Thoughts on Pt Nurse ratio

anotherone, BSN, RN · Jan 10, 2013

what type of patients do you get? to say med surg is not enough. as that includes assignments of walkie talkie cystic fibrosis pts in for abx, broken hip/ pelvis 90 year olds, other total cares, walkie talkies thyroidectomiea, gastic bypass post ops, IDs of different body parts. so much variation. pts with q1 orders, or getting blood, insulin drips, where i work 7 on days would be a complete nightmare. are there aides?

pugmom79 · Jan 10, 2013

i haven't started yet so i honestly don't know the answers to some of your questions. there are aides (thankfully!) my title is oncology RN but i know i can get med surg overflow etc, so i would imagine it could be a combo of the above. i know 6 is the standard there and i was told until i orient (12 weeks long) and are doing well i would not be thrown in in with that many if we had an emergency and had to have 7.

lpn2good · Jan 11, 2013

Hi All,
I am a new grad and just accepted an offer on a med surg/onc floor. The patient ratio on days is 1:6, and if someone calls out or things are hectic, they were honest and said it could be 7 occasionally. I really liked the vibe there, everyone was friendly and really seemed to believe in teamwork. Orientation is a solid 12 weeks so they don't just throw you to the wolves which is great.
I was just curious from some experienced people what you think of the ratio. It's a little more than I was expecting, but certainly not as scary as some others I have seen. Thoughts?

Been a nurse for 10 years and 6 pts are really busy and 7 is too many!! We most of the time do not have a CNA on the floor I work on and we are full care nurses! I do work at night have for 10 years! and love it!! But when we do have a CNA it makes for a good night! We have a lot of total care pts and self care are few and fare between. we have surgical pts as well at times! Keep organized and you will do well!! I work in the ER sometimes as well and that is a hole different bull!! Love both types of nursing!! My advice to you keep your CNA your friend and help her or him as much as you can, show them always you are a team member!!

RNlmk · Jan 11, 2013

I work on a med surg/onc floor and our ratios are the same - occasionally we go up to 8 pts, once I had 10. I also had 12 wks orientation & that was enough time for me. Most of my patients are not walkie/talkies but we have amazing cna's I learned as much from them as I did from my preceptors. We also have a great charge nurse who helps keep us up on changing orders. It's busy and overwhelming sometimes but if you have a good team around you it will be ok and you will learn so much. Good luck!

Nurse ABC · Jan 18, 2013

That's normal-not ideal-but normal.

BostonRN84 · Jan 22, 2013

6 or 7 on days???!!! That is very high and no offense, but once hearing that on an interview I would head for the hills regardless of this economy as I wouldn't want my safety and others, not to mention license on the line. I've been an RN 6 yrs now, just turned 29. After reading several posts, I feel fortunate for the ratios of the 36-bed General Surgery and Trauma Unit I work on in Boston at a level 1 trauma center teaching hospital, been on unit 5yrs now and hospital is not unioned for RNs. Ratios on day shift are 1:3 if full staff, sometimes 1:2 if census is down during holidays which is a rare treat. If short, ratio can be 1:4 max on days. Eve shifts are 1:3 or 4 and Nights are 1:4-6 but max is 6 for any nurse and would be a "bad night." Although it's a general care unit, acuity can be extremely high in addition to dealing with entitlement and psych issues to complicate things of patients and working with demanding families. "Walkie-talkies" are far and few between now and we're more of a step down unit as I get the SICU transfers. Most general care units now have patients what would have been ICU patients 10yrs ago. We have 3 PCAs on day shift who each have 4-5 patients, 2 PCAs on eves in which they are each assigned a side on floor, and night shift is just 1 PCA. Night shift is especially heavily dependent on nurse to nurse teamwork.

When interviewing, ratios was first question I asked. My first new grad job was in a community teaching medical/surgical hospital that's unioned but acuity was no where to what I deal with now, why I left to challenge myself at a level 1 trauma center. My ratio was 1:4-5 on days and 1:5-6 max on nights as I was a day/night rotator. PCAs did all VS, finger sticks regardless of being "assigned" to patient and I never did one bed bath but was challenged with what seemed like never ending med passes, dsg changes, tasks. Now I'm day/eve rotator with no nights (yay!) and oritenting to day charge soon, yikes! I'm anxious about that even though I was thrown into charge on eves but hopefully it will be ok, it better! Having strong support helps too, like active Nurse Manager and CNS to provide support for floor needs. Good luck on your new position and I really hope that ratio will change, regardless of acuity.

MgMRN1 · Jan 22, 2013

So interesting to hear of med-surg floors that has ratio of 4-5 patients. This is great for patient safety and especially the darn hcap. What state do you guys live in?

BostonRN84 · Jan 22, 2013

So interesting to hear of med-surg floors that has ratio of 4-5 patients. This is great for patient safety and especially the darn hcap. What state do you guys live in?

Massachusetts, state does not have a "safe ratio" law like California but where I work in Boston, ratios are very good as acuity is much higher compared to community hospitals.

N1colina · Jan 24, 2013

So interesting to hear of med-surg floors that has ratio of 4-5 patients. This is great for patient safety and especially the darn hcap. What state do you guys live in?

I live in NY (not NYC) and we have 4-5 on days, 5-6 on evenings, and 6-9 on nights (nights is always short)