Nurse-patient ratios and team nursing

[_melissa]

I'm reposting this thread because I'm participating in a project for one of my BSN courses and need feedback. Any opinions would be greatly appreciated.

I know every hospital is different when it comes to the amount of patients a nurse is responsible for and a lot of times staffing plays a large part in that. I work on a Telemetry floor and the nurse-patient ratio used to be 1:8, which is too many as far as I'm comcerned. Granted the higher acuity patients would decrease the ratio, but many times we have stable and unstable in our groups and it's difficult to manage your time with 8 patients. What do the staffing ratios look like where you work?

Recently, my floor decided to go to team nursing, where an RN, LPN, and PCA make up a team to care for 10 to 12 patients. It sounded like a great idea, but because staffing is so bad the teams are often up to 14-15 and even 18-19 when a team has 1 RN and 2 LPNs, which is unfair because the RN is ultimately responsible for all of those patients. Is there team nursing where you work and if so any tips on how you make it function effectively?

Again, any feedback would be greatly appreciated. Thank you.

-Melissa, RN

[tobby_walter]

i agree on your sentiments. in my institution i handle 10 patient composing of one PN and RN and more often that 10 patient is mix with stable and unstable patient which make your work jeopardize in balancing your time. what i do is to prioritize my patient from the most critical down to less critical then cater their needs accordingly and maximizing each time i come to their room doing the needed nursing assessment.

[mn_nurse]

I just transferred off of a tele floor. It was all RN's and PCA's. The maximum number of patients would be 4 (at night) Usually during the day 2-3. At the hospital they have a complex classification system which is usually pretty accurate at predicting workload. When I first started nursing I was in a VA facility where they did team nursing. I would work with an LPN and a PCA. Usually I would be assigned 15-20 patients. I felt that I could not be an effective RN with that many patients. I am not a fan of team nursing. In my limited experience it did not help the patients or RN's. It does save the facility money in hiring less RN's.

[Cardiacwiz]

I work on a cardiac floor at a Magnet hospital :). From 0700-2300 we have 3-4 patients and are teamed with one other RN (who also has 3-4 pts) and a nursing tech. 2300-0700 we have 4-5 patients and are teamed with two RNs (who each have 4-5 patients) and a nursing tech. 99% of the time I think it works out great and I feel like I have time to properly care for all of my patients!

[doubleplay]

How do you do paper work on 10, 11 or 12 patients?