med surge staffing ratios

meownsmile, BSN, RN · May 14, 2005

11 with no LPn is dangerous. We routinely have 11-12 patients on days, but have a LPN for meds, and a CNA for baths,vitals etc. On nights,, they may staff 2 RN's 1 LPN and 1 CNA for 18 patients. But depending on the patient that is hardly enough to actually do the job.

RNPATL, DNP, RN · May 14, 2005

Hi,
I just found out about a rural hospital med surge unit that is 11 patients per nurse on all shifts. Each nurse has an aide, though not sure about nights. Some aides can do vitals. The pt population includes peds. What do you think about this staffing? Thanks.

11 patients per nurse with an aide ... and the fact that you have pediatrics ... unsafe to me. The aide is fine ... but only you as the RN can do the complex parts of the job .... and doing that on 11 patients with pediatrics thrown in is an unsafe staffing pattern as far as I would be concerned.

plumrn, BSN, RN · May 14, 2005

What kind of care could you possibly provide for 11 pts? Answer: Very poor!

How likely are you to have an occurrence where a pt is injured or dies because you were spread much too thin? Answer: Very likely!

How will you feel when it finally happens? Answer: You will carry it around with you in your heart for a long time, and the lawyers will make sure you never nurse again, or have much money to live on.

11 pts is horrendous. You could only provide a minimum of care for these pts. How many times will the post op pt be turned,coughed and deep breathed? Walked in the hall. Help feed the new CVA pt. with aspiration precautions, and the other 2 feeders on the floor. Closely monitor a baby with low sats, & you feel uneasy about. Change multiple drsgs. Change the leaky bag on a new Colostomy pt, and take the time to teach them as you go. And these are not the urgent matters that come up routinely through every shift. I would steer clear of this hospital.

rnmi2004 · May 15, 2005

Hi,
I just found out about a rural hospital med surge unit that is 11 patients per nurse on all shifts. Each nurse has an aide, though not sure about nights. Some aides can do vitals. The pt population includes peds. What do you think about this staffing? Thanks.

Not only is the staffing ratio unsafe (esp. with peds thrown in!) but why is it that only "some aides can do vitals"? Is the hospital not bothering to even hire appropriately trained aides?

findingmywayRN · May 16, 2005

Yikes! Glad I posted this question here to get your opionions. I thought it seemed heavy, but this hospital seems to have poor staffing in every area I've inquired about. Looks like I'll be looking elsewhere!

findingmywayRN · May 25, 2005

Hi,

Just wanted to update on this topic. I had an interview at this hospital for med surg and found out some more specifics. They have 41 beds. Day staffing is 4 to 5 nurses and eves/nights is "one less." They have one specially trained aide on days and eves who does blood glucose checks, vs and non-sterile drsg changes. There are LPN's and RN's but they each have their own patinet load. Some patients are on telemetry. Peds cases come in about "twice a month" and anything serious gets sent out. Infants can go to ICU for closer monitoring as do Peds with breathing issues. They also have a nurse on eves who does all admissions. They are recruiting for nights, but you also don't have the aide trained to help with vs and other stuff. The nurses there say they've all been there for years. Nights seem rediculous, but the NM said they are taking turns floating to nights while there they are short and no one is happy about it. Does this sound ok for days or eves or does it still sound unsafe? I'd appreciate your insight. Thank you:)

meownsmile, BSN, RN · May 25, 2005

So you are saying 4-5 nurses, that is LPN's and RN's correct? I still would want to know exactly how many RN's are around on each shift. So actually they could work 1RN and 4 LPN's? Nope,, still not safe in my opinion. Even though LPN's are very competent and capable,, they still have to work UNDER the direction of a RN per most states nurse practice acts. So basically one RN may still be fully responsible for all 41 patients on an acute care unit. No way!!!!

findingmywayRN · May 26, 2005

So you are saying 4-5 nurses, that is LPN's and RN's correct? I still would want to know exactly how many RN's are around on each shift. So actually they could work 1RN and 4 LPN's? Nope,, still not safe in my opinion. Even though LPN's are very competent and capable,, they still have to work UNDER the direction of a RN per most states nurse practice acts. So basically one RN may still be fully responsible for all 41 patients on an acute care unit. No way!!!!

I never thought about that or I would have asked how they staff RN to LPN ratios. I think this doesn't sound right for me (or my licence). Thanks for all of your insight - it's been a big help! :)

pie123 · Aug 11, 2005

Hi,
I just found out about a rural hospital med surge unit that is 11 patients per nurse on all shifts. Each nurse has an aide, though not sure about nights. Some aides can do vitals. The pt population includes peds. What do you think about this staffing? Thanks.

I don't care if I did have an aide, I would not do this.

laurakoko · Aug 13, 2005

about med/surg staffing ratios............

any more than 5 to 6 being the MAXIMUM pt load to one nurse, LPN/RN

is DANGEROUS.

Been a nurse for a while, and in many positions, and however trying to work it, more than that, now, is very unsafe.

THE PATIENTS ON MED SURG ARE SICKER TODAY THEN THEY EVER HAVE BEEN.

When I do med/surg now with 7 patients, and I have 11 years experience, am logical, have been the clinical manager on the unit, and at the same hospital for 8 years, and don't want to toot my own horn, but good, and FAST,

and I STILL can't keep up........ something is wrong.

I am feeling sorry for anyone new, new grad....

I do case management now, and you have to be REALLY sick to even get in the door. Sure surgeries are simpler.. and recovery is easier, that is why most of them are in the OUTPATIENT setting!!!!!!!!!!!!!

AND most of the laparoscopic or ortho surgeries are d/c the next, or 1-2 days anyways...

A med/surg unit is keeping the ILL patients. The ones with sepsis, osteo, wounds, endocarditis, arrthymias, s/p CABG, and the many other dx that require LOTS of nursing care! IV abx, analgesics, and constant monitoring.

O.K. I'll stop, as I am now ranting, and would LOVE to change things, and have tried SOOOOOOO hard, and can't. The people ruling the money, win.

It's just a shame the patients don't.

Ashera, LPN · Aug 14, 2005

Hi,
I just found out about a rural hospital med surge unit that is 11 patients per nurse on all shifts. Each nurse has an aide, though not sure about nights. Some aides can do vitals. The pt population includes peds. What do you think about this staffing? Thanks.

RUN ...VERY FAST....AWAY FROM THIS!