Nurse to Patient Ratio

mwboswell · Apr 7, 2009

There really is no "normal" nurse to pt ratio; it varies widely.

From my own personal experience I can tell you I've worked in places where the ratio is as low as 3:1 up to 8,9,10:1 ...!!!

It really boils down to:

1. your volume

2. your staffing

3. your manager

4. your manager's staffing budget

5. your support (IE: unit secretaries, techs, CNA's etc)

6. your patient acuities

Unfortunately there is no universal standard.

There is much anecdotal commentary on the subject, but to the best of my knowledge, no scientific research to "prove" what ratios are the best.

I would advise you look at the ENA (Emergency Nurses Association) webpage.

On there, you can find publicly accessible documents and position statements that your national ENA has made regarding safe staffing.

There are some models which are acuity based which seem to be most utilitarian.

So I guess there's no easy answer for this; but just remember, during a mass casualty it could be 20:1 !!!!!

hope this helps.

-MB

LittleLindz · Apr 7, 2009

Thank you so much for the helpful reply! I had been looking on the nursing licensing page and just all sorts of stuff to find ANY preset guide to the staffing ratio. Sometimes we have just too many beds, too high acuity, with no support staff for any one nurse to handle. So, i thought if i could find some documented information, it may help. The ENA webpage is a GREAT idea. Thanks so much!! :)

Editorial Team / Moderator · Apr 7, 2009

In our ER, we do zone nursing. We have 5 beds in each zone, so usually that's the max a nurse will have. However, I'm sure we've all see the "two-fers," where a parent and child, or a couple of siblings, or even a family signs in at one time. I often have the zone that has the peds room, and I can usually count on a two-fer or two during my stretch of shifts. But our triage nurses (usually) take patient acuity into account so as to not overtax one zone or the other (i.e., if I have 4 cardiac work-ups already, don't stick a two-fer in my peds room with cold symptoms or sore throats). Triage really is an art form sometimes! :)

mwboswell · Apr 7, 2009

In our ER, we do zone nursing. We have 5 beds in each zone, so usually that's the max a nurse will have. However, I'm sure we've all see the "two-fers," where a parent and child, or a couple of siblings, or even a family signs in at one time. I often have the zone that has the peds room, and I can usually count on a two-fer or two during my stretch of shifts. But our triage nurses (usually) take patient acuity into account so as to not overtax one zone or the other (i.e., if I have 4 cardiac work-ups already, don't stick a two-fer in my peds room with cold symptoms or sore throats). Triage really is an art form sometimes! :)

We have a hospital in our region that has "Areas" and each area has 5 rooms, HOWEVER, in each area there is room for 2-3 stretchers in the hallway!!!! So each RN could have up to 8 patients each!

-MB

Editorial Team / Moderator · Apr 7, 2009

We have a hospital in our region that has "Areas" and each area has 5 rooms, HOWEVER, in each area there is room for 2-3 stretchers in the hallway!!!! So each RN could have up to 8 patients each!

We're small -- 15 beds, and maybe every now and then we set up some "hallway beds" in the form of chair where patients with wrist injuries and whatnot can sit ... but we don't even possess any more stretchers than the 15 we have in our rooms. It's a freestanding ER with few resources beyond ourselves. I'm kinda glad we don't have more room for hallway beds!