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.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
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.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
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.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
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.

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I work on a 44 bed med-surg unit. Our current ratio is 1:6 with occasionally 1:7, rarely 1:8. That is a big improvement over the 1:8 a year ago. I can go home @ the end of the day feeling like I did at least an acceptable job caring for my patients now & our patient satisfaction rates are going up. I feel there is still room for improvement but we are lucky to have a manager who does care about this. Don't use acuity either.

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Specializes in everything but OR.

I work in a 650 bed teaching hospital. Our nurse/pt. ratio is1:5 or 6 on all shifts. Na's are a bit scarce but they are beginning to hire more.:rolleyes:

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Specializes in medical oncology and outpatient surgery.

From Indy area, work at a 125 bed suburban hospital where ratio is 1:4 on days, 1:5 on eves and 1:6-8 on nights. One or two techs for days, one for eves and one for nights. No secretary on nights and charge takes pts all three shifts. The unit I work on is a medical/oncology unit, 18 beds, chemo and hospice, ecf pts. Its really not to bad. Days and eves often have lpns in order to do pod nursing.

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an RN on days usually has 6 pts with IV covers, 7-9 on evenings and same for midnights, sucks doesnt it? sometimes i will only get 4-5 but that doesnt happen much....as well as sometime i get 7 pts with 5-6 covers

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Specializes in Gen Med,LTC.

I work on a 34 bed medicine unit with RNs and LPN's. We are in the midst of changing things a bit, but as it stands an RN and LPN paired together would have 6-8 patients on day shift and an RM alone would have 3-4 patients on days. On nights we have 4-5 RN's on and the assignments are split...so 6-7 patients each. Usually 2 LPN's on nights who do the bulk of the "care", glucs,vitals. RN's give meds..LPN's do not in our institution.

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Specializes in Gen Med,LTC.
Originally posted by NS_RN

I work on a 34 bed medicine unit with RNs and LPN's. We are in the midst of changing things a bit, but as it stands an RN and LPN paired together would have 6-8 patients on day shift and an RM alone would have 3-4 patients on days. On nights we have 4-5 RN's on and the assignments are split...so 6-7 patients each. Usually 2 LPN's on nights who do the bulk of the "care", glucs,vitals. RN's give meds..LPN's do not in our institution.

Oh, and I must add that the staffing levels I work at now are the best I've ever had in my 12+ yrs of working medicine. I remember 2RNs1LPN for 28 patients from 1500-0700!!! And on a 35 bed unit, the assignment on nights would be 17pts for 1RN and 18 for the other!!!Imagine!!:eek: What I do now (if I am with and LPN 6-8 pts, alone 3-4 pts) is gravy compared to anything else I've ever done.

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I work on a 34 bed Med/Surg unit. Ratio is 7:1, on days and nights. On days, the total number of nurses never exceed 5. NEVER more than 2 RNs, then the 3 LPNs. with one RN as "charge". As soon as 4 nurses reach 28+, the "charge" takes up to 6. No regard for acuity. Never more than 3 CNAs for 34 patients. I was happy to read staffing is better in other places. Cause I have about had it.

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24 bed medical-surgical-telemetry unit. Days & evenings 1:6 (3 aides); nights 1:12 (two aides.) Charge nurse (guess who?) has full patient assignment.

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Specializes in Oncology/ante/post Partum.

I work on a 22 bed oncology unit in central Oregon; days usually 1 RN to 4 or 5 pts; eves 1:5 or 6; nocs 1:5-7 with Charge Nurse days and eves no pt load; nocs; Charge Nurse takes up to 4 pts; days and eves have ward clerk; none at noc; aides are 3 on days, 2 on eves, one or 2 on nocs; generally very reasonable staffing compared with back east where I worked it was very bad; if we were lucky enough to have one aide on days, they would usually pull her to be a sitter somewhere and we would be left to do all baths, meds, dressings,procedures, toileting, etc. etc.; also gving chemo, blood, etc. acuity didn't matter; just the numbers. I think west coast is much more enlightened than east coast. And attitudes are better too. We have float nurse to help with admits and iv starts, ostomy nurse on days, pharmacist on the unit on days, and Resp. , Phys Therapy and Occup/speech therapist during the week on days. When we have sick calls managemnt will generally try to get replacement even if they have to get agency. I feel very lucky to have found this hospital. I will never, ever work on the east coast again. No way.

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