nurse-patient ratio - page 10

Within the last year, we restructured our Med-Surg nurse patient ratio to be 1:6 for days/eves, and 1:8 for nights. I am interested in hearing what other ratios in Med-Surg are. I work in a 400 bed... Read More

  1. by   busyrninva
    Where do you work ? I would be willing to move if thats the ratio and the thoughtfullness that administration is willing to provide for the nurses.

    Originally posted by ruby mcbride
    I work at a 175 bed hospital. We recently had a consulting team evaluate our patient:nurse ratio. It basically is 1:4 for day shift, 1:5 for pm shift and 1:6-7 for night shift. We have aides on days, pms and nights. They also vary as to acuity status. It is a good system, and most of the nursing staff feel they can live with the numbers. The charge nurses have the final say in staffing. If they feel they need more staff (based on influx of admissions or patient condition) they can request more staff, the same if the patient census goes down, they can send people home low census/on-call. It seems to work pretty good. Other nurses that come to this facility to work feel we have very good staffing. Good luck.
  2. by   alli
    I'm from Montreal. The 24 bedGen surg unit I work on the ratio for days is 1:4-5 and on nights 1:6. This is the usual. There are usually 5 RN's on days and 4 RN's on nights. We do 12 hour shifts
  3. by   NursesRmofun
    [font=franklin gothic medium]my experience at two hospitals has been nurseatient 1:4-6 days and, long ago, 1:6-7 eves and nights. however, the even. and night staffing was changed to the same as days at some point. i think one person here (yada-yada?) did say it had something to do with ancillary staff, and i agree. our ancillary staff was 1 aide/tech. or a shared aide/tech. between two units per shift! not good. :angryfire
  4. by   reeze
    does anyone know if there are studies that show what the "burn out" ratio is for ED nurses ? I need to locate info for a research paper I need to complete
  5. by   Tadpole
    I work at a big teaching hospital. Our ratios are currently 1:5 or 1:6 days (depending on the acuities); 1:6 on eves; and 1:7 on nocs. We have RN/CNA teams (we would GLADLY have RN/LPN teams, but we are short on LPNs ). The CNAs have 1:8 on days; 1:8 on eves; and 1:15 on nocs. The RNs who work on nocs are expected to pitch-in and help the CNAs with their work (answering lights, bathroom trips, nurishments, VS, etc, etc). I am fortunate that I work on a pretty good floor. All the nurses have a very good concept of "teamwork gets the job done" and live up to it for most of the time. When we get float nurses assigned to our floor, we don't have it as good.
  6. by   cindyrn1
    I use to work in a small rural hospital with 12 surgical beds and 12 medical beds. Most of the time it was 1:5 to 1:7 in most cases. This was on days and then it was much higher for night with up to 1:8 or 9! The last few weeks I worked at this horrible institution, I had a NEW RN, one insubordinate aide and myself (who was in charge the entire shift as well). I had 7 patients including one new surgery and a patient receiving blood. The orders were written all day long and medications were a nightmare. The aide that day refused to do anything that she was asked because she was in a bad mood! When I took all of this to my supervisor, she just told me to forget about it and start over with a clean slate. I reminded her that we were over worked that day and that this aide was refusing a directive from a supervisor. Again, the supervisor ignored this and sent me back to work on the floor. The staffing for this hospital is both scarey and very unsafe for the patients that are admitted there. I just wish there was some way that the town would know what kind of place this hospital is so that they could go to another one to receive better care for their money. I have heard some horrible rumors about this hospital before, but until I started working there, I didn't believe them. NOW I know why there are so many bad things said about this hospital. Until they fix their nursing shortage and get a better Manager of the nurses etc, they will continue to have poor service and eventually have to close down due to poor service. They need nurses so badly, but when you don't get treated right as a person, why would anyone want to work in that kind of institution? While I was there, I tried to work extra shifts to help out, and tried to be the kind and caring nurse that everyone expects.....but it was almost impossible with having to take 7-8 patients for 12 hours and that was without any major incidents occuring! I am going back into psych nursing for the pure fact that you can have 10 or more patients, but you are not looking at life or death situations every shift you work.
    Treat others as you would want to be treated.
  7. by   Lysa
    I work on a 33 bed surgical unit. Many times I've gone through up to 14 patients (considering discharges and admits). These pts. include fresh post-ops, epis, PCAs,hep. drip,ect. The list goes on. There is absolutely no time to talk to the pts. one to one let alone remember their names!!
  8. by   busyrninva
    Quote from Lysa
    I work on a 33 bed surgical unit. Many times I've gone through up to 14 patients (considering discharges and admits). These pts. include fresh post-ops, epis, PCAs,hep. drip,ect. The list goes on. There is absolutely no time to talk to the pts. one to one let alone remember their names!!
    Did you have them all to yourself or was there anyone else on your team?
  9. by   Lysa
    Quote from busyrninva
    Did you have them all to yourself or was there anyone else on your team?
    We have two LPNs for the entire floor on days and one LPN on nights!!!
  10. by   D. Gardner RN
    No real method to the madness and this system sucks too. Just jum on the opportuntity to have the extra hand.

