Nurse-Patient Ratios on East Coast

[shhhh]

A fellow nurse has relocated here (West Coast) from the East Coast, and we work critical care together in a pretty large hospital that serves a lot of the state (meaning, we get our fair share of exciting cases). This nurse (lived and worked in NYC) once told me that it's very typical for nurses in East Coast hospitals on med/surg floors to have 5 to 6 patients on days, while night shift has up to 10, "and they're really sick patients. Like, way sicker than the patients that are on the med-surg wards here. The only reason anyone would be in the ICU is if they're vented. As soon as they're extubated, they're transferred to the med-surg floors." As far as ICU goes: "No one-to-one patients over there like here. Everyone gets two patients, no matter how sick they are. They're all vented and basically circling the drain."

I just question what this particular nurse told me, because not only is she well known for having an ego the size of the Good Year blimp (very knowledgeable and skillful, and don't you forget it!), many of us who work with her could definitely see her embellishing a bit to make herself look even more knowledgeable and skillful.

So... my dear allnurses... does any of that ring true for any hospitals on the east coast? If so, you all are pretty much demigods in my eyes. But if it's not true, that's great too because I'll be less terrified of relocating to NYC.

[Bill E. Rubin]

Here in my Boston hospital, on my medical unit, we typically have 3 pts during the day and 4 at night. We don't have any PCAs/techs on my floor (though the medical unit down the hall does have PCAs and has the same ratios as we do). Our pts are pretty sick most of the time. The MICU typically has 2:1, don't know about the other ICUs.

[colleennurse, ASN, RN]

Wow I guess I am lucky! I live in western NY. I work on a behavioral medical (we have some tele beds) and it is 5:1 on any shift. 1 time I had 6 on nights d/t a call in. Plus we usually have at least 1 tech if not 2. I worked med-surg tele at another hospital in my area and it was 1:5 on D/E and 7-8 on nights.

[OldNurseEducator]

I think however CA is the best state because it is regulated nicely by Arnold Swartzenager(sp?)

Not any more! Did you miss the last election?

[OldNurseEducator]

Thanks for your answers everybody! I admire all of you for working in challenging positions over there. You all ARE demigods... and deserve ice cream sundaes. :)

This nurse also told me she thought I was a "sweetie" and a "cutie", so since you all basically proved she's apparently not a fibber, I MUST be sweet and cute, then! HAHAHA.

You are! :)

[RNTOBE_1970]

I'm in Louisiana, and graduated 20 years ago from LPN school. My first job was in a small rural hospital at night on the med surg unit. We started with about 8 or 9 patients, and when the ER was rocking and rolling, we would end up with over 12...not including AM admits for surgery. If we were lucky, we had an aide. In 1996 worked nights on a tele unit, and we had at least 7 to start and that would often include a fresh CABG patient...again, lucky if we had an aide or monitor tech. 10 years ago, worked in a LTAC, usually assignment was 6 or 7 rehab type patients, or 2 step down patients.

[~Transplant Nurse~]

Large Pennsylvania Level One: tele specialty floor 4-5 days and nights. Many are VERY sick or are fresh transplants.

[jbboogie]

I am a new grad and started working in a LI hospital on 9/13. I work the day shift (7a-7p) on a ortho rehab and TBI unit. The ortho rehab max is 8:1 with an aid and secretary (we have to take our own vitals, blood sugars and manage our time around the pt.'s 3-4 hours of therapy throughout the day... which can be a pain if you have multiple pt.'s who have therapy at 9am) I would say 6 is manageable. There is just SO much paperwork and we are required to write a FOCUS note on each pt. (even if there really isn't anything significant to write about).

The TBI unit is a max of 5:1. The pt.'s here are a much higher acuity (IV's, PICC's, peg's, trachs, PVR's/st. cathing) and have a much higher incident/risk for falls and you still have to work around the therapy schedule. But sometimes if the census is low on the ortho side, they will assign 1-2 of those pt.'s in addition to the 5 TBI pt.'s... NOT FUN! 5 alone is stressful especially if they are 'heavy' pt.'s.