Nurse Patient Ratios - always different than what you're told at initial interview?

[BookishRN]

I've been a nurse for 8 months, and due to a geographical move for husband's job, am in my second position. I was told at my interview in this second place of employment in northwest Virginia that the patient ratio for this post-op unit would be 5 (or 6 at the most). Of course, I'm now hearing it will be seven with the floor full (21 beds). I'm about to go off orientation (of six weeks) tomorrow night and am feeling a bit overwhelmed at the load I'm going to take on since I've had my "babysitter" in the background up until now.

Is this typical of all hospitals? Being told one thing and having it just not pan out that way? Or is this patient ratio typical for this type of unit? OR am I being a wimp??!

[BeckRN]

I'd say no, its not *always* different. What type of post-op patients are you generally receiving? What type of nursing care do they require?

If you're concerned, talk to your NM about it before you come off of orientation. This is why I find it helpful to do share or shadow days before I take a position... then you can talk to the nurses that actually work the floor and they'll tell you the real story. Not that I think administration is generally deceptive, but they're not there, working that floor, shift after shift, like the staff nurses are.

I've been in more than one working situation where the actual conditions were much worse than advertised, and I've left. Don't be afraid to do that if you feel like your license or your mental health is in jeopardy.

[BookishRN]

I think the ratio is 5 during the day, and perhaps the NM was generalizing. I'd heard it would be 2 RNs, 2 LPNs, 2 techs, and a "resource nurse". I think that nights when it's a full floor, some resource nurses may take a patient or two, and others won't. Initial admission assessments are to be done by RN. At night, it'll be 2 RNs, 1 LPN, one resource nurse, and 2 techs. (all 12 hour shifts except where a float might be needed)

Post-op prostatectomies, lots of bowel surgeries, lap choles, seem to be the majority of surgeries. Actually, I spent the first six months in my first nurse job at UVA on a medicine floor, so the acuity seems less here - but I'll have more of a patient load. More walkie-talkies here, less meds - and with it being 12 hour nights, I'll see how it goes. Some of the time wasting seems to be in useless computer charting.

I have no problem asking for help, and asking questions - and will. That's what the resource is for, right!? I know I have not run into everything that I'll face - and it's a field where learning happens all along. So I'll learn. Patient safety is more important than my independence.