nurse to patient ratio orthopaedic floor? - page 3

Hey there! I work for a Texas post total knee and joint surgical unit. 6years ago the nurse to patient ratio was 1:4 on nights(no cna, no secretary). 1:4 on days with a nurse aid. However, one... Read More

  1. by   RNSA1998
    Is it crazy? 1:6(7) here (Baptist health system in San antonio). We feel too tired and it is not safe for our patients. Can we form a union to protest it?
  2. by   MsNurse11
    I have been working on the same Orthopedic floor for roughly 4 years now. When I first started the ratio was better but at this point it has changed. Our dayshift is about 1:5 with 3 CNA'S-our floor holds 24 beds. There is a scale for how many CNA's we get though, as 3 is if we have a full house and are lucky. Evening ratio is 1:5-6, and Nights is 1:6-8. Even though orthopedics is not critical care, it demands ALOT of time since mobility is a great issue-it can take 5 minutes or more to walk someone to the bathroom. Being understaffed makes us more concerned about patient falls, i.e., someone has to go to the bathroom and decides they have been on the light for too long without response so they walk there on their own. Many falls happen that way. I understand the hospitals are suffering financially but as the difference in ratio increases the patient satisfaction scores become worse and patient safety becomes an issue.
  3. by   WAorthoRN
    I work on a 30 bed orthopedic/plastic surgery unit in non-profit hospital in WA. On days (7A-7P),we have a 4-5:1 ratio for RN, 7-8:1 ratio for CNA, 1 secretery, charge nurse takes no patients. On nights (7P-7A), 5-6 ratio for RN, 1-2 ratio for charge RN, 8-10 ratio for CNA, secretery until 11:30P if 18+ patients on unit. The acuity of these patients is getting higher and higher and more is expected from the RN and CNA, which leads to poor charting/poor pt care/poor pt satisfaction/increased risk of errors! Unfortunately, our staffing is considered pretty good compared to nationwide on similar units.
    Most of the staff love what they do and it shows in the teamwork we have on the unit.... We have resource team of RNs and CNA's that fill in holes in the core staffing. They have told us frequently how no one wants to float to our floor as it is one of 2 of the hardest units to work on (the general surgical/neurosurgical unit is the other one and has similar staffing matrix) due to staffing ratios. We frequently will discharge between 1-4 patients and be expected to take over the postops/ED admits that refill those beds, which can mean electronic charting on up to 9 patients during the day!
    Very frustrating to say the least, especially if you are detail oriented! At present we do have a "flex nurse" M-Th from 10:30A-7P that helps settle the postops and helps with tasks for the nurses. Several of the nurses, including myself, are requesting that the flex nurse position be absorbed into the matrix so more RNs can have max of 4 patients, esp. in the higher acuity groups.
    Good luck people! I think it will just be getting worse and these days will be considered "the good ol' days", so try to keep a positive attitude and do the best you can, and continue looking for ways to save time (volunteers are great at restocking, answering call lights/phones, walking with the confused patients....just hard to find a good one that's reliable and enough bodies to help out every day of the week day and night!)
  4. by   Portuguese Nurse
    Hi everyone! Although i've been reading allnurses for a long time, this is my first comment here. I'm a portuguese RN and reality here is very different.

    I've started working in ortho a week ago. We have two wards in our floor (32 beds each) with 12 Intermediate Care beds. We have both pre and post-surg patients, most of them above 60 years old, except for polytraumatized patients which are usually younger.

    Our nurse/patient ratio is awful. Day time - 1:12/14 (regular patients) and 1:6 (intermediate care patients); nights - 1:16. Charge nurses take no patients and there are 3 aids during days and 1 at night.

    I think it is important to clarify something: in Portugal, there are only two types of nurses (RNs - with a 4-year Bachelor's Degree and Nurse Specialists - who are RNs that get a Master's Degree in one of these areas - paediatric and child's health nursing, women's health and obstetrics nursing, psychiatric and mental health nursing, community health nursing, rehab nursing and medical-surgical nursing). About our aides, their responsabilities are to help nurses and doctors with routine tasks, and cannot be responsible for any type of care.
    Last edit by Portuguese Nurse on Aug 11, '12
  5. by   sweetgeorgia
    5-6 pts per nurse.
    no cnas.
    no techs.
    no lvns.
    1 charge.
    1huc during days.
    no huc during nights.

    it's HARD work ALL the damn time.
  6. by   FollowThru11
    Our Ortho floor RN's regularly carry 6:1/ 7:1 at all times going up to 8 patients at times while waiting for discharges. I work weekends where staffing is usually worse plus we discharge a lot & begin getting medical overflow admits. I'm very comfortable carrying 6 patients but something about the 7th brings chaos. Our poor techs carry 9-12 patients. This is very hard on the techs & we have a lot of unsatisfied patients due to the time it takes us to get from one room to another. It usually takes no less than 15 minutes to get a patient up safely to ambulate to the bathroom.
  7. by   stnurseuk
    Our ward takes trauma and elective lists, we have 4 bays of 6 and 3 side rooms.
    During the day we have 3 RN's and 2-4 healthcare assistants.
    Nights we have 2 RN's and 1 Healthcare.
    Makes things fun sometimes with sickness
  8. by   habs18
    I work nights and our ratio is usually 6-8 on weekdays and sometimes 9 on weekend nights (my unit gets many ER admissions on the weekends because the census is usually lower than other units). We also have 3 techs and 3-4 nurses on weekdays and 2-3 nurses on the weekends (1 tech though on weekend nights). One thing my units been doing lately is having 4 nurses 1900-2300 with each having 6 patients and then 2300-0730 we have 3 nurses with 8 patients. Which isn't too bad because the extra nurse was there for the 2100 meds and 1st set of neurochecks, which I believe to be the busiest part of the night.
  9. by   benmca13
    We usually have 1:5, but frequently it's 1:6 at night with no aids. You learn to work as a team. Time management is key too. I try to get everyone to the bathroom around the same time whether they have to or not, that way I can find time to sit down and do my charting.
  10. by   Chixie
    We have a 30 bed ward, staffing can vary. We work on long days 0700-1930

    A good day looks like the following
    1xCharge nurse=takes no patients
    3xstaff nurse=10 patients each
    3xsupport workers=10 patients each

    A bad day looks like the following
    1x charge nurse/ward sister=no patients and spends all day in office doing "paperwork"
    2xstaff nurses (1x 3 years ortho experience, 1x6 months experience)
    1xagency nurse(never worked here before, not many return either, no registered on the electronic medication system, has no idea what they are doing)
    1x clinical support workers

    Nights run 1900-0730
    2x staff nurses (dedicated night team of nurses)
    1xagency nurse
    2xsupport workers
  11. by   mmc51264
    We have 4-5 days usually have an aide, sometimes nights don't secretary both shifts. There is some flexibility in staffing. Weekdays chose to have 7 nurses with 2 aides (if we are full @ 31) where as weekends would rather have 8 nurses and one aide. We have a lot of discharges and admissions Sat, Mon, and Thur for some reason .
  12. by   MissRNBlue803
    I work in a hospital that's strictly ortho patients in the whole hospital except ed. on days and night you can get up to 7 patients with 1 tech and 1 huc except on sundays huc until 1pm .
  13. by   KassieMO
    I walked into an apple store a couple days ago. And there were literally 20 workers with 5 customers in the store.

    I work on an orthopedic trauma with 5:1. PCATS have 10 patients.