Nurse pt ratio in the er

turnforthenurse, MSN, NP · Jan 28, 2016

5:1 sounds awful. We're 3:1 on the more "acute" side but if we have a very sick ICU patient or something like a conscious sedation, you're 1:1 or maybe even 2:1 depending on the patient. I had a ROSC patient the other day that was supposed to be admitted to ICU but they were holding in the ER for most of my shift...I was stuck in that room pretty much the entire time.

On our less acute side, we're 4:1 but sometimes we get some pretty sick patients over there, too. I had an SVT patient and they were given adenosine on that side. It just depends on the day, I guess.

Nalon1 RN/EMT-P, BSN, RN · Jan 28, 2016

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.

Wow, that is just insane. Literally.

How the heck can they get away with placing multiple psych patients in 1 room in an ER?

I would be looking for another job.

CTrain · Jan 28, 2016

We have a 4:1 ratio for ER patients. If the patient is ICU, you are 2:1 unless the patient is unstable then its 1:1, or someone else gets the patient set up until the primary nurse can care for both. If it is a step down from ICU it is 3:1. I think the 5 and 6 ratios are unsafe in an ER setting unless they are "hallway" patients who are not critical. At times I'll have 10-15 "clinic" patients who need prescriptions and medications. However, if patients do not have admitting orders yet, but they will be an admit to ICU, we have to tell our charge so we are not over ratio and assignments can be rearranged.

btmbonze · Feb 3, 2016

On average 1rn : 10-14 pts mixed acuitity

Artsy_RN · Feb 4, 2016

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]

Same in my ED. We sometimes will go 6:1 when the ED is slammed and the waiting room is full, which happened twice this week. Fun times...

Nalon1 RN/EMT-P, BSN, RN · Feb 5, 2016

On average 1rn : 10-14 pts mixed acuitity

You have 10-14 patients in the ER at one time? That is outright dangerous.

gemmi999 · Feb 5, 2016

Depending on the area of the ER, we are typically 4:1; when we have an ICU hold (which happens A LOT because our ICU is tiny) we are either 3:1 or 2:1. Last night, for instance, I had an ICU hold that was unstable and one other room. Typically when that happens I'm given a low acuity patient. Last night I was given an new unstable ICU pt. Normally when this happens another RN steps in to help; last night when I asked for help, I was informed "everyone is busy" and basically left to deal with it on my own. At 2 am when ICU beds became available and I asked my Charge for ten/twenty minutes to catch up on all my delayed charting before I got new patients...well, no. New patient's in rooms immediately.