Our charge and triage nurse is counted in the nurse/patient ratio. Ours is 1 nurse/4 patients. We have approx 40 beds and see approx 100 per day plus.
Most nights 0300-0700 and 0700-0900 our charge has to take a zone due to lack of staff/increase patients/increase acuity.
Many times we use a NA to watch triage during those times for a nurse can give pt care and calls for RN when patient arrives!
All of charge nurses are basically burned out!
Press Ganey scores are low...mostly due to increase wait times in triage and for MD to eval or f/u on busy nights.
We are asking for charge and triage nurses not to be counted because they are not giving patient care in a zone, but they are being counted in the nurse/patient ratio.
We have 3 zones with 4 telemetry bed, 2 zones with 5 minor medical and 1 MH bed and fast track with 14 beds. Only our fast track gets 2 nurse/emt assigned.
I'm preparing to write up suggestions and need back up of how other ER's are staffed. Any advice or suggestions will be much appreciated.
Thanks for responding to my question. It seems the 1/4 ratio is a standard for ER's, but the charge and triage RN resposibilities differ. Glad to hear your have some Quiet time...we seldom do anymore! I work weekend 1900-0700 only, but they say the numbers show that Mondays and Thursdays are the busiest.
I am the Casse Manager for the ER. My 40 hrs and the ER Manager's 40 hrs and the clerk's hrs are all counted against our staffing ratio. We have 7 rooms (1-OB, 1-ortho, 2-traumas, and 3-basic) and we will see over 21,000 pts this year. Our regular staffing is 2 nurses from 7a-7p, 1 nurse from 9a-9p, 1 nurse from 3p-3a and 2 nurses from 7p-7a. I hope this information helps you. I need help with my problem. Mt administration takes the number of pts and multiplies that by 1.85 to determine our targeted FTEs. How do y'all determine yours?
I'll have to ask how the administration determines our FTE's. I only know they use a 1 nurse to 4 patient ratio which include our charge nurse and triage nurse.
Again, how can they count your hours, the nurse manager and clerk???
When it comes to patient care they should only count the actual number of nurses giving patients care! That is just common sense to me.
By the way, how are the Press Ganey scores doing for your ER's??? Ours weren't so good. No matter how hard we work, how fast we go or how good the care we give...it's not good enough when those scores come in!!!
"How can they count the manager's hours...?" They just DO. They are administration and they use anything and everything to keep the budget short. Our hopital didn't get a raise last year. They banned all agency nursing from the ER. They told us, "learn to do or do without." Morale is low. Call-outs are up. Pt complaints are up. Things will get better. Our nurses all feel that great things are on the horizon and our hospital is about to take off. We are suffering through the low times right now.
We do not use Press Gainey Scores for pt satisfaction. Our Physician's group "Phyamerica" mails out questionaires to pts and we also collect comment cards from them while they are in the ER.
Specializes in Alittle of everything but mostly ER.
You have an actual ratio of nurses to patients? What a luxury! I work in a 30 bed ER (includes 9 acute beds, 21 non-acute) and nights is staffed with 4 RN's, one triage nurse and a charge nurse. Two nurses take care of the acute side, 2 on the non-acute. Most nights all rooms are full plus patients in the hallways! Talk about unsafe!
I definitely need a new job. C.G. said it better than I could. If my bosses were ever really asked about staffing ratios the only sincere response would have to be, "So solly, no speeky de Ingleesh!" I know that "phantom" staff are reported to administration--yeah, so they're invisible, but they shore are cheep! Our place uses at least HALF agency people, who are mostly pretty good, but as soon as they pay for the new fridge we don't see them again.:roll
God, I would LOVE to have a staffing ratio of 1:4. Right now i'll be lucky if we meet 1:8! There are 23 beds in the Main ED plus 8 virtual beds (i.e., hallway), 1 Trauma Room, 6 in the Pediatric ED , 10 beds in Urgent Care and up to 35 seated patients (let's not even count what's in the waiting room). There is a Nurse Manager on at all times (or an assigned Charge RN) and they dont take a patient assignment. That being said, both the Nurse Manager and the Triage Nurses are counted in the mix when determining staffing levels (average: 20 RNs and 9 Techs in a 24 hour period). We average 70 to 73,000 visits annually. Ok.. i just got dizzy all of a sudden. LOL.
You have an actual ratio of nurses to patients? What a luxury! I work in a 30 bed ER (includes 9 acute beds, 21 non-acute) and nights is staffed with 4 RN's, one triage nurse and a charge nurse. Two nurses take care of the acute side, 2 on the non-acute. Most nights all rooms are full plus patients in the hallways! Talk about unsafe!
There is a Nurse Manager on at all times (or an assigned Charge RN) and they dont take a patient assignment. That being said, both the Nurse Manager and the Triage Nurses are counted in the mix when determining staffing levels (average: 20 RNs and 9 Techs in a 24 hour period). We average 70 to 73,000 visits annually. Ok.. i just got dizzy all of a sudden. LOL.
KKERRN
80 Posts
luv2nurseinER,
Thanks for responding to my question. It seems the 1/4 ratio is a standard for ER's, but the charge and triage RN resposibilities differ. Glad to hear your have some Quiet time...we seldom do anymore! I work weekend 1900-0700 only, but they say the numbers show that Mondays and Thursdays are the busiest.