Nurse pt ratio in the er

[floridaRN38]

What is your ED like?? Our nurse pt ratio is 5:1. I can handle it. But sometimes u have 2 ICUs and three more pts. As long as u have a bed open they put a pt in there. All pts r triaged at bedside. Only thing they do out in triage is the chief complaint and vitals. What is your like? [emoji4][emoji31]

[Nalon1 RN/EMT-P, BSN, RN]

A thread HERE with some responses about this.

I know there are quite a few threads here about it, it is a subject that comes up quite often.

For me, 3:1 in the acute area (6 beds total), 4:1 in regular area (8 beds total), 5:1 in continuing care (5 beds total), results pending is supposed to be 6:1, but can be more at times.

5:1 with critical patients is crazy.

[floridaRN38]

Thanks !!

[NickiLaughs, ADN, BSN, RN]

1:4, if you get a super sick icu player it can be 1:1 or 1:2 if theyre stablish icus. Low acuity patients are seen in another area by docs only and they grab a nurse when they need tylenol or a tdap shot.

[Lev, MSN, RN, NP]

Usually 1:4, sometimes 1:3 (only 2 lucky nurses get that assignment per shift). When a nurse gets an ICU patient, they stop sending patients until the patient is settled, or they send another patient back with a float nurse. Once the ICU is settled (as long as not crashing), they still send you patients.

[NurseIndependa]

We are 1:4. If someone gets an ICU pt or trauma, other nurses are supposed to step in to help out with the remaining patients. If we are really under staffed and have to open the back part of the ER, we get 5 patients.

[CrazierThanYou]

In my ER, we get 5-6 patients. It doesn't matter how sick they are or anything else. If a bed is empty in your section, you get a patient.

[CrazierThanYou]

In my ER, we get 5-6 patients. It doesn't matter how sick they are or anything else. If a bed is empty in your section, you get a patient. And I forgot to mention, if we have mental health patients we are holding in the ER, you can get an unlimited number of those on top of your "medical patients".

[RNator]

I can't believe that there are so many 5:1, 6:1 ratios in ER!! That, to me is just not safe. At my place it is 4:1, and many of us RN's try very hard to NOT give anyone a 4th patient unless they are a low acuity (4 or 5). I am a fast, multitasking RN, and for me if I have 2 Acuity 3's I can be maxed out as far as "how many patients can I REALLY get to?" Most of my coworkers, as well as I, help out each other when we get the Code, ICU, TRAUMA patient.

RNator

[Lev, MSN, RN, NP]

I'm interested to hear what level of acuity (ESI) does everyone typically deal with in the main ER and what your ratio is there. We have a 1:4 ratio in the main ER and have mainly 2s and 3s with a couple 1s. Occasionally some nurses go up to 1:5 in the wee hours of the morning if another nurse leaves and there are still a lot of patients to be seen. The 4s and light 3s are seen in fast track where the ratios are anywhere from 1:4-8 depending on staffing and acuity. If its all 4s we can have 8 patients sometimes if staffing is bad but we dont need to do assessments or repeat vital signs on 4s. The fast track area closes at 11p or 130a so if there are any 4s or 5s left we see them in the main ER.

[Lev, MSN, RN, NP]

In my ER, we get 5-6 patients. It doesn't matter how sick they are or anything else. If a bed is empty in your section, you get a patient. And I forgot to mention, if we have mental health patients we are holding in the ER, you can get an unlimited number of those on top of your "medical patients".

Wow that is crazy about the psych patients. Where do you hold them? In the hallway? Keeping them in an area with all the monitors beeping and the chaos is a perfect setup for agitation. We will get psych patients who need medical clearance and then they go over to the crisis intervention center where they are held.

[CrazierThanYou]

Wow that is crazy about the psych patients. Where do you hold them? In the hallway? Keeping them in an area with all the monitors beeping and the chaos is a perfect setup for agitation. We will get psych patients who need medical clearance and then they go over to the crisis intervention center where they are held.

They're kept in regular rooms. They'll pack three or four to a room sometimes. It's like wall to wall beds in that case. We hold them there until they get placement. In a few cases, we've held them there for months. Literally.

When I interviewed for the job, the part about caring for the mental health patients on top of the medical patients was conveniently left out. I was under the impression they had their own nurse.