Nurse Patient ratio in NJ

NJNursing, ASN, RN · Jun 26, 2008

I had a hard time finding anything. I know that Nj passed a law requiring facilities to make PUBLIC their nurse/patient ratios. I could find where NJ was trying to put a cap on RN/patient ratios, but couldn't find whether they passed it or not. I got a lot of runaround on the net. The best I could find was this:

http://www.nursingworld.org/MainMenuCategories/ANAPoliticalPower/State/StateLegislativeAgenda/StaffingPlansandRatios_1.aspx

NJLaurenRN · Aug 2, 2008

i heard that there isn't any law set for a med/surg nurse to pt ratio. i know that the max pts on a tele floor is 6; ICU/CCU 1-2, but i dont think there is a set max for med/surg. i work on a ortho unit, and wish i only had 6 pt's at a time. sometimes i end up with 10-13pts. crazy and unsafe and exhausting

emtb2rn, BSN, RN, EMT-B · Aug 3, 2008

i heard that there isn't any law set for a med/surg nurse to pt ratio. i know that the max pts on a tele floor is 6; ICU/CCU 1-2, but i dont think there is a set max for med/surg. i work on a ortho unit, and wish i only had 6 pt's at a time. sometimes i end up with 10-13pts. crazy and unsafe and exhausting

In Atlantic Health (Morristown & Overlook), I've seen ratios of 10:1 on the overnight for tele floors, normal was 8:1. Definitely no max for med/surg, seems whatever the staff will take, saw up to 7:1 daytime at Morristown. Mountainside has gone to 10:1 days and 12:1 nights. Not safe.

AtomicWoman · Aug 3, 2008

Wow, that is A LOT of patients to care for! How on earth are you supposed to avoid making mistakes when you must be running from pillar to post from the moment you step on the floor?

NJNursing, ASN, RN · Aug 4, 2008

I don't think there is a state mandate for nurse to patient ratios as of yet. I get a lot of emails from the ANA and the NJSNA about pushing for legislation about it so that really firms up that there's nothing in place nationwide. We have to be our own advocates. Keep complaining up the chain until you get someone to hear you. Of course a lot of places are going to cry about the Governor's budget cuts to hospitals and nursing homes and the medicare cuts, etc. which will be their excuse as to why they don't hire more people. I think the fact that a lot of places are starting to phase out LPN's is crazy - at least at this juncture. A lot of places are looking at the bottom line and think of employees as expendible. If there's an error they'll replace someone with another person until they make an error and so on and so forth. It's insane. I'm very thankfuly that so far at the new hospital I'm at I haven't had to deal with more than 7 or 8 patients at a time (night shift) and it's mostly 5-6 most days. It's unionized and there are union regulations based on unit census to staff ratio which is much more favorable than my last job. :yeah:

NJLaurenRN · Aug 5, 2008

think the fact that a lot of places are starting to phase out LPN's is crazy - at least at this juncture. I'm very thankfuly that so far at the new hospital I'm at I haven't had to deal with more than 7 or 8 patients at a time (night shift) and it's mostly 5-6 most days. It's unionized and there are union regulations based on unit census to staff ratio which is much more favorable than my last job.

i work at Community Medical Center in Toms River, NJ (exit 82A).

#1- yeah they're phasing out LPN's in my hospital too. I think they're trying to push them out. Some are now working as Resp Therapists, most were put in a float pool. And now if we have an LPN floated to our floor we have to do their fall assessment for them, do the physical assessment for them, then open their note for them (the narrative) then co-sign the end. they just started to implement this policy this last month. some of the LPN's are better than some of the other RN's I've seen; especially if they have alot of experience. had to do it the other day. luckily i knew the nurse and he is awesome. i opened the note on what he told me. but i wouldn't do that for anyone else.

