nurse-patient ratio

Specialties Med-Surg

Published

Within the last year, we restructured our Med-Surg nurse patient ratio to be 1:6 for days/eves, and 1:8 for nights. I am interested in hearing what other ratios in Med-Surg are. I work in a 400 bed city hospital, and the Med-Surg units are a mix of med-surg, ortho, oncology.

I WORK ON A SURGICAL UNIT AND AVERAGE ON AM'S 1:4-5, PM'S 1:6-8 AND NOC'S 1:6-9. OUR UNIT AS YOU MAY IMAGINE IS FAST PACED AND MOST OTHER NURSES IN THE HOSPITAL DO NOT WANT TO "FLOAT" TO OUR UNIT. IT SEEMS AS THOUGH MANAGEMENT IS IGNORING OUR PLEA FOR SMALLER, SAFER RATIOS. HEALTH CARE IS NEGATIVELY AFFECTED BY THESE STAFFING CUTS EVERY DAY YET WE ARE EXPECTED TO PROVIDE OUTSTANDING CARE WITH THE MINIMUM RESOURCES WE ARE GIVEN. IF I KNEW THEN WHAT I KNOW NOW, I'M NOT SURE NURSING WOULD HAVE BEEN MY CAREER CHOICE. WE FEEL OUR VOICE WILL NEVER BE HEARD. I LIKE WHAT I DO BUT I WISH THINGS WERE DIFFERENT.

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Gibby- Your nurses are OVERWORKED and UNDERSTAFFED!.8 -1 on days! REALLY!Don't give us that managers tripe about poor organizational or delegation skills.WHO are they going to delegate to.EVERYONE is too busy.It's amazing how many nurses are acused of this.A real wonder they can even find their way to work everyday.Try lowering the nurse to pt ratio and see quality of care and job satisfaction improve.Who can get organized in that mess.They're too busy putting out fires all day and drowning at the same time.GO MILLION NURSE MARCH! Pts and their nurses deserve more than this.PQUOTE]Originally posted by gibby:

I manage 5 units- one 8 bed ortho, one 15 bed oncology, two 24 med/surg and one 25 bed med/surg. The ratio's are 8:1 on 7-3 and 3-11, 10:1 on 11-7, except the large units - if above 20 we had the 3rd nurse. Same ratio's for nurse assistants, 11-7 we always maintain 2 nurse aids. We have no charge nurses, use a clinical resource nurse to float between the units to assist with all needs, also float a nurse tech on 7-3 and 3-11 to do glucoscans, peipheral IV removal, dsg. changes, decub. care, ostomy care, g-tube fdgs. All units have a unit sec. The staff seem to be overwhelmed most of the time. We have very rapid turnover in patients. Many seemed to be overwhelmed by the pace. Delegation, prioritization and organization seems to be a problem amoung some of the nurses. They previously depended upon a charge nurse and appears they have not had the opportunity to develop these skills. Any suggestions for improve would be appreciated.

[This message has been edited by plumrn (edited November 22, 2000).]

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Gibby:

Will you let your nurses have 1/2 hour for report? 1 hour. 5 minutes to check each chart? 40 minutes. 5 minutes for assessments? 40 minutes. 5 minutes to pass meds? Another 40 minutes (twice). Dressings, IV or NG pulled out? 40 minutes. Please let them have 10 minutes to chart on each patient! 80 minutes.

How about mobilization. Assessing balance or turning, helping into a chair? 5 minutes OK (they have help I know but we don't want contractures and decubiti) 40 minutes.

Lunch?=1/2 hour.may a nurse use the bathroom twice for 5 minutes? 10 minutes.

There is rapid turnover. Give 1/2 hour for one discharge, one admission, one transfer. Please! Thank you!

Your nurses need at least 5 minutes a patient to track down results call the MD, follow through.

Well, they have worked more than 9 hours in an 8 hour shift. No codes, upset families, lost belongings, missing meds or equipment. Pretty good nurses! Why are they so overwhelmed? Can't they do 9 hours work in 8 hours, go home wondering (or knowing) what they missed, be sorry for not being able to be in more than one place at a time, and have energy left for their family?

How long will it take before they go back to school to learn computers?

PS: You are overworked too! that is too many patients! YOU have been made responsible for the quality of nursing care without being provided control over the resources needed for that care.

Please don't let your so called superiors tell you the nurses need better delegation skills. NURSES should do nursing! NOT delegate it to others. That is the reason for nursing school!

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I also depend on a charge nurse. There may be an alternative. What is it?

Also I depend on O2, H2O, and nutrients. Sometimes what we depend on is necessary.

