I work a realitvly small KY Hospital. We have two acute medsurg floors each with 33 private beds seperated into 4 wings. There is a central desk were the unit secetary answers lights and enters orders. Each wing has a small room with a counter, med cart, computer, shelving full of supplies, patient fridge, icemaker... you get the picture. Each wing is designed in such a way that you may not see any other nurses that day. I was recently speaking with another nurse who had returned home from travling these past 7 years. "I ask him how are the other hospitals? Did you like them?" He looks and tells me straight up that in the 8 diffrent facilitys that he worked at across the country, our small facility had THE highest ratio he experienced. I was amazed and I wonder.. is that accurate? What are your ratios?
Here is where i work: 8:1. RN, LPN.. whatever. 8 patients, 1 license... unless your the unlucky nurse of the day that gets the wing with the extra room.. then its 9:1. So, that is 33:4. .. it could be all RN or 3 LPN and one RN... but that doest matter because each wing has everything you need.. you don't really see your coworkers.. your nurse aide can make or break you in terms of care. aide ratios are 8:1 from 7am-3pm.. then they drop to 16:1 . No charge nurse.. no IV team, admit/discharge team.. whatever kinda teams we don't have 'em. we do it all. Oh and the rounding with a purpose.. was just implemented..
It seems to me from the responses, the nurse to patient ratio is dependent on the location, availability, acuity, risks, experience, finances, management, and the circumstances (which is really in a a nutshell, those that I just mentioned).
Let us ask ourselves, do you honestly feel that staffing practices put patient safety as the number 1 priority? Do we leave work each day feeling good about ourselves and our employer? And what about California with their mandated 1 nurse to 5 patient ratio, practical or paranoia? At my institution, there is really a nursing shortage...for experienced nurses. New grads are in a tight job market right now. Nursing school teaches us the "ideal" but not the real world. Every nurse know this. Then why is this the approach? I know I am throwing quite a few questions out there. Just like everything in life....finances dictate practices.
No, staffing practices put the almighty dollar as #1, not patient safety. Our hospital is having this problem right now. Lets see how many pts we can pile on the nurses without killing people, causing a mass exodus of nurses and before the nurses break down.......
a 1:5 ratio is fantastic, of course unless you work in ICU/CCU/PCU - then it's overkill. California has the right idea. But for med-surg, I think 5 patients is ideal to give really good patient care and give each patient really dedicated time. I agree, there is NO nursing shortage here in the northeast. New grads can't get jobs and many hospitals are on a hiring freeze. I agree that nursing school is nowhere NEAR real life nursing. Why do they do that? Because their goal is to prepare you for the NCLEX, not the real world. My professors would often tell us that our TRUE education would come in the first year or nursing and why they really push students to do med-surg for at least a year before specializing. When I was a new grad and went right into a speciality I thought, for what? But when I went from the specialty to med-surg, OMG, I had like NO skills. All of my med-surg stuff from school was lost for a while and time management? Non-existant.
i work on a busy 37 bed medical/telemetry unit.we have a max of 6 pts day or night.typically i get 5.with the acuity of our pts we should really get 4.i could not imagine getting moe than 6! to me thats compromising pt safety and your license.we have a monitor tech,secretary,2-3 nursing aids,a charge nurse that takes 1-3 pts, a resource nurse that does not take pts but helps w/admission and discharge pp and helps with any questions if ur pt starts to crash or u st to drown! we also have an iv team,respiratory therapy,etc. and to be honesti think i work at a horrible hospital.we all think our ratios need to be less.i always feel so overwhelmed and like im missing something.our pts r really sick and i think if our ratio increased alot of people would quit including me!
Our staffing is 1:6-7 with a floating charge nurse who helps do admissions and discharges and checks on everyone. Techs have a 1:12. We have a secretary 16 hours a day.
I work on a busy med/surg/tele floor where we are only supposed to max at six patients a piece day or night. Typically it ends up that we take seven and I've been told by the nursing supervisor that need be we will take 8 a piece but I have never had to and probably would refuse. We still do paper charting and have a rediculous amount of it. I am the charge nurse on midnights and take a full team. We do not have a secreatary at night. I am expected to help out my fellow RN'S and typically barely have time for my own assignment. On my shift most of the nurses I work with are new so I get a ton of questions all night long, which I don't mind but it takes away from my own patients. It would be much easier if I could take a few patients less and then I could really help the floor to run efficiently.
The unit I work on is surg/tele with some med/surg overflow. Ratios are 5:1 at noc with one aide and 4:1 when we don't have an aide. We have an IV team and charge nurse that will enter our orders (they don't take pts), resource nurse & aide. I don't think I'd make it with some of the above posted ratios:(
I work nights on a general medical floor and I'm 80% of the time the charge nurse. 32 beds. We usually have 5-6:1 for licensed nurses and usually 2 techs on the floor. I take patients of course. The most I've had was 8pts and very recently I've been having 6-7pts.
I am a go to person but with a heavy load, I can't help as much as I would like. to. No secretary on weekends for night shift and weekdays after 11p.
We're within budget but they wonder why patient satisfaction scores are down..hello!
Specializes in med-surg 5 years geriatrics 12 years.
I work a med-surg floor, night shift. We are expected to take up 5 pts. Techs get 9-10 pts. Of course with the admits sometimes we end up with 6 pts. Have worked an LTAC where we routinely had 9 very sick patients, so 5 pts is a dream come true for me.
in VIC australia I have 4 pt on AM or PM shift with a Charge without a pt load. At night time the charge has 6 pt and the other 2 nurses have 7. No ward clerk at night or after 5pm.
We only have one CA for the ward who has to do water jugs linen skips and washes the discharges beds and is supposed to help us if needed. 3 reg CA and the rest is bank staff who often refuse to help with a hoist or turn.
Only 2 CA for 14 wards at nights. Spend most of the time doing turns at 2 and 6 and running up and back to the lab as the main block does not have a pod system. Rarely see them at night unless going to X ray or hanging bloods or someone on spinal precautions because they spend most of their time on trauma and medical turning etc.
The hospital I worked at in Ireland had 2 porters for the general wards at night but if they opened a theatre at night to operate the surgical porter had to be in the theatre.
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NJNursing, ASN, RN
597 Posts
No, staffing practices put the almighty dollar as #1, not patient safety. Our hospital is having this problem right now. Lets see how many pts we can pile on the nurses without killing people, causing a mass exodus of nurses and before the nurses break down.......
a 1:5 ratio is fantastic, of course unless you work in ICU/CCU/PCU - then it's overkill. California has the right idea. But for med-surg, I think 5 patients is ideal to give really good patient care and give each patient really dedicated time. I agree, there is NO nursing shortage here in the northeast. New grads can't get jobs and many hospitals are on a hiring freeze. I agree that nursing school is nowhere NEAR real life nursing. Why do they do that? Because their goal is to prepare you for the NCLEX, not the real world. My professors would often tell us that our TRUE education would come in the first year or nursing and why they really push students to do med-surg for at least a year before specializing. When I was a new grad and went right into a speciality I thought, for what? But when I went from the specialty to med-surg, OMG, I had like NO skills. All of my med-surg stuff from school was lost for a while and time management? Non-existant.