Nurse/patient Ratio.....

Anniekins · Aug 21, 2004

I work on a surgical floor specializing in organ transplant and bariatric surgery.

Days: 1:6

Evenings: 1:5 (No aid's on evenings)

Nights: 1:10 :rolleyes:

EMTPTORN · Aug 21, 2004

44 bed level 2 trauma center: ratio officially just reduced from 4:1 to 3:1.....unoffically could be up to 5:1 with hall pts...could be worse with multiple traumas in the house....

KacyLynnRN · Aug 21, 2004

I work day shift (7am-7:30pm) on a med/surg unit...each nurse used to have 4 patients per day, 5 if it was really crazy, and 2 nurses shared 1 tech/CNA as well...last year they laid off a bunch of management and all of our Techs/CNAs...now we have 4 patients with no help on a great day, 5 most days, and yesterday I came in and we were 6 nurses short!!! and I had 6 patients. It was HORRIBLE. And management laying off our techs really hurt...they were invaluable. :crying2:

lsyorke, RN · Aug 22, 2004

I work on med surg floors and occasionally telemetry(float pool)

7a-3p 6-8 patients

3p-11p 6-10 patients

11-7 8-12 patients

rsh3rn · Aug 22, 2004

Recovery room ratio can be bizzarre I can have 2 floor or IMC level pts when beds are tight (like they ever arn't), plus anything that comes out of surgery on night shift. Most nights I work alone then if staffing is good I may get an aid or on really good days another nurse. Can't complain too much most nights I recover one patient in 8 hrs and about 50% of the time I have an overnighter

Gompers, BSN, RN · Aug 22, 2004

In the NICU it's anywhere from 1:1 thru 1:4, depending on patient acuity.

Rare cases include a baby so sick we need 2 nurses to 1 patient, or if we're crazy busy and it's hitting the fan, then we might be 1:6 with "easy" babies and a NICU respiratory therapist helping out with feedings and such.

rhonda L · Aug 23, 2004

I work at a nursing home and am resposible for around 33 residents. I usually have 3 CNA's sometimes 4 if i'm lucky. My a.m. med pass is hell:crying2:

hi i also work at a nursing home i am responsible for 42 patients and usually have 4 cna's sometimes 5. most difficult med pass consisting of tube feedings, crushing meds for alzeimers patients who can't swallow pills. i have been doing 12 hour days for several weeks due to nurse shortages, and i am exhausted. i know how you feel........ :uhoh3:

Ari RN, BSN, RN · Aug 23, 2004

Thank you to everyone that posted. Please continue posting!

Here's another question in conjunction with the original question.

How many patient's is too much?

Thanks!

pickledpepperRN · Aug 23, 2004

Our critical care units have had a mandated ratio of 2 or fewer patients per licensed nurse for a quarter century. Still we had to learn that this means at all times. Now we have ratios for all os acute care. Long term care needs ratios too!

Telemetry uses two basic staffing acuities 1:3 for vents and unstable patients, 1:5 for "regular" tele patients. Depending on the assertiveness of the staff they use a sensible acuity common sense RN over ride of the computerized system.

Med surg is 1: 6 or fewer patients per nurse.

My unit sometimes does not have a break relief RN due to admissions or a late sick call. Then sometimes a competent supervisor does her best to relieve us for breaks. More likely she has her secretary bring food to the unit. This is outside the legal regulations but happens less than once a week.

On weekday day shifts our manager provides break relief or transports a patient so days is almost 100% within ratio at all times.

This is MUCH better. We can truly provide quality care almost all the time!

How many is too much? Depends on how sick the patients are, the experience level of staff, and other variables. My personal opinion is that between the charge nurse and the nurse(s) assigned to the patients they know! Their opinion needs to be trusted!

http://www.nursingadvocacy.org/news/2002oct23_jama.html

http://www.nursing.upenn.edu/news/detail.asp?t=2&id=23

http://query.nytimes.com/gst/abstract.html?res=F30713FB3B580C768EDDA90994DA404482

http://jama.ama-assn.org/cgi/content/abstract/288/16/1987?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=aiken&searchid=1065888732940_1831&stored_search=&FIRSTINDEX=30&journalcode=jama

Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

Linda H. Aiken, PhD,RN; Sean P. Clarke, PhD,RN; Douglas M. Sloane, PhD; Julie Sochalski, PhD,RN; Jeffrey H. Silber, MD,PhD

JAMA. 2002;288:1987-1993.

Context The worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-to-nurse ratios demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital practice.

Objective To determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention.

Design, Setting, and Participants Cross-sectional analyses of linked data from 10 184 staff nurses surveyed, 232 342 general, orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 30, 1999, and administrative data from 168 nonfederal adult general hospitals in Pennsylvania.

Main Outcome Measures Risk-adjusted patient mortality and failure-to-rescue within 30 days of admission, and nurse-reported job dissatisfaction and job-related burnout.

Results After adjusting for patient and hospital characteristics (size, teaching status, and technology), each additional patient per nurse was associated with a 7% (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.12) increase in the likelihood of dying within 30 days of admission and a 7% (OR, 1.07; 95% CI, 1.02-1.11) increase in the odds of failure-to-rescue. After adjusting for nurse and hospital characteristics, each additional patient per nurse was associated with a 23% (OR, 1.23; 95% CI, 1.13-1.34) increase in the odds of burnout and a 15% (OR, 1.15; 95% CI, 1.07-1.25) increase in the odds of job dissatisfaction.

Conclusions In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.

lee1 · Aug 23, 2004

I think it depends on the type of hospital---high acuity, trauma level

Types of patients---

Do you all know that your hospitals have to abide by certain state regs????

In NJ the hospital state regs say 1:3 for ICUs but must be able to flex up to 1:1 or 1:2 if acuity is needed. AACN promotes not more than 1:2 which it has for many years. Telemtry or intermediate care 1:6. Unfortunately there is NO protection from unscrupulous hospitals as of now for med/surg. This is why there has been a BIG movement by many organizations for federal regs. CA still has their ratios that they were supposed to be doing being fought over by the greedy hospitals. Why is it that they are not more publicized?????