Nurse patient ratio?

UnidentifiedNurse · Feb 4, 2007

where I work, nurses get 3-5 patients. Average is 4 patients though

DutchgirlRN, ASN, RN · Feb 4, 2007

No law that I'm aware of in Tennessee, however, the hospital I worked for had it written in policy that 6 was the limit and 4-5 optimal. Only 4 total allowed if one was a post-op epidural. I got old, and too tired to keep up. Now happy in home health.

Cattitude · Feb 5, 2007

wow, you guys had very good ratios. i worked nights on an ortho/med-surg floor and had a minimum of 7 pt's many that were post op and max of 10 pts. i never had only 4! and i worked at a level 1 trauma center too. we had some floor pt's that would have been considered icu at smaller community hospitals. 7-10 of those kept us busy.

EarthChild1130 · Feb 20, 2007

Our policy says no more than 6 per nurse, but I have never had more than 5, and I only had 5 for one hour...I had 4, and we got a direct admit an hour before shift change...once shift change, I kept 4 and gave one away (some of us work 8 hours and some of us, including me, work 12 hours).

Suzy2 · Feb 24, 2007

I live in Tulsa,OK and we always have at least 7 and up to 10 pt.'s every night. This is very dangerous practice. I am planning on working at a different facility within the next 6 months. It is ridiculous to carry such a large pt. load and definitely not beneficial to the patients. I am

afraid of being legally liable for something missed r/t the inability to keep up with such a large workload.

Wise Woman RN · Feb 24, 2007

I wonder about the patient ratio changes... if you have a 5:1 ratio, which is very good, but lose techs and secretaries, and cut back on other ancillary staff, will the stress be less?? It's really hard to have 5 patients, have to enter all the orders, answer the phone, keep track of the patients, (acute rehab)answer lights, pass trays, deal with families, fax discharge info, put the charts in order before sending to medical records, etc, etc... but it's all about the bottom line, isn't it?? Having to pay for more nurses will probably mean paying for less of the other services, and having nursing absorb those duties as well... More and more will be actually put on the nurses...so there will still be too much to do, and too little time in which to do it...

SillyLilly · Feb 24, 2007

I work in a community hosptial, part of a large hospital system in the Chicagoland area. We have 5 on a tele/medsurg/ortho floor. But they do not keep in mind the pt's acuity (many places dont, which is not the way it should be). We d/c and admit before you can blink your eye, and with alllll the new admission and d/c papers relating to medications, it takes up alot of time. Especially for me, since I am a new grad. They NEVER account for the time it takes to admit and discharge, and then receive post-ops, etc.

Often we only have 1 tech, so we have to help feed, bath, accu check, etc on 2-3 of our pts. That kills me on a busy day! And it tears me up that my lil old pt has almost no time to be fed, among other basic care they do not receive.

I had a pt sit in his mess for much longer than Id hope because he was incontinent, could not feel the urge to move his bowels or urinate, and was a mess like once an hour or more. (on a 12 hour shift, I cleaned him 4-5 times, and he still had to sit in the mess, had a rash, and everything). Even with an aid though, it would have been hard to manage.

In Illinois, I know some nurses from the Chicagoland area are fighting for all around nurse pt ratios. Some are even going down to the capital soon, also going to go to a rally for Obama.

Im still sorting out my thoughts on law mandated nurse-pt ratios.

Gromit · Feb 25, 2007

Florida doesn't have any law regarding ratio that I'm aware of either. Typical here is max of 6, my floor has fairly acute patients (vented, trached, hardwired telemetry, that sort of thing) and we are at 3, if they are really bad, it is 2 to 1. Of course our patients would be ICU patients at any smaller facility. The part that bites is that our nightshift has no ancillary help -unit coordinator or techs -they just can't keep 'em. The facility doesn't pay them very well, and our patients are quite a handful, so I really don't blame 'em for not wanting to work in our unit, but it does make for a long shift as a nurse.

fromtheheartRN · Feb 28, 2007

We usually have 3:1 without a tech. Do our own blood draws, orders, and ECG monitoring. 5:1 with a tech. Sometimes the tech can do all the delegatable stuff, sometimes can do little more than VS and baths. The other day we were short staffed and I had 6 patients with a tech that was a newbie...no phlebotomy...no orders, and didn't know how to read tele. UGH! These were patients on higher acuity than norm also. Told me that I was given that particular assignment because I am a "strong nurse." I don't think it's safe, but what can you do when there is no other alternative, and I KNOW it? I have recently learned the charge role, and although there is a matrix that we "need" to follow, it gets tossed out if the hospital is threatened to go on divert. Sometimes, the charge has a pt assignment as well. There are no "laws" that protect us here (like the ratio law in CA). It gets very frustrating for the floor and the charge. The directors just go home at 5pm and leave the oncoming charge with the wrath that is certain to happen when the night shift gets their oversized assignments. One night, there were FIVE rns for FORTY patients! And ALL were tele! Needless to say, we have a high turnover rate of rns (the major reason that the previous admin was fired). Other floors in the hospital, there is a 4:1 WITH a prn tech, AND a secretary that does orders. And those are regular med-surg WITHOUT tele! Hmmm, now how can we prevent this high rn turnover????

SteveNNP, MSN, NP · Mar 23, 2007

We have ratios from 1:1-1:3 depending on acuity. Whatever we end up with, you can bet we're busy all 12 hours......

Stephen

ginger58, ASN, RN · Mar 23, 2007

In California it's 5:1 for med-surg. In the more acute areas the ratio is lower. I feel for all of you who have six or more patients and I don't know how you do it.