Nurse-Patient Ratio Adult Unit

[pennie4n6]

What is the average ratio for nurses? I just started on an adult acute behavioral health unit. When I was hired I was told 1/6. That seemed safe. Now it is changed to 1/8. We have a lot of acute psychotic patients. I just got hit or the first time this week. Several staff have had serious injuries recently. Now I am reconsidering if I made the right decision. I really like this new job nut I want to be safe and keep my patients safe.

[vintagemother, BSN, CNA, LVN, RN]

NickFitz1969: re:What is LVN, SNF, LTC?

LVN = Licensed Vocational Nurse, known also as an LPN (Licensed Practical Nurse)

SNF = Skilled Nursing Facility

LTC = Long Term Care

[TCASII, ADN]

I managed to survive 18 months at a crisis facility, as the sole nurse on a locked unit with 15 to 18 involuntary patients. Most of them were high on meth, but extremely agitated, psychotic, manic and unruly. Very few were actually true MI, and the ones who were caused less trouble. Only the manic bipolar Pt's were difficult d/t constant redirection and the fact that you cannot medicate a manic to sleep.

I honestly attribute my ability to survive on my the techs, namely two who were part of my team every shift. Without those two people I would have quit. The other saving grace was the provider on call was an NP who really allowed me to medicate when I needed it.

Having said that, most places here in AZ are difficult at best.

[Neurotic Student]

I work in a smaller unit, but for all units we typically have 2 licensed nurses (1 RN, 1 LVN or LPT) and 2 unlicensed techs. Max capacity on units range from 14 to 20. I don't have to pass meds, I do assessments and paperwork. I find the max 20 patient units to be overwhelming.

1:8 is a lot if you have only 1 other tech with you. I typically have 12-14 patients and I find it overwhelming if we have just 2 patients that are acting up/needing a lot of attention. In those situations I get stressed out because I feel we don't provide enough attention to all the other patients and it is unfair to them. 12-14 patients can be a lot for me if my staff suck, but if I have a staff that is reliable, I'm good and feel my unit is really easy compared to the rest. When the psychotic units get really really bad, they usually add 1 tech indefinitely until the unit calms down.

[Girz71]

I work nights, on either acute (12 patients, 1 Rn + 1 unlicensed tech) or dual (24 patients, 1 rn + 1 unlicensed tech). It's overwhelming, except on the very rare occasion where everyone sleeps.

[Psych-n-Stuff]

16 bed locked acute unit. Ratio is 5 patients per nurse, minimum 3 nurses per shift. There is also an intermediate unit, which is reserved for substance abuse detox, for the most part. Have a lot of admissions and discharges at times and this adds to acuity level.

[shamrokks, ADN, ASN, RN]

Dayshift and nightshift differs but for adult we have up to 1:16 at night with 2 techs ... On days they get 2:16 with 2-3 techs depending on acuity ... Geriatric is 1:8 with 2 techs day or night and pediatric is 1:10 with 2 techs day or night .. If acuity is higher they always try to staff extra

[pennie4n6]

In acute behavioral health?

[pennie4n6]

I want to move to your state.

[pennie4n6]

Since I posted this question I was punched then kicked in the throat by the same patient Was sent downstairs to the ER. Had a CT of my cervical spine done with dx of cervical strain. Physically I am fine but mentally not so good. I went to EAP counselor who recommended for my safety I get out of psych nursing. I am still there but my manager agreed to put me on "safer, less potential for violence" areas while I am looking for a position in a different department. I was injured because the policy was not followed on our unit. My charge nurse is more concerned with patient's feelings than nurses safety. More injuries have occurred when she is in charge than any other time. There have been minor injuries, such as mine, black eyes, bruised noses, and severe injuries such as concussions and a vestibular injury. Through all of this the charge nurse is still in charge and the nurse/patient ratio keeps getting raised. I am sick of it. Sick of it. I have been a nurse for 32 years and am weary of fighting "the system" that makes all of the decisions and has a deaf ear to all of its nurses. Nurses have gotten no further with our rights than where we were when I started in 1984.

[angeloublue22, BSN, RN]

Mine was 1:30 with an LPN med nurse. Our Hospital did not allow LPNs to do anything other than pass meds. We also had 2 techs. It was crazy. As you can imagine, it was a revolving door for nurses.