Nurse:Patient ratio

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Hello everyone,

I was wondering what is the RN to patient ratio on your unit. I work on a surgical unit and we have 1 Rn to 4 patients for the day shif, 1 to 5 for evenings. Also do you have LPN's working on your surgical floor?

Thank you.

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Hello everyone,

I was wondering what is the RN to patient ratio on your unit. I work on a surgical unit and we have 1 Rn to 4 patients for the day shif, 1 to 5 for evenings. Also do you have LPN's working on your surgical floor?

Thank you.

You don't say where in Canada where you are working. It's very usual to have LPNs on the surgical floor.

Here in AB, I work Surgical Services in one of the busiest hospitals in the province.

On a day shift, each nurse ideally has 3 patients, four is the norm due to staffing issues. After 1500 hours, it is 4--5 patients. Nights can involve 8+ (again depends on if sick/vacations/no show staff can be replaced).

Each RN and PN is accountble to the Charge for their patients. Each nurse provides total care for their own patient. The only exception being patients on blood or TPN. Legally, the RN is required to pierce the Travisol or Blood bag and hang it. So, they walk back to the bedside with the LPN, do the duplicate checks, hang the bag and walk away. The PN is then responsible for everything. The same thing happens when an RNs patient requires blood or Travisol, the two nurse check is duplicated at the bedside and the PN walks away.

LPNs don't work Recovery but that isn't a surgical floor really. But we are in Gynie, Trauma, Thoracic, Ortho, General, Opthamology, Cardiology, Urology, etc.

The reality is with the change in PN education (with it now being the old diploma course in most aspects in several provinces) you will see more and more PNs all over the acute care spectrum. I've worked shifts where out of the six scheduled nurses to be on the floor, there have been five LPN and one RN. The Charge is of course an RN and therefore we always had an RN on the floor over break times.

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Thank you for your reply. I work in Vancouver. Our LPN's do not deal with any intravenous treatments either. We have a PCC for the day shift. The charge nurse for the evening and night shift is one of us (usually the most senior) and has a full assignment. Does your charge RN has an assignment or her duty is being charge ?

Thanks

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Specializes in acute care med/surg, LTC, orthopedics.

I work at several hospitals ranging from small-town to big inner-city, and the nurse/patient ration depends mostly on acuity.

Ideally days/evgs is 4-5 and nights can be up to 8, but if we're working short we can pick up an extra patient or two - on my ortho unit they'll give us an extra orderly to compensate.

RPN/LPNs work on all the surgical units (gen surg, ortho, thoracix, respirology, gyne) and the medical floors (medicine, psych, ALC) including MBU, emerg, all outpatient clinics and also in the OR (with the extra certificate.) But generally not on L&D, ICU, NICU, CCU, or PACU.

None of my units has a TL who doesn't have a full patient assignment of her own: primary nursing model of care means you're only assigned a patient you can fully provide care for so RPN/LPNs don't rely on an RN for anything (with the odd exception.)

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Thank you for your reply. I work in Vancouver. Our LPN's do not deal with any intravenous treatments either. We have a PCC for the day shift. The charge nurse for the evening and night shift is one of us (usually the most senior) and has a full assignment. Does your charge RN has an assignment or her duty is being charge ?

Thanks

Currently in AB, we do not access central lines (but it's coming according to our CNEs). LPNs are responsible for their own IV starts and med administration including PPN (we just get an RN to pierce the Travisol and hang the bag for us). You should probably check out the actual scope of practice for PNs in your province.

Days/Evenings Charge does not have an assignment. Night Charge has the easiest or closest patients to the desk.

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Ideally days/evgs is 4-5 and nights can be up to 8, but if we're working short we can pick up an extra patient or two - on my ortho unit they'll give us an extra orderly to compensate.

RPN/LPNs work on all the surgical units (gen surg, ortho, thoracix, respirology, gyne) and the medical floors (medicine, psych, ALC) including MBU, emerg, all outpatient clinics and also in the OR (with the extra certificate.) But generally not on L&D, ICU, NICU, CCU, or PACU.

None of my units has a TL who doesn't have a full patient assignment of her own: primary nursing model of care means you're only assigned a patient you can fully provide care for so RPN/LPNs don't rely on an RN for anything (with the odd exception.)

ORDERLY???? OMG you are living in the lap of luxury. We don't have an NA after 23hr. Orderlies don't even exist here anymore.

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Currently in AB, we do not access central lines (but it's coming according to our CNEs). LPNs are responsible for their own IV starts and med administration including PPN (we just get an RN to pierce the Travisol and hang the bag for us). You should probably check out the actual scope of practice for PNs in your province.

Days/Evenings Charge does not have an assignment. Night Charge has the easiest or closest patients to the desk.

Obviously, the scope of practice for LPNs is different in BC. The fact that your Charge does not have an assignment makes a huge difference too.

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Specializes in acute care med/surg, LTC, orthopedics.

Yep, I love orderlies, but we don't have them on all the units. Ortho is particularly heavy with all the post op hips and knees, couple that with so many elderly means that a very small portion of these patients are independently ambulatory. The majority are two person assist, some mech lifts and if it wasn't for the orderlies the only thing the nurses would get done is the personal care. There would be no time for meds, assessments, getting orders, admit, d/c and I must say... they seriously work their butts off being paged from room to room. We used to have two orderlies on days and two on evenings but cutbacks meant one orderly position was eliminated (better than a nursing position) so now one shift overlaps. At night we don't have orderlies unless we're down a nurse. All in all, I have to say the staffing levels at each of my hospitals are pretty reasonable the majority of the time, only once was I involved in a workload grievance and that's only because the other nurses complained and sort of roped me into it, but I didn't really think it was that bad.

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I am an RPN who works in a rural hospital in Ontario and was wondering what the nurse patient ratio is at other facilities as we are feeling overloaded. We are an active medical floor with palliative, medical, occ peadiatrics and pts awaiting placement. On days and eve we carry a 6pt workload and are up to scope (most are not yet starting IV) they now want us to do dr orders. We do everything for our pts. On nights 9pts. RN carries 5. We work all units except Intensive Care and OR.

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Specializes in Oncology, Medical.

I work on a large (58-60 beds) medical-oncology-palliative unit, so we see everything from "failure to thrive" to "febrile neutropenia" to "below the knee amputation" (why amputations fall under acute medicine rather than surgical I will never know).

For day shifts, it's 1 nurse to 4 patients ideally but there's always one or two nurses with 5 patients. For night shifts, it's 1:6 or 1:7 (two nurses will always end up with 7 because charge nurse gets 4). There are no PSWs on our floor so nurses handle all patient care. It's an insanely busy floor and is rather notoriously disliked amongst the float pool nurses because of it, unfortunately (there are other reasons for the dislike, too, but that's another story).

We have both RNs and RPNs on the floor. Our RPNs do almost as much as the RNs except for chemotherapy, neutropenic patients, handling central lines (although that's soon to change regarding PICCs), acute dialysis patients, fresh trachs, and tunneling wounds.

In the hospital as a whole, I believe RPNs are everywhere except in critical care areas (not too sure about the ER, though).

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