Nurse:Patient ratios

my3suns · May 18, 2012

Im a GN but on the unit I work on it is a 3:1 ratio. It is a cardiac unit.

KelRN215, BSN, RN · May 18, 2012

When I worked acute care, our ratios were supposed to be 2-3:1 on days and 3-4:1 on nights. I don't remember the last time I worked a night and had fewer than 5 patients. I do not think that, in any way, assignments reflected that nurses needed time to provide "family centered care". At my particular hospital, it was lose-lose. If you spent time with one particularly needy family, you could bet that your other 4 patients would be calling for something that they didn't actually need YOU for (I need to be unhooked from the monitor, I want juice, my room is too cold) and then those people would complain to your manager and you'd get yelled at for taking too long to respond to a call light.

phillycpnp-pc, MSN, RN, NP · May 18, 2012

The peds floor where I started was 1:4 days and 4-5: 1 on nights... I've had up to 7 a few times when we were really short staffed.

Double-Helix, BSN, RN · May 19, 2012

Our general peds floor is 4-5:1, with 5 being more common. Our ICU ratios are 2:1.

You're right that in peds you have to care for the whole family, but it's different from maternity in that you're only addressing the medical needs of the child. Sometimes the family will be there constantly and the care of the child. Other times there will be no family present. But your patient load is not adjusted based on the family. If there are no family members present or 5 family members present, you'll be assigned the same number of patients.

Obviously, how busy you are and how much time you have to spend with the family will depend on your unit and how sick/involved your patients are. If you have several patients that need enteral feeds, transfusions, chemo, lots of meds, etc. then your day will be more task oriented then family oriented. But on other days your assignment might consist of more kids who are there for observation, or who are discharge ready and have a few meds, or the family will be there to do the feedings, etc. But I do try to connect with the family as best I can- even if I only have a few minutes to try to establish a connection. That's one of the reasons that I prefer ICU- because I often get to spend more time with the patient/family addressing the psychosocial needs.

wooh, BSN, RN · May 20, 2012

Our ratios suck. Better than adult care. But still suck. And will get worse. Economy sucks. Management knows nobody will leave peds to do adults, and knows even if we were willing to do that, in this economy, wouldn't be able to find a job anyway. The best part is, we had a huge med error made by MULTIPLE nurses on MULTIPLE patients recently, and when I said something about the ratios, it was immediately poo-pooed, as OBVIOUSLY it was just us nurses being stupid and not paying attention. How we're supposed to pay attention with as many patients as we have, as sick as they are (a good half of our load would be in ICU at our sister hospital) AND keep our customer service numbers up, there's no advice except, "Well we just have to do it."

If you work someplace with decent ratios, STAY, and fight to keep them. It's only going to get worse....

Gold_SJ · May 24, 2012

Our ratio's are 3:1 once we get four little ones we're supposed to have a EEN (LPN) come and work with us. How often this happens is debatable, however if we push we always get someone so I'm not going to complain.

I'm actually quite lucky in my work environment, it has a great culture compared to other floors.

NovaRN777 · May 27, 2012

i work per diem at hospital and it 1:4 and at my other job which is a peds long term care facility it is 1:7 or 1:9 with a nursing aide or a LPN in the room with a RN.