Is it just me? (Nurse/patient ratio related)

[devi]

Hope it's alright to put this under general discussion. I just wanted to get some other nurses' opinions on a new staffing grid that's supposedly going to be unveiled during our next unit meeting at work because I'm not sure if I'm overreacting.

I'm a new grad RN, a couple months shy of the one year mark. I work nights on a Surgical/Oncology floor. Mostly post-op orthopedic surgeries, abdominal surgeries, bariatric, etc. and maybe 1/4 Oncology patients, although we're seeing more and more of them and are working on getting all our nurses chemo certified. We also get medical overflow as well as many patients on telemetry. Assignments are not based on acuity.

When I was interviewing, I was told ratios were 1 nurse to 5-6 patients. The reality has been 6-7 patients per nurse and one PCT to anywhere from 10 to 30 patients. No LPNs.

On the rare night with 5 patients (only when we are accidentally "overstaffed"), it seems ideal to me. 6 is usually fine. 7 feels unsafe and is impossible most nights without cutting major corners. I often don't feel safe with 7 patients, and I leave work depressed after a night with that many. Of course, this is all relative. We all know that some days, 5 patients can be busier than 7, but I just mean in general.

There have been more and more nights with 7 patients and less with 6 lately. And now...word is that our staffing is being changed to a standard of 8 patients per nurse on nights. I've never taken 8 patients and can't even imagine it. IMO, it would be very unsafe for the patient and for our licenses.

So, I guess what I want to know is...AM I overreacting? Is this an acceptable ratio for the types of patients on my floor and I just "had it easy" with 6 or 7? I've never worked anywhere else, so I have nothing to compare to, but I'm just so upset about this and trying to figure out if it's just me (being a new grad, less developed time management, etc?) or if this would be unacceptable to even more experienced nurses.

Thanks in advance for your replies!

[MikeyBSN]

Hey Mickey, have you ever done oncology?

Not sure how your question is even relevant, but do you ever read the threads?

[mama_d, BSN, RN]

Bingo! Look for a place that staffs each unit based upon actual acuity, rather than ratio.

Wait, there are hospitals that actually do this? Seriously, if I found one, I'd think I'd fallen through the looking glass!

[ArwenEvenstar]

I read the first post and only glanced at some of the others. I left the hospital setting 4 years ago. Before that I worked at two hospitals (one in the northeast and one in the southeast) for a total of about 14 years. I always worked the floor - various med/surg type units and cardiology units as well. And I worked evenings or nights. EIGHT patients was always the norm wherever I worked! You ran constantly and worked very hard. This was "normal"! On a rare "over staff" or low census night you might have had six. On not-so-good nights you would have 10 or more patients!! Insanity! I read about nurses working places where they only have 4 to 6 patients, and I can hardly believe it! Dang that would have been nice! After 14 years of hospital nursing, I was frazzled and burned out. I left. No plans of ever going back.