ortho patient load

analiezel · May 5, 2005

I know what you are going thru, about a year ago, i left an ortho/trauma floor that i loved! It was also my first nursing job and i was there for 6 years. But like you said the patient load was too exhausting. I did the 7p-7a shift and we started out with 5 pts at 11p we picked up another 2 for a total of 7. Let me say it again seven! 7 :angryfire . We did have a free floating charge nurse from 7-11p but where are they when you need them? And they expected us to check and document our epidural infusions q 1h our pca pumps q2h, rotate cpm's q 4 hr , pass out our meds, chart, turn pts that have fractures in every bone in their body q 2 hrs. talk about burnt out :crying2: not to mention the backpain, the sore feet, leg cramps, my growling belly and the dry lips coz you just don't have time..... we went to administration and they finally came thru and gave us another RN but that still left me with 5 - 6 pts. woop-ti-do.

I thought that I would be on the ortho floor forever, i loved my coworkers (thet practically became family) and the ortho pt population but......I just couldn't do it anymore.

After months of contemplating, and to much of my trepidation... i applied and got accepted to a med-surg ICU. And I love it... this is the best thing I've done ever for my career. I should have done it sooner! Not to say that ICU is easy... but instead of having 7 pts I have 2 . I still see alot of the ortho patients and even when they leave the ICU I usually visit these pts. on my old floor, which is so gratifying. I did pick up extra shifts on the ortho floor but then i thought to myself......... why?

To me, what it all boiled down to was.....were all my sacrifices worth it? I asked myself, what if I injured myself? What if I got burnt out to the extend of hating this profession that I passionately love? .......... :rolleyes: hope this helps

Kymbearlee · May 20, 2005

On our ortho unit our ratio is 8:1. We normally have 12:1 nurse ratio on 11-7shift. I have been on this unit for almost 7 years. I love it but as you can understand the ratio is killing all of us. I am going now for my MSN because I know I can't do this kind of nursing for my rest of my life. My body won't take it.

meownsmile, BSN, RN · May 22, 2005

You have a fairly good patient/nurse ratio. We routinely have 8-12 patients on our med/surg/ortho floor. It does get a little nuts at times, but you have to make sure you plan in your lunches and breaks. Very rarely do i miss lunch, i may drop breaks, because i dont go and eat breakfast like some of my counterparts but that is their choice.

You have to take care of you, and make time to do it. It isnt going to hurt a patient that is nauseated to hurl once, it might help. What i mean is,, you cant be right there for all your patients at the same time, so remember you have to take care of you before you can take care of your patients.

jojoENZED · May 30, 2005

I just cant fathom your patient ratios.Far too many nurses are leaving nursing because of work overload and many nurses feel demoralised because they can not deliver the care they went into nursing to provide. Where I am working we to keep a 5:1 ratio on our patient loads. This attributes to good patient care, less stress on nurses and less sick leave and burnouts. Ortho is a heavy work load anyway. We also have 8 hour shifts. The orthopedic ward is renowned for having a pace that most nurses dont like so really it does take dedication to stay there with the proverbial rocket where the sun dont shine. You RNs packn in the 12 hour days with huge patient loads...I fall to my knees and worship your dedication.

You have a fairly good patient/nurse ratio. We routinely have 8-12 patients on our med/surg/ortho floor. It does get a little nuts at times, but you have to make sure you plan in your lunches and breaks. Very rarely do i miss lunch, i may drop breaks, because i dont go and eat breakfast like some of my counterparts but that is their choice.
You have to take care of you, and make time to do it. It isnt going to hurt a patient that is nauseated to hurl once, it might help. What i mean is,, you cant be right there for all your patients at the same time, so remember you have to take care of you before you can take care of your patients.

meownsmile, BSN, RN · May 31, 2005

Id give my right eye tooth for a 5:1 ratio dont get me wrong. But thats just not the norm at my facility. We dont however have total patient care for all our patients unless we have a low census, which isnt very often, but we are responsible for the LPN and CNA's duties. It takes a while to get to a point in med/surg that you can juggle and get things done and stay CALM and learn to delegate, but it does come with time. Letting yourself get frazzled just amplifies the whole problem and then the whole team gets in a fuss and everyone is nuts before its over.

I have days when i just hope i get through the day without catastrophe, but part of the key is staying CALM and prioritizing. You can let yourself get stressed real easy, but if you take an attitude that it will all get done eventually and to do the best you can, you save yourself a whole lot of heartache and stress. I can be a pro at multitasking but I no longer feel bad if i have to leave a few things for the evening shift to do, sometimes i do, thems the breaks! But the next shift will do it, because its their job too.

joyful nurse · May 31, 2005

You need to find another job.

shunnaparks · May 31, 2005

WHAT!!!!!!!!!!!!!! Are you all kidding???

I am currently completing a contract in orthopedics. The nurse patient ratio on days is 1:4-5 and on nights it is 1:5-6. The numbers you all are quoting.....I just can't believe it. Orthopedics is extremely diffiicult and is a heavy floor.

I love nursing and very much value my license. I refuse to put either in jeopardy. The day I'm told I will have 7 or more orhto pts will be the day I calmly tell them to kiss my tush.

jojoENZED · May 31, 2005

WHAT!!!!!!!!!!!!!! Are you all kidding???
I am currently completing a contract in orthopedics. The nurse patient ratio on days is 1:4-5 and on nights it is 1:5-6. The numbers you all are quoting.....I just can't believe it. Orthopedics is extremely diffiicult and is a heavy floor.
I love nursing and very much value my license. I refuse to put either in jeopardy. The day I'm told I will have 7 or more orhto pts will be the day I calmly tell them to kiss my tush.

I guess I have to agree with you Shunnaparks, however it isnt just my registration and practicing certificate I value, its my back, my stress levels, and my most of all my sanity. :rotfl:

P_RN, ADN, RN · Jun 1, 2005

I did ortho for 22 years (same unit) and for the first 10 years or so the RN had 20 patients! There would be an LPN/CNA to do the bedside etc, but many's the night I cried right there on the floor.

The last 12 years or so we went to a team of Rn+LPN+CNA for 10 patients. The team's rooms were permanent. So I guess you could say 1:5.

However, with discharges, admissions, transfers the total for the day could be as many as 20 patients if all 10 on your team were discharged.

I left d/t a back injury (what else?) from pushing a HilRom bed with the patient in it, (with help) to another room. I miss ortho very much.

Ortho_RN · Jun 3, 2005

We can have as many as 7-8 on day shift..... Night shift has had as many as 12 a piece.... Which is WAY too much... I think this is what stresses me out so bad.... I'm so physically tired.... I had 3 admits the other day, which fresh surgeries take ALOT of time... Especially when you have to watch their breathing extra b/c the OR gave them 5-8ccs of Fentanyl... :)

GeeBeeRN · Jun 27, 2005

Wow! I seriously shouldn't complain. When I first started as an RN, I worked on an Ortho/Trauma floor and had a 1:8 ratio which was HEAVY. Then in January of 2004, California mandated a 1:6 ratio. The hospital I work at now (still in Ortho but mixed w/ General Surgery) sticks to giving us 1:5 on all shifts except of course if someone calls in sick or if we're just really short staffed. But only once or twice have I had 6 patients at this hospital since the ratio went into effect. We do primary nursing w/ a 1:5 ratio and a "Unit Assistant" who takes vitals and helps out within the unit. One of our travelers was saying that she interviewed w/ a hospital in NY and their ortho floor had a 1:9 ratio. Yikes. Gosh...I'm not sure what part of the country everyone is from but I guess I should consider myself lucky to be maxed out at 5 patients.