Where I am now we usually have 1:5 with no other cover - though most of us will help each other out. The nurse in charge usually has no patients, occasionaly 1 or 2 if there is an excess number of patients to staff.
Here's the scary thing for you USA nurses though, the care assistants also have their own patients (1:5 again) with the nurse in charge - or more usually one of us (whose already up to their eyeballs) doing their meds or theatre runs!!! They admit patients & everything, care plans
Now we do have excellent HCA's (some I'd trust more than other trained staff to spot a problem
) but at the end of the day they are not
trained nurses & I think they should be in a supportive role under the RN's direction because if they did make a mistake the nurse in charge would be accountable, even though they have no choice but to allocate them because that is the management's policy. It stopped me applying for a senior nurse position when it came up!
We have no LPN's, there used to be the equivalent, called enrolled nurses but that training has ceased & there are very few of them left now, the vast majority did their conversion course.
We have to do the whole
lot for our patients from washes to beds, meds to dressings, vitals to documentation.
However, this is still way better than the job I left where, on a very busy, acute medical ward it wasn't unusual to have 1 trained & 1 care assistant to 12 patients at the top end of the ward, & 1 trained, 2 care assistants to 16 acute medical elderly patients at the other end, with 1 nurse/sister in overall charge!!!! Again there were no LPN equivalents.