    Quote from NurseGr39
    Wow, lots of posts. I work on a 26 bed M&S unit we usually have 4 or 5 nurses on days w/ 3-4 aids, 3 nurses on evenings w/ 1-2 aids and 3-4 nurses on nights w/ 2-4 aids. Our manager wants us to change to team nursing (we are currently primary nursing) and is looking for our input as to how to develop the teams. She wants 2 teams of 13 a piece. What is reasonable staffing for this? How about delegation of duties w/in these teams. Any input appreciated.

    Nurse on a Mission
  11. by   D. Gardner RN
    With 25 yrs. under your belt I truly reapect your opinion, and suprise suprise guess where I work? On the EAST (Beast!) coast!

    Quote from BeeStrong
    I work in a 250 bed hospital in a mid size city in Oregon, Oncology unit of 21 beds; staffing on days: 3-4 pts, usually 3 CNA's plus sitters when needed; eves': 5-6 pts with 2 CNAs and nocs 6-7 pts with one CNA, 2 if over 18 pts. This seems to be working well. When I worked back East, they would pull our One Cna on days to be a sitter or whatever and RNs would have to give all baths, meds, treatments, sometimes even be ward sec. when they called in. It was horrible. I would never work on the east coast again, Ever!! I have worked both with acuity systems and without; the acuity system took a lot of our time to fill out the forms and then it seemed that it didn't matter; it was always the "butts to beds" that counted. That's my two bits after 25 years in nursing, thanks, Bee Strong, RN
  12. by   birder101
    Quote from D. Gardner RN
    With 25 yrs. under your belt I truly reapect your opinion, and suprise suprise guess where I work? On the EAST (Beast!) coast!
    Oh how I know how this is. I worked on a med-surg floor for 13 years when I had my defining moment. Now I work in a Doctor's office and am sooooo much happier. Don't get me wrong, I loved med-surg nursing, but the staffing ratios where crazy where I worked. I decided to get out when I had 9 (yes that is right) patients on day shift on a telemetry unit that I was pulled to. We averaged 7/8 on days. Way too much. Our unit held up to 45 patients. We often only had 2-3 nursing assistants for that load. And for those that think staffing should be by acuity, we did that. It never did anything. Staff was never bumped up for high acuity. But was lowered when the census was down. They finally did away with that because in my opinion, the hospital would have been in trouble if anyone ever checked on the staffing ratios that were never met. Has anyone ever noticed that the med-surg floor is always the last to receive staffing. Someone calls out in ICU, pull from med-surg. Leave them short. That's how it is in the East.
  13. by   Katy2
    Quote from justkrn
    Our 25 bed med surg unit has just recently revamped the matrix. We used to get 3 nurses for 12 patients. Now it is 3 nurses for 15 patients. We loose one of the aides at 11 am on days if it stays at 14. However, should we drop to 13, they call the aide back in and send one of the nurses home. Then should we get two admits they want the nurse they sent home to come back in. Confused yet??? It is rediculous. They wanted to send a nurse home the other day at 2:30 (her shift ended at 3 pm anyway) when the census dropped to 14. Is this nuts or what??? We can get 7 to 8 admits in one afternoon--and this can happen in a matter of minutes--we have three nursing homes nearby, and have direct admits from the various doctor's offices, as well as transfers from ICU. Not only that, our hospital is on a campaign of patient satisfaction. what is wrong with that picture?? Doesn't make sense to any of us that they want us to leave on time to prevent any shift overlap but we are suppossed to cater to every whim our patients have for high patient satisfaction, and they add to the patient load for each nurse. Our managers are constantly on our butts to leave when the census goes down by one, but then dissapear when we need some help (like getting an admit 10 minutes after they tell one nurse to leave.) Getting very disgruntled. And they wonder why people leave the nursing field, and don't want to recommend it as a career to someone else. And it seems as if it is getting worse instead of better.
    Do you get call pay for being at their beck and call???