

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