Nurse-pt ratios

jodyangel, RN · Oct 17, 2005

Lol, right on.

I hang all my own IV antibiotics. I do my own head to toe assessment. I call the doctors..but am not allowed to take the orders. I talk to the docs on the floor. I'm telling ya, I'm on my own!! I do 90% of the work of an RN, but get paid LPNs wages.

Thus, I'm back in school to get better compensated!

It is lovely! screech....BAM! I just crashed and burned. It all depends on your patient acuity. I bet there have been days when you had those 8-10 patients, a CNA and possible an LVN to assist you and things went smoother than doody from a goose. Question, your LPN's give IVPB???

MQ Edna · Oct 17, 2005

I'm lucky to work where I'm at I guess. I take telephone orders everything except hang blood. Push cardiac drugs, everything. I do not have an RN assigned to watch over me. We have an RN charge nurse. Each nurse has 4-5 patients, we have 2 nurse tech's for the unit (max 30 patients total capacity) they draw all our blood. We are 99% functionally independant. We just cannot do the initial assessment of new admissions and hang blood. All routine meds PO IV Drips can be done by LVN's. Plus we are mostly all ACLS certified as well. I had a 6 week critical care orientation as well as IV therapy classes, EKG classes, etc when I was hired. I have also worked ICU and taken full load of ICU pt's, vented, drips, etc. I guess Texas has looser rules for LVN's than other states.

All_Smiles_RN · Oct 18, 2005

On my tele floor, our nurses have 4-5 on a typical day with their pct's having 10-13. Some of your ratios scare me to death. I graduate next year and would be petrified to take on 7-8. God bless you all.

lee1 · Oct 18, 2005

I'm an LPN on a telemetry unit. We do not share assignments and we do our own IVs, except for IVP's and blood. We generally have pt care techs but our ration is 6 pts to one nurse, on all 3 shifts. IF we're lucky, and this doesn't seem to happen often anymore, we'll have a nurse designated for admissions, discharges and transfers.
Becky

It doesn't matter if you don't share assignments, they are certain things you are still not allowed to do including assessments and the RN on the floor is still held legally accountable.

lee1 · Oct 18, 2005

Be careful all and READ your state mandated/standards/policies that cover what you are allowed/not allowed to do

jodyangel, RN · Oct 18, 2005

I would say the person ultimately responsible for you would be the charge nurse...but you would be held accountable also.

The only things I cannot do on my floor is hang certain meds to TLC's, remove those TLC's,...hang blood...*thinking hard now here*....

I do my own head to toe assessment and MY name is on the nurses flow sheet, no one elses. When a patient is first admitted it IS the RN who does the initial assessment but day 2 thru whatever I do it on my own.

Unless I see something outrageously differant, the RN doesnt really get involved. Im a smart enough nurse to let my charge nurse Know if there are major changes tho....or I tell the doc himself.

It doesn't matter if you don't share assignments, they are certain things you are still not allowed to do including assessments and the RN on the floor is still held legally accountable.

beckyboo1, BSN, RN · Oct 18, 2005

Jodyangel, I'm with you. I do the assessment, no one follows behind me to say it is correct. We do initial assessments also. In Missouri, LPN's ARE allowed to do those things. The charge nurse is there if I need her, but I do my own patient care, write orders from docs, do IV's except IV pushes, blood and 1st bag of TPN. There's very little difference in what I do and what an RN does. But I am going back to school to get my RN, partly for the pay increase and mostly for the increase in job opportunities.

janf_rn · Oct 20, 2005

I work in a hospice in-patient unit (ICU for the terminally ill) we carry 10-12 patients with 1 aide per 15 patients...we are all burned out! Management says they are hiring, but the new nurses all quite.... The families are out of control..... This is too much to handle, but what do we do?

beckyboo1, BSN, RN · Oct 20, 2005

What exactly is ICU for the terminally ill? In this area, hospice means keeping the pt and the family comfortable basically.

laurakoko · Oct 20, 2005

This is directed to "FIRE WOLF".

You sound like you work in the same facility as I do...................

I am really wondering if you do........

andrea30 · Oct 20, 2005

i dont understand everyone complaining about patient ratio of 4 5 or 6 patients. i am an lvn in a sub acute /rehab, i have 12 patients ,i pass my own meds, call doctors,carry out my own orders, do transfers, discharges and admissions,report labs , i dont rely on and rn to do my job, i have an rn as a supervisor , and sometimes and lvn supervisor to help,BUT NOT DO MY JOB , i also do my own iv's starting and hanging fluids, an rn iv nurse does pushes and abt,, i dont understand why rn's feel lvn's are substandard to them. my license is just as much on the line as an rn's

BillEDRN · Oct 20, 2005

In Missouri, we ARE allowed to give IVPB, just not pushes. And I can't believe there are hospitals who still only utilize LPNs for med nurses??? In my hospital, we do our own assessments and chart them. It would be an insult to me for an RN to have to be the one to do it. We have an RN charge nurse and occasionally an RN on the floor, but my unit is generally staffed with mostly LPNs and we do a good job :)
And....I'd LOVE to have a day with only 4 patients!
Becky

I would check the law in your state about LPNs being able to assess patients. In some states, like Hawaii, RNs are the only ones that are legally able to "assess" the patient. LPNs (and I am not 'dissing" them, just commenting on the legal restrictins imposed on their practice) can provide an assessment and chart it, but the RN is legally responsible for ensuring it's accuracy and applicability to the patient's current condition. And, in order to do that reliably, it requires the RN to make his/her own assessment. Hence my previous comment about the irrelevance of having an LPN and/or CNA to help with your high patient loads. If I were an RN practicing in your states, I would make sure that there were no statutory impediments to LPNs providing assessments. Do not rely on past practices, ignorance of the law is no excuse in a lawsuit.