Med surg patient ratio

Mommy&RN, BSN, RN · Feb 17, 2013

Our "specialty" is supposed to bed GI illness, GI surgery, Bariactric surgery, vascular surgery. Now we are getting TONS of medical patients. Employees are dropping like flies. 1:5 on nights is good. We are so short staffed right now, that it was 1:8. With me in charge with 6, then an admit to total 7. The acuity of many of these pts is far beyond what these ratios allow us to take care of.

MANY orders are being missed, or carried out 4+ hours after they were written. It is a SSE waiting to happen!

uRNmyway, ASN, RN · Feb 20, 2013

Before I came to the US, I worked med-surg night shift, midnight to 8am. If I had my own patients, patient ratio was 1:7 on a good day, but usually 1:8-9. If I was working with 1 LPN, she would have 7-8 patients, I would have 7-8, and although she would do most of the bedside nursing skills within her scope, I was technically responsible for all. If I was supervising 2 LPNs, then they each had 7-8, and I was responsible for all of them. Our department could have up to 40 patients, and we usually had 2-3 CNAs, depending on patient load, acuity, if we had 1:1 supervision, etc.

Judging from other responses, while our patients might not be as heavy (ie, didn't often have TPN, saw maybe a handful of trachs during the 2 1/2 years I was there) we did have a very heavy geriatric population, lots of dementia and behavioral issues, MANY IV ABX therapy, wound care, diabetics, COPDers, etc. Also, our delegation was very different. In Quebec, CNA's are not allowed to take vitals, BS levels, etc. LPNs are not allowed to install IVs or inject anything more than NS for irrigation. We didn't have phlebotomists to do blood draws for us. Any wound care that had any kind of medicated ointments or dressings needed to be done by RNs.

Looking forward to seeing for myself, in person, how different med-surg is here compared to what I have experienced. :)

PS. In case anyone currently working in Quebec comments, I have not worked there since late 2011, and this is how things were last time I did. If things are different now, forgive my mistake . I do know that they were starting to train LPNs to install IVs, but the restrictions were not supposed to change re: IV meds.