nurse-patient ratio

lv2ski · Nov 19, 2001

Hi, In resonse to ldjrn... It is infuriating and saddening to see what you are up against I too have had many a shift with what I consider unsafe staffing. Presently I am at a hospital where the staffing is 'ok' when compared to most places. I left a smaller community hospital with little resources and bare boned staffing. Until the 'higher ups' in administration realize nurses are the back bones of the hospital things will not get much better. I don't think there is a nursing shortage as much as nurses job-jumping for safer and more rewarding situations. we can either bail out and look for better situations, as I have done, or get active and political so our voices WILL be heard. I plan to do just this, by writing to local representatives and other politicians. I remind them that it will help their campaign to mention the nursing shortage...there are alot of nurses that vote! It is only in fairness to our patients and ourselves that we fight for better working conditions.

good luck to all.....

ohbet · Aug 8, 2002

If staffing is dangerous doesnt the buck stop with management?

Repat · Aug 8, 2002

My husband asked the same thing, but although I have seen the lists from the BON of nurses who have lost their licenses, I still have yet to see a hospital lose anything important. Bottom line, it is our licenses at risk. Before I started back after a long break, I thought that all the 'belly-aching' was just that, but was I ever wrong. It's worse than I thought, and I don't see too much happening to improve anything. The Nurse Reinvestment Act may get more people into school, but it has not addressed how to keep the graduates in the job. Money, staffing levels, patient acuity - no mention of these.

2rntish · Aug 9, 2002

Enjoyed reply #16 from Cindy Lou. We too have spent up to 3 hours in class learning to smile and give "scripted" answers when patients ask for something. Not 3 hours of how patient care could improve or how dangerous it really is.

jacknpheebs · Aug 12, 2002

here in the uk im working nights on a 29 bed acute medical ward including 4 cardiac monitored beds , one RN (me) and two health care support workers (equivalent to your aides) please tell me californias better, ive passed my nclex have been approved by ins and should be emmigrating in december -january (ish)

cannot wait

:) :devil:

Scavenger'sWife, RN · Aug 13, 2002

GADS...The posts about ratio are so varied and mostly BAD! :eek: I used to think my hospital was tough, but now I think we are more in the better category. I work on a 42-bed med floor, occasionally get a surg pt. We have Marquette tele which we carry pagers for that beep us with lethal rhythms (as determined and set by the programming RN). We also carry cell phones so the unit clerks, docs, families, etc. can get their phone calls to us w/o the RN having to come to the desk. (We can also call out to other units in the hospital such as to pharmacy or lab) We also wear tracer badges that light up a signal over the patients' door when we are in the room. RNs light up green, aides light up yellow. Call lights flash yellow. Our pagers also beep or vibrate when the patients we are assigned for that day put on the call light.

Ratio is RN-Aide to 6-8 (sometimes 9, rarely 10) patients. RN-LPN-Aide get 10-12 patients. We work a lot of "triads" which means RN-LPN-Aide who are always together. (Scheduled together) We do get to pick who we want on our triad when we set it up. We also have "Nurse Technicians" who are Aides with an additional 40 hrs training to do things like put in foleys, assist with sterile procedures, do simple dressing changes, etc.

We usually have a "float RN" who does not take patients, but does the admits, makes phone calls, takes off orders, goes with pts for tests if they need to be accomp by an RN, etc.

We are looking into establishing a permanent Charge RN position, as currently the charge does patients also. In the new position, charge will not take a pt load. They are still ironing this out. Prob be 2 months before it happens.

We work 12 hour shifts, 7 to 7. We always have a unit clerk for phones, docs orders, etc. We also have a pharmacist on the floor during the day shift.

We also have "Professional Nurse Coaches", which I think is a temporary "new idea" from admin...they are supposed to oversee the staff and try to defuse problems, look for ways to improve, and even do hands-on if it's a really bad day. Some of the coaches are really great at this, some are not. Our nursing supervisor is usually nowhere to be seen.

Sorry such a long post....I guess it really doesn't sound bad here, even though at my hospital, the floor I work on is referred to (jokingly, I think) as "Bosnia". It is very busy, usually high acuity. We used to do acuities, but now it's as someone else said, "butts to beds". Only exception is doctor-ordered 1:1 - then there must be an aide to sit with the patient at all times.

Anyone want a job??? E-mail me! [email protected]

rebelwaclause, ASN, RN · Aug 22, 2002

22 bed, smaller hospital. 1:4 ratio at nights (usually). 1 CNA/1 - 2 LVN's depending on census.

preciousnurse · Sep 9, 2002

Hey Deespoohbear. Where do you work because the setting sounds IDENTICAL to mine! Is it in the Shenandoah Valley?

deespoohbear · Sep 9, 2002

preciousnurse- I am in northeast Indiana, south of Ft. Wayne.

BBFRN, BSN, PhD · Oct 19, 2002

I work 7p-7a on a 30 bed Trauma Med/Surg floor, and we're doing 7-8:1 right now with Telemetry (no Telem Tech), usually 2 Pt. Care Tech's, and 1 secretary. We usually have 1 RN (charge), and the rest of us are LPN's. This really sucks! The bad thing is that we're phasing into a Step-Down unit. We're only losing 2 beds, and it looks like the ratio will be the same, except all pt's will be on Telem., and we'll have a Telem. Tech. I am scared! I don't feel it's within my scope of practice to take care of pt's on cardiac drips, and we are going to lose what little RN night staff we have. I wouldn't want to be the only RN on a Step-Down unit.

Luv cats · Oct 21, 2002

I work in a 60-bed hospital on a 26-bed Med-Surg floor. Ratio is 1:13 (depending on census of course) for 1 RN charging and 1 LPN passing meds. Our staffing plan is 5 for the entire floor (1 aide for the entire floor). Our floor does it all except ICU status or OB. Ortho, Peds, Psych, surgical, medical, extended ED, etc etc...

Tweety, BSN, RN · Nov 1, 2002

Originally posted by ohbet
If staffing is dangerous doesnt the buck stop with management?

True, but when you make a mistake and go to the state board, they will look at you stern faced and say "you accepted the assignment, you made the mistake, give us your license for xxxx amount of time..." I've seen it happen to a coworker when she made a med error in direct relation to having 11 patients and no aid.

But yes, it is a management problem.

The ratio on my facility varies, on med-surg it's depends on how many CNAs are on the floor, a day nurse may have to take 7 patients with his/her own CNA all to themselves, or nights up to 9. In neuro med surg, we go from 6 up to 8, mostly six or seven, with two aides on the floor.