The nurse manager who posted was overworked so couldn't possibly take up the slack as my manager does when the charge must take a full assignment.

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Joy, Your comments are resounding across the nation I'm sure.We feel the same way where I work.Hang in there;It can't get any worse...can it? If it does,I will just have to leave this profession I love and am actually very good at.(Charge nurse (who takes a pt load also) on a busy surgical floor.)

Originally posted by JOY, RN:

I WORK ON A SURGICAL UNIT AND AVERAGE ON AM'S 1:4-5, PM'S 1:6-8 AND NOC'S 1:6-9. OUR UNIT AS YOU MAY IMAGINE IS FAST PACED AND MOST OTHER NURSES IN THE HOSPITAL DO NOT WANT TO "FLOAT" TO OUR UNIT. IT SEEMS AS THOUGH MANAGEMENT IS IGNORING OUR PLEA FOR SMALLER, SAFER RATIOS. HEALTH CARE IS NEGATIVELY AFFECTED BY THESE STAFFING CUTS EVERY DAY YET WE ARE EXPECTED TO PROVIDE OUTSTANDING CARE WITH THE MINIMUM RESOURCES WE ARE GIVEN. IF I KNEW THEN WHAT I KNOW NOW, I'M NOT SURE NURSING WOULD HAVE BEEN MY CAREER CHOICE. WE FEEL OUR VOICE WILL NEVER BE HEARD. I LIKE WHAT I DO BUT I WISH THINGS WERE DIFFERENT.

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What is all of this talk about leaving the profession? We are a large and potentially powerful group. This means that if we don't like what's going on in our profession (staffing) we can change it. We just need some dedicated people to devote some time and effort. There are things we can do other than giving up and leaving the profession. There are nursing unions that have been successful at fighting for nurses' rights. There are also nurses going into business for themselves and calling their own shots. We can do it too. And the quality of patient care will be all the better for it. Please don't give up. Let's get together. Email me.

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I work on Med/Surg and the ratio is 1:7 days, 1:10 evenings and usually 1:15 nights. Over worked and under payed. When will a bill be passed to mandate nurse patient ratios as they have with teachers. Patient care is suffering. They keep adding paper work, forms to be filled out...what happened to quality of care.

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I work on a 50 bed unit. The ratio is 1:8 on days and afternoons. Midnights is 1:12. $aides on days and afternoons, 2 aides on midnights. Paperwork isnt too bad, but as you all say overworked and underpayed.

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Our 25 bed med surg unit has just recently revamped the matrix. We used to get 3 nurses for 12 patients. Now it is 3 nurses for 15 patients. We loose one of the aides at 11 am on days if it stays at 14. However, should we drop to 13, they call the aide back in and send one of the nurses home. Then should we get two admits they want the nurse they sent home to come back in. Confused yet??? It is rediculous. They wanted to send a nurse home the other day at 2:30 (her shift ended at 3 pm anyway) when the census dropped to 14. Is this nuts or what??? We can get 7 to 8 admits in one afternoon--and this can happen in a matter of minutes--we have three nursing homes nearby, and have direct admits from the various doctor's offices, as well as transfers from ICU. Not only that, our hospital is on a campaign of patient satisfaction. what is wrong with that picture?? Doesn't make sense to any of us that they want us to leave on time to prevent any shift overlap but we are suppossed to cater to every whim our patients have for high patient satisfaction, and they add to the patient load for each nurse. Our managers are constantly on our butts to leave when the census goes down by one, but then dissapear when we need some help (like getting an admit 10 minutes after they tell one nurse to leave.) Getting very disgruntled. And they wonder why people leave the nursing field, and don't want to recommend it as a career to someone else. And it seems as if it is getting worse instead of better.

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Standard staffing levels on my NHS acute surgical ward are never higher than 1-10. This is about the normal level for every ward in the hospital.

Extra staff are just not available due to the general shortage of nurses in the UK.

Thank heavens for HCA's

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This is why I went to L&D so fast out of school! 1 RN, 1 LPN for 12 patients on the orthopedic floor I worked on briefly.

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most of the posts I have read are a dream I work on a med tele 12 hour shifts and our ratio is 1-7 sometimes 1-9, we have 38 beds and many days have only 4 RNs 3 aides, we very seldom get a clinical anymore, somedays I feel as though I have done nothing for my patients, we do use an acuity but it is so out of line that even the high acuity do not show as being as high as they should be. Now with the shortage it is only getting harder, what keeps me there is the people I work with and the company is truly trying to help there staff, the give yearly bonsus and are always looking for ways to show how much they appreciate us. not to mention my patients, they need us, we truly are their only advocate in a hospital.

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