Nurse-to-CNA ratio

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I am a 2nd year nursing student, trying to write a research paper for my summer internship at a hospital. I've been working as a CNA in a Cardiac/tele unit. CNA's have 10 patients and work for 2 or 3 nurses during each shift. I had an idea that if there was a Nurse-to-CNA ratio of 1:1, patients would receive better care, there would probably be fewer pressure ulcers, falls and hospital acquired infections, and patients would be more satisfied with the quality of care received. I have hours trying to find anything published on this topic, but I can't find anything.

Are there any RNs out there who have more than one CNA per 10 patients on their unit? I would like to ask a few questions for my paper.

Also, are there any RNs out there who include the CNAs in the end-of-shift report?

I only have a few questions, or if you would like to share your experience... I'll take whatever I can get.

thanks in advance!

Amy

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Specializes in Pulmonary, MICU.

In our ICU at night our CNA patient load is 24:1...which is okay because the nursing ratio is 2:1. During days it is 12:1 Patient:CNA ratio. We don't include the techs in report at end of shift, but they have their own report that they give.

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Specializes in Float.
In our ICU at night our CNA patient load is 24:1...which is okay because the nursing ratio is 2:1. During days it is 12:1 Patient:CNA ratio. We don't include the techs in report at end of shift, but they have their own report that they give.

:uhoh3: Is that 24 patients to 1 CNA in Intensive Care Unit?

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Specializes in Pulmonary, MICU.
:uhoh3: Is that 24 patients to 1 CNA in Intensive Care Unit?

Yes. But when I have only 2 patients, and sometimes only 1, what do I really need a CNA for realistically? Not saying they are useless, but with that many RNs ancillary staff becomes less necessary. When I was a floor nurse, I NEEDED my techs. When we don't have a tech in the ICU, I barely notice. Even when we have techs, I bath my patients without them, turn without them, get my own vitals, get my own blood sugars, do my own I+O's. I usually don't get my own temperatures...mostly because they have the thermometers ;). But if I have a patient on a cooling or heating blanket, I'm getting my own Q1 hour temps anyway and have my own thermometer. Same with blood products.

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Specializes in Med-Surg.

I'm not an RN, I am an LVN but on our floor, they base the number of CNA's we get on the number of patients we have on the floor. They call it the staffing matrix, which none of us have ever seen, For instance we aren't supposed to even get one CNA until we hit 18 patients. The CNA takes 10-12 patients and does baths, vitals and helps answer lights. Our CNA's only work 8 hour shifts. We have 30 beds on our unit and at the very most, we only have 2 CNA's. Ever. Period. End of story. The Nurse to patient ratio on my floor is 5:1. So the CNA could very well be working with 2-3 nurses and more if she's the only CNA on the floor. We have been fighting very hard to get our CNA's back to 12's AND to get one on nights. the night shift have NO CNA's at all. All the CNA's at our hospital work 7am-3pm. It kind of really sucks. I work on a busy Surgical floor. But all the Med-Surg units are staffed this way. The Tele nurses are 4:1 but the CNA's are staffed the same as Med-Surg. In DOU I believe they get 1 CNA and they have 12 beds, and oncology is the same. Oncology and DOU are 3:1, but if someone is getting Chemo, I believe they go to 2:1. I think. Not sure if our ICU/CCU even get CNA's but I don't think they do.

Back when I was a new CNA, 7 years ago, we worked in pairs with a Nurse. There would be 1 nurse and 1 CNA with 6-8 patients. We would have 3 CNA's and we had CNA's all night long, so there was 24 hour coverage by CNA's and licensed nurses.

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I am a tech in the ICU where I work, and when there are no patients I float to the floor or ER!.. SUPER TECH~~

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This is exactly what I wanted to hear. I would love to talk to you about what it was like when the CNA:Nurse ratio was 1:1. If you could email me, or write again, I have some questions.

When you had a 1:1 CNA:Nurse ratio,

1) did you do end-of-shift reporting with your RN?

2) What differences in patient care did you notice, compared to now?

3) Were any records of pressure ulcer rates from back then?

4) What were differences in Nurse-to-CNA communication when you were working in pairs?

Thanks so very very much

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