how many patients?

[oreo75]

I just wondered how many patients other nurses in the uk are expected to look after on a shift? I'm not so much interested in ItU but more wards. I feel our nurse to patient ratio is unsafe, if I have patients I look after 14 on a shift. I work on a busy orthopedic ward, which is trauma, so a high percentage of elderly confused sick patients. Other wards I have worked your usual is 8 patients but when you are short shift (maybe about once a month) you may have a work load like this but this is every shift.

There is a reason behind this, & I have on several occassion address the nurse/ patient ratio to the ward manager, where I've been told we used to do it like that but we don't have the staff to have few patients, which I can see that point but rather then covering with band 5 bank staff we are covering the shift with band 2 band staff & not just using band 2 when we cant' get band 5 cover. Back to my reason for posting, today came on shift my ward manager was on so I didn't have to be in charge (I'm one of the ward sisters) I was allocated my 14 patients the other nurse on is newly qualifed, has a pin & this is her 3rd week on the ward & 1st week not being supernumery. The ward manager then says this am that she has a meeting & I have to oversee the other nurse as well as look after my own patients, which 2 of which were sick, plus 2 discharges & 1 admission. One of the patients came back infected so had to be transfered to the infection control ward, which the other nurse didn't know what to do, so rather than have the time to show her what needs to be done, I had to sort it out. So in reality I didn't document on the other 14 patients I was in effect looking after them. This is an awful day, but quite normal for the ward. I love being a sister & have been in post between this ward & my last ward where I was acting for a year now, but I can't cope with the patient ratio, & feel like I'm giving poor care & poor standards of documentation & am worried for my career.

These ratios might be the normal in many places & need to know if maybe I can't cope with nursing any more. Also if anyone has advice on how to handle this situation then I'd be grateful.

[ayla2004, ASN, RN]

Can I ask, when you say you have 8 patients, does that mean you have to do all of the care for those patients ie obs meds ADL's etc or do you have an unqualified helping you with the ADL's?

when i have 8 i work with an assitant wo can do adls, obs, some can do dressings.

i do meds, obs, careplans, mdt, talk to familly, arranged discharge etc, my pt are too dependent for a nurse to do it all.

[AZ hopeful]

We have 28 pts on a VERY busy ward, worst in the hospital!

3-4 RNs (3 RNs have 9-10 pts each & 1 RN in charge when available), 2 Healthcare Assistants who are allocated to each ' end' of the ward to help with 14 pts each so we have to fight for their help lol. Plus we are a teaching hospital so we have students who are supernumary. So yes we have to do evrything except obs as a RN

[ayla2004, ASN, RN]

i like my ratio more now than some of yours.

however we may be getting another post on the late shift which would be ver welcome.

how often do u float to another ward to cover a trained post and do u like it when you do. ive done it twice and enjoyed it my load was resonable in a new area and i was supportive and i was replaced with a aux so that they stayed with enough staff

[sofaraway04]

I've never had to float somewhere else, I don't think I would mind for the odd shift, but I have said I wouldn't go to another unit for a month when they wanted me to.

A very busy acute medical ward total 24 patients

On an early it's 2 staff nurses and 1 HCA for 12 patients, we are the only place I've worked where 2 staff nurses work together and share patients.

On a late it's 1 staff nurse and 1 HCA for 12 patients then 1 staff nurse to float and be in charge.

nights 2 staff nurses and 1 HCA for all 24 and we all work together

[peterthescot]

I am working in acute medical. It is not uncommon to end up to look after 15 patients on your own with no support whatever, an assistant will help if you call for support. Of course than you get the usual discharges/boardings resulting in admissions.

To keep the story short, it is dangerous in all matters, care planning and delivery are scraping around the basic mark and documentation and Health and Safety went right out of the window!!

So Oreo75 to answer your question, I am sure you are able to cope with nursing and you deliver great care but you get cut down in your efforts by this staffing levels to the point where you can only do whatever you can, perhapst often or most times reacting to care need instead acting/proacting. But please keep in mind that you do the best you can under these circumstances.

There wont be much change to this situation untill the management structure within the NHS will change and NHS management is more focused on care delivery instead of selfpreservation and "Management by Helicopter".

In addition I think nurses need to learn to fight for their causes better and stop hiding behind "no-strike" regulations and vote for industrial action. This should be really on RCN Manager minds!!

You are right to be worried about your career and beeing frustrated. I think the most nurses are. To keep yourself save as possible I suggest you report this, even so it is a common situation. I don't know about your place but we have a "Serious Incident Report" system. I am using this system to report this staffing level and that care delivery is impossible under these circumstances, these reports are official and going up the chain of management as far as HSE or CEO. Inform the duty manager at start of the shift about the shortcommings. In addition I am going to the Senior Charge Nurse and complain about the shift (that is the nice description, you don't like to hear the original version :angryfire). That deals with the legal side of the matter.

Please be adviced!!!! It is needless to say that in the "blame less or blame free" culture of the NHS of today I am not very popular with neither management nor Senior Charge Nurse.

[Higgs]

When I worked in surgery i the UK I'd have 8 on days and 12 on nights. One night shift there was a staffing crisis and I had all 24 with 2 unqualifieds. At the end of the shift sometimes the staff would have a group hug just to celebrate the end of a shift that we just scraped though unscathed.

I moved to Canada 2 years ago and have 4 on days and 4 on nights. They're still just as ill, but I can get it all done properly and not feel as if I'm running from crisis to crisis and lucky to get out alive at the end of it. Oh, and I make almost 3 times the money for the same job I did in the UK...