nurse:patient ration in the ED

debrn · Jan 10, 2000

From small hospital in rural, small town..patient to RN ratio in med surge is anywhere from 6:1, to 28:1 depending on who calls in sick, or if the ER nurse is busy, and can help on the floor. We have one RN, 2 CNAs,one LPN, and one ward clerk on any given night,7p-7a shift...thats the whole hospital,baby. Our security is the city police dept. and we have a janitor from 7p to 3a. And, I have to say,we do a darned good job too!!!!

Peanuts · Jan 26, 2000

I work in a level one Trauma Center in NY. Our ratio should be 1:10 according to EMS standards. The ED is divided into 2 sections

medicine 2 nurses sometimes 3

surgery the same

one triage nurse for walk ins

all the nurses in the ED triage

1 head nurse/charge nurse

and when a trauma or medical emergency comes in on nurse is pulled from the side to work that. The doctors are great and help alot we have an ER residency program.

staffing has been pretty lousy over the last few years. We hope to be staffing with 8 to 9 nurses for days and evenings and nites with 7 or 8.

CHUBBY · Feb 3, 2000

the reality is: as the insurance dollar gets tighter and the pts get older and sicker..the only place left to squeeze is the staff. Its the biggest budget a hospital has. You're seeing departments now reverting back to "team nursing" hiring LPN's and UAPs working under an RN...In an ER, that could be a dangerous thing..especially if it's all new or inexperienced staff. Lets see how California does with TITLE 22 SB 363..which (in theory) with designate nurse to patient ratios... By the way, CountessvonH...where did you come up with that one?

countessvonH · Feb 3, 2000

I think in general that ed nursing is taken advantage. I have anywhere up to 8 patients critical and non critical. I care for patients that get moved to the hall which is a disgrace. if this staffing went on in a critical care unit the staff would not allow it. I have refused to take more patients because when the chips fall i am not putting my liscence on the line.

edrn · Oct 5, 2000

Originally posted by chubby:
the reality is: as the insurance dollar gets tighter and the pts get older and sicker..the only place left to squeeze is the staff. Its the biggest budget a hospital has. You're seeing departments now reverting back to "team nursing" hiring LPN's and UAPs working under an RN...In an ER, that could be a dangerous thing..especially if it's all new or inexperienced staff. Lets see how California does with TITLE 22 SB 363..which (in theory) with designate nurse to patient ratios... By the way, CountessvonH...where did you come up with that one?

TKOLRN, BSN, RN · Oct 18, 2000

Originally posted by Hayden:
Just wondering what sort of nurse atient ratio hospitals are working with. I'm only new in an aussie metropolitan ED and find my patient load varies from 5 to 8, in our acute section.
What are other hospitals working with, what do people think is safe?

Hi Hayden,

Interesting you should bring this up...I just had this discussion with my managers boss the other day...I work in a 45-50k per year er...We have a total of 26 rooms..20 acute care, 6 trauma...The acute beds are 2rns/10rooms 20hrs. per day..at 3am, we are 10pts/nurse until 7am... We are still very busy at that time and it often presents an unsafe situation...Response from administration to correct this problem has been very slow...

Ted

LerRN95 · Nov 14, 2000

I too work in a rural ER we see about 30-40 patients a day. We have 2 RN that cover the 24 hours. 1 LPN that works 12 hours (from 11a-11p) During the most busiest times. No Techs, no aides, no ward clerks. If it get BAD we will put from the floor or ICU until it calms down. We have seven beds. There has been times that I was alone and had four critical patients at the same time. (and no one to pull). After 4pm we have no respiratory therapist, so the nurse has to do their job. If we are lucky enough to have a doctor that don't mind to help out, it is great. But we do have those that don't help to answer the phone when they are sitting by it.

jellie · Jan 18, 2001

Originally posted by Hayden:
Just wondering what sort of nurse atient ratio hospitals are working with. I'm only new in an aussie metropolitan ED and find my patient load varies from 5 to 8, in our acute section.
What are other hospitals working with, what do people think is safe?

Hi Hayden,

I too work in australia at a hospital that is often on television (you know the one, that shows that saccharine sweet half hour of infotainment).

The reality is that on a given day, RN's in my department, can have an allocated patient load that can exceed 10 each in the acute area.This means that pts regularly are nursed in the corridor, and these days that patients remain on ambulance stretchers for 1 hour. (great turn around time for the ambo's) And still we don't go ' LTO'.

As a group of nurses we are so fed up that after multiple discussions last winter with an administration that offered no solutions. This year, we are considering our options, and will not be frightened to utilise the union in our fight for decent basic care standards for our patients.

Perhaps you will read about this in the newspapers, or see it on television, but I doubt that it will be included on the logie winning television show!!!! (for you non-Australians, the logies are the Ozzie equivalent to the emmies.)

jimminy · Sep 5, 2001

Nurse/pt ratio? Those actually exist? Since the upstairs won't accept patients because they are short staffed, all the admits back up into our holding area (ICUs, telemetry, regular beds).. We have two-three nurses handling 35 pts. Last time we had 4 ICU admits, 7 tele holds, and 10 regular admits, PLUS 20 more new patients for work up. We actually had to go on driveby due to the fact our OR would not accept any patients (they had no rooms available). We did surgical cases in our trauma rooms. NIGHT from HELL. This did not include the Team Hall area that sees clinic type patients. Safe Harbour anyone?

Luckily, the shock rooms calmed down, so those nurses came to help in back. We made it through, but it was frustrating. We have a good team to work with.

CEN35 · Sep 6, 2001

21 rooms........9 nurses and a medic........ and one is in triage.........so about 2.65 pts per nurse/medic.

:)

me

JillR · Sep 6, 2001

I have read all of the staffing issues that all of you deal with from day to day and I Can't even inagine. I work at a very small rural er in the midwest, on the- 3-11 and 11-7 shifts we are lucky enough ro have very knowldgeable techs to help out during those times, when they are not out on ambullance calls. So,I could have three serious patients,and one cardiac comminigm in on ambulance,which fills us up. Who is the triage nurse? ME

Who takes the cardiacs?ME Who takes the GI bleeds?ME. WhO Takes care of the phych case who is threatenining everyone, well I hope I get the haldol there fast enough.. Now the Amb is back with the last patient who seems to have more etoh and other drug problms than cardiac. My tech gets off at 11, now it is just me to deal with these first patients that have been waiting for four hours to be seem for that sore throat they

have had for three week,

This is the reality in my ER.

The clinilcs in oour area are not accepting thier cards, without payment upfront, so not my ER, iss thee clinic

CEN35 · Sep 7, 2001

Sorry to hear about that Jill

Sounds like a very very small town.

me