#2 where do u work. i wish i started with only that amt of pt's. today i had 8 to start. discharged 1; and got two more admissions.:banghead:

#3we tried for a union, but it got shot down. not being racist (I'm Far from that) but we have a good amt of phillipino rn's and i heard that they all turned it down. i wouldn't mind having a union. would u mind telling me the pro's and con's of a nursing union. i know that when my mom worked for jersey shore they went on strike in the 90's they were on strike for several monthes; she had a great position for w/ great hrs(she had worked there for almost 30yrs)in the end of the strike she lost her job to a scab (actually a new grad) and she got stuck on a renal floor going back to floor nursing. she quit a yr later:scrying:

NJLaurenRN · Aug 5, 2008

Wow, that is A LOT of patients to care for! How on earth are you supposed to avoid making mistakes when you must be running from pillar to post from the moment you step on the floor?

yea we run are butts off. put it this way. its a great diet. i lost 35 lbs in the last year. before nursing i was a bartender. was eating fried food at 4am then going to bed. i went from a size 8 to a 2 now. and just in time for bikini season. lol so there is a bonus for being over worked. only bad part was i had to buy all new clothes and bathing suits. :cool:

AtomicWoman · Aug 5, 2008

yeah they're phasing out LPN's in my hospital too. I think they're trying to push them out. Some are now working as Resp Therapists, most were put in a float pool. And now if we have an LPN floated to our floor we have to do their fall assessment for them, do the physical assessment for them, then open their note for them (the narrative) then co-sign the end. they just started to implement this policy this last month. some of the LPN's are better than some of the other RN's I've seen; especially if they have alot of experience.

That is really sad for the LPNs. It seems so insulting to those of them who have lots of experience.

I wonder... do hospitals get a break on their malpractice insurance if they have mostly RNs and few or no LPNs? Just trying to figure out why they would be trying to push out experienced LPNs...

NJNursing, ASN, RN · Aug 5, 2008

I wonder... do hospitals get a break on their malpractice insurance if they have mostly RNs and few or no LPNs? Just trying to figure out why they would be trying to push out experienced LPNs...

I honestly don't know. I think it's just more of an inconvenience for most hospitals. The hosptial I used to work at was phasing out LPN's but the ones who were there had to rely on the RN's to really complete half their work. The LPN's couldn't take any verbal MD orders, had to have their charts signed off by RN's, could give any meds IV push, but could start IV's. So if the one LPN on our floor had a lot of post-ops on iv pain meds, the poor RN assigned to her would basically have double the case load covering both patients which just seemed unfair. While this LNP had like 20 years experience and was a great nurse, it must be frustrating for her seeing fresh grads with more priviliges than her and her needing to go to them to get her patient care done.

NJLaurenRN · Aug 6, 2008

i believe they do save money that way. also i think its easier for staffing, ex-like a day lpn can not follow a night lpn. so that an assessment (fall) gets done once a day by an RN. and also they can only have one LPN on a unit at a time. i don't know theres a lot of political B.S. in hospitals. plus i heard that in the next year or two they are only hiring BSN and not ADN's. i have my ADN but am going back for my MSN in an excellerated online program possibly next yr. but if i didn't i think i would be grandfathered in. in fact i think a lot of hospitals are now requiring BSN's only so no associates degree RN's are even considered and def not LPN's. most LPN's working in nursing homes in my area

camlvn · Oct 29, 2009

Somehow we as nurses have to push toward better staffing ratios. I work in a subacute facility where it is common for a floor of 32 high-acuity patients(PEGs, trachs, IV ABTs, wound vacs, life vests) to be staffed with 2 nurses and 2-3 CNAs. :down:We have no secretary and no charge nurse. All we have is one supervisor over the whole house(4 units). We do our own admissions also. Since our manager likes to hire new RNs, I frequently find myself (an LPN) basically keeping track of all the patients on the floor. I do everything the RNs do except mix TPN and d/c PICCS. And that house supervisor- is an LPN on the weekends:crying2:. When we ask about better staffing we get told that two nurses is perfectly legal and then we get reamed out for asking. The patients and families complain constantly and what can we do? We're so busy we never get breaks much less have time to explain facility policies. I can't believe that national nursing organizations aren't on this and trying to make changes. It's unsafe and a lot of days my coworkers and I look at each other and ask why we got into this. And- get this- we're supposed to be one of the better facilities. New Jersey- pay attention and improve health care in this state!