Safe Pt Ratios for Med Surg

Specialties Med-Surg

Published

I have tried to find a thread on this, and nothing addressed it quite adequately for Med/Surg pts, ESPECIALLY surgical pts.

Our new Clinical Manager for our surgical care unit wanted to know what we consider safe ratios with our population: fresh surgeries from PACU, outpatient surgeries, and 1-3 day recoveries, and swing bed patients. Right now we usually have 1 RN and 1 or 2 LPN and 1 or 2 CNAs for 16-35 patients, avg is about 21 pts. I think 4-6 pts to a team of 1 RN and 1 LPN and 2 teams sharing a CNA sounds about right-the fresher the surgeries, the less pts should be in a group though, just for safety, and orthos I think should lower ratios also.....what are your opinions, just for sake of info gathering?

BTW, our hosp is trying to get Magnet status, but yet our staffing is awful, some shifts, it goes beyond pt safety issues....They have juggled numbers to make it look good on paper. Do these Magnet folks read between the lines?:confused: Any thoughts on the staffing question are much appreciated.

I work on a 46 bed med/ surgical. We don't do primary care.

Days 4-6 patients per LPN and Evening 6-8 pts and night 8-10.

Some days it works ok. Others I wonder if it is safe.

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Specializes in Trauma ICU, MICU/SICU.

I work on a Trauma Med/Surg floor. We have 28 beds, 4 of which are 4:1 observation room. We have 6:1 and no charge on night shift. We shoot for 3 techs, but often have 2 and rarely have only 1. If we are short staffed we go to 8 patients at the most. Most of our patients don't walk and we usually have the record for number of 1:1's for the hospital.

The 4 bed obs room has a nurse or tech in there at all times. Of course, there are nights when you can have 5 staff members trying to keep things at bay. Head injuries.:uhoh3:

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Specializes in med surg, telemetry, stroke.

hi guys, well i am a new LVN on my 8th day with a preceptor (new one today) and the worst thing that can happen, happened to me. i work med surg, sorry. i have 11 -15 patients and today 11. my preceptor (the new one not my usual one) was rushing me rushing me and i was so stressed out she grabbed my meds went in and gave to the wrong patient then had me give the patient an injection. when i went to grab chart i realized bed 3's med sheets were switched with bed 3's. i know i was responsible to for trusting her and not checking the patient's armband myself. i almost had a breakdown cried all shift. we monitored the patient (tiny cerebral palsy lady 30 yrs but looked 10) and the next day also and she is fine, but what if she wasn't. dear lord i don't think i can do this and i have just begun. our hospital patient ratio is crazy. even though we have an RN that's too many patients 11-15. i have been having such anxiety i don't even think i can go back there in a week. i almost quit the other night. i did not care if they fired me just cared about my poor little patient. the preceptor was not even upset and i was going out of my mind. i had to fill out the QRR. my DON and my nursing instructor said to not let another nurse (preceptor or not) rush me to where i do not do what i know is right. please guys if you can give me your thoughts. i am so scared that i did this and i know better. i graduated top of my class and was going on for my RN, now i wonder if this was a sign i can't do this. i am so stressed every day i go there, but wanted to get one year experience. now i'm not sure i can do this. any thoughts are most appreciated. very upset LVN in california:bluecry1:

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You might want to read up on California's nurse:patient ratio at:

http://www.dhs.ca.gov/lnc/NTP/default.htm

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Specializes in Trauma ICU, MICU/SICU.
what about having 6 patients and no LPN? this hospital i was looking into does primary nursing. THe nurse does EVERYTHING>>>>meds,iv's etc. that makes it hard don't ya think? never mind whatever admissions come in? I heard someone mention self staffing. is this effective?

That is the ratio that I work on a Trauma Floor. And we are primary nursing. Most of our patients cannot walk, many require dressing changes. Also, we get a LOT of admissions on nights esp. during Trauma season.

We are a well oiled machine though and help each other a LOT. I've started IV's for other nurses. People have given out meds for me when I'm busy with more pressing matters. Teamwork is required with this ratio.

It is busy, but doable. We are staffed for 3 techs, but often go down to 2 or even 1 with callouts and 1:1's.

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Specializes in Trauma ICU, MICU/SICU.
hi guys, well i am a new LVN on my 8th day with a preceptor (new one today) and the worst thing that can happen, happened to me. i work med surg, sorry. i have 11 -15 patients and today 11. my preceptor (the new one not my usual one) was rushing me rushing me and i was so stressed out she grabbed my meds went in and gave to the wrong patient then had me give the patient an injection. when i went to grab chart i realized bed 3's med sheets were switched with bed 3's. i know i was responsible to for trusting her and not checking the patient's armband myself. i almost had a breakdown cried all shift. we monitored the patient (tiny cerebral palsy lady 30 yrs but looked 10) and the next day also and she is fine, but what if she wasn't. dear lord i don't think i can do this and i have just begun. our hospital patient ratio is crazy. even though we have an RN that's too many patients 11-15. i have been having such anxiety i don't even think i can go back there in a week. i almost quit the other night. i did not care if they fired me just cared about my poor little patient. the preceptor was not even upset and i was going out of my mind. i had to fill out the QRR. my DON and my nursing instructor said to not let another nurse (preceptor or not) rush me to where i do not do what i know is right. please guys if you can give me your thoughts. i am so scared that i did this and i know better. i graduated top of my class and was going on for my RN, now i wonder if this was a sign i can't do this. i am so stressed every day i go there, but wanted to get one year experience. now i'm not sure i can do this. any thoughts are most appreciated. very upset LVN in california:bluecry1:

If you're in CA why do you have so many patients? I have no comments because I've never done "Team" nursing. Does the RN have only 5 and the LVN has 11? I don't understand, please elaborate.

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I went to school in New Brunswick and did almost every institutional clinical at the Chalmers Hospital in Fredericton. They do primary nursing there, and I saw that nurses usually had 6-8 patients each, with I think 1-2 LPNs floating to help everyone. Don't quote me ;) Anyways, when I came home to PEI for preceptorship it was team nursing, 10 patients per 2 person team, plus floats, and nurses helping each other out on the unit when they can.

I never got the hang of 10 patients, whether I was trying to team lead or as worker, I was continously overwhelmed. I felt like if I had just a few less patients I might get it right with time. It just seems like there is no willingness on anyone's part to develop better ratios. For me, that's the keypoint that will probably keep me out of med/surg nursing.

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