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Nurse/Patient Ratios

Nurses   (3,379 Views 19 Comments)
by EJSRN EJSRN (New Member) New Member

EJSRN has 2 years experience and specializes in med surg/icu/tele.

3,402 Visitors; 102 Posts

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Just wondering what your opinion is about nurse/patient ratios. How much is too much? Please share!! Thanks!

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DorthyinOZ has 10 years experience and specializes in Pediatrics.

756 Visitors; 7 Posts

on my peds unit we assign 4:1 max. i tell my nurses if they feel 4 is too much r/t to a particular patient, to let me or the charge nurse know and we adjust accordingly.

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diane227 has 32 years experience as a LPN, RN and specializes in Management, Emergency, Psych, Med Surg.

11,929 Visitors; 1,941 Posts

I work on a 34 bed med-surg floor. We have a 5:1 patient ratio. (3-11). As the population ages and people are sicker, going about this 5:1 ratio simply would not be safe. I am amazed to hear about some of the staffing ratios that people are expected to work with.

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BroadwayRN has 4 years experience as a ASN, RN and specializes in ER.

2,625 Visitors; 164 Posts

I work in the ER and we go more by the acuity of the patients than purely by the numbers. I know on the floor on days they have 5 or 6 patients each. It's strange how some nurses end up with all easy patients and some all more acute patients. There doesn't seem to be a rhyme or reason other than dividing up the rooms. i.e. one nurse would have Room 601 thru 607. I don't think that's right at all.

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diane227 has 32 years experience as a LPN, RN and specializes in Management, Emergency, Psych, Med Surg.

11,929 Visitors; 1,941 Posts

When I worked in the ED you never knew how many patients you were going to have. The hospital I worked in was a large county trauma facility and we very often ran out of places to put people. They would just be lining the halls on stretchers or in chairs. But the care was different there because you were usually doing the minimum you needed to do to get the pt stable and ready for admit. When I went to med surg, where I am now, it got harder because we are sort of the end of the line. We have to do everything, admissions take forever, can't get the equipment or supplies that you need. I could go on and on. All areas in a hospital are busy but all for different reasons. We all have to remember this when we are working between areas. We are all working our butts off.

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Kiringat specializes in Acute Care.

5,034 Visitors; 239 Posts

4-6 total, 2 or 3 of those primary care. Gets a little scary at times...

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dorimar has 25 years experience as a BSN, RN and specializes in ICU, Education.

7,467 Visitors; 635 Posts

In ICU in AZ it is 1:2 and that is minimum patient ratio in ICU by law (of course exceptions apply, but it is serious if it is breeched, and it is truly only breeched in emergent situations uncovered). ICU is the only specialty with a minimum ratio established in AZ. I myself am for minimum nurse patient ratios and believe they should be established for all areas of nursing, especially m/s. I truly believe that in this economoy, miminum ratios will be more important. The company I am working for now is understandably implementing extreme cost-cutting measures the face of this econmy, but cost-cutting measures should be judiciously implemented. I truly believe this corporation would have us working 3:1 in ICU across the entire metropolitian Phoenix area, if the minimum ratio was not established by law, as they have a monoply on the nursing laobor market here and some of the other cost-cutting measures have not been in the best interest of the patient or nursing (but I wonder wat executives are still getting bonuses?).

Just an example of why I think minimum nurse/patient ratios should be established for all specialties and areas of nursing here in AZ: I worked in a rural hospital (for a very short time) in which the M/S nurses were responsible for 8-10 patients on day shift. This included infants being admittted to the general M/S adult unit because there was no peds unit in that area. They had nurses with no peds experience taking care of a few infants as well as adults and all ages--truly 8-10 patients per nurse and not very good resources there for them either. That was the absolute scariest place I ever worked, but it was allowed because it was teh only job in town....

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echo23 has 3 years experience as a RN and specializes in ER.

2,148 Visitors; 35 Posts

1:20 in a government hospital in my country, lol..;)

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885 Visitors; 13 Posts

it really depends on situation and staffing the verage should be at least 6:1

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1,354 Visitors; 21 Posts

Nursing home 4:80. We do it all to. They stay if it is even a acute condition. Sometimes it is alot to balance. We have CNA's that are great. Lots of work. I always laugh when a med surg nurse crosses over because she wanted a "slower pace". Med surg nurses not a cool statement. Nursing homes do alot, draw blood, IV's, Cath, tube feedings, hospice care you name it. Very busy but I love it.

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AnnaMary has 13 years experience and specializes in general medicine.

1,474 Visitors; 16 Posts

I worked on an acute assessment, general medical and care of the elderly ward that was 35 beds. We had 2 RN's per shift. It nearly killed me and ruined my family life.

I cannot believe the lengths that management was going to in order to avoid hiring nurses and staffing that ward. Patients suffered horrifically. They even got rid of our care assistants and replaced them with 16 year old "cadet nurses" who weren't even allowed to take vitals. The vast majority of our patients were on pages of meds and required total care. The mobile ones were confused. The "cadet nurses" were put in the same colour uniforms as the RN's.

It just gets worse with the intentional short staffing by management and the response of the British newspapers, hospital managers, and public has been to hand out "dignity cards" to the nurses.:sniff:

It is obvious that basic care is not being met. But no one seems to connect the dots and see that these nurses are overwhelmed. They are constantly being accused to "not caring" and being "too posh to wash". Can you imagine taking care of between 12 and 18 acute medical total care patients?

The dignity cards are going to be handed out to the nurses to remind us that dignity and basic care are our jobs and that it is not very nice to leave people waiting for the bedpan for more than a minute. They are also asking the public to remind the nurses that patients suffer when they are not fed. Sometimes on that ward I had 15 feeds simultaneously by myself with acute admissions during meal times.

It's unbelievable.

:no:

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Sydangle2 specializes in Cardiac/Med-surg/ LTC.

1,283 Visitors; 25 Posts

Med/surg Cardiac- our ratio goes as high as 1 nurse/ 10 patients depending on census. Too much for primary care nursing, esp. when you consider the the acuity of care- & that these pt's are considered critical. & most have complex cardiac & multiple medical problems.

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