was curious to find out what the average patient ratio is on a neuro floor? I worked on a combined neuro ortho floor and it was 4-5 which at times was difficult, having 2 post ops ortho pts and add on 2-3 confused patients with evd drains lol
i got a job offer for a neuro floor stroke certified center rated number 1 in my state. i am assuming they will be high acuity patients too. the ratio on this floor is 5. and in neuro icu 2.
I have to say, 6-8 pt load is too much. I don't know how safe pt care can be delivered, following all hospital policies and unit practices, with even 5 pts. and CNAs who do nothing. and charge RNs sitting at the desk playing candy crush. and.....you see what I mean. how is your pt supposed to be 1. ambulated if possible 2. washed/clean 3. in tact skin 4. all meds on time 5. perfect I/O Q4 or Q8 6. drips drains EVD LD monitored 6. supported/educated/etc ???
I work on a Neuro-tele unit, specializing in stroke but really we take everything. The ratio is 1:4 as mandated by the state of California because of the telemetry monitoring. Occasionally we have to go over ratio to 1:5, which happens more frequently when we are 'in season' Sept-April (resort type community). It's back breaking work, and scary even at 1:4. We don't have an official step down unit, and the patients we have on the floor can be really precarious. Oh and ironically when we go over ratio we have no charge nurse because they've already been pulled into the mix and we still don't have enough staff, so it means no lunches or breaks. Good times.
When I worked on a floor (I work in a combined surgical/trauma/neuro ICU now) we had 3-5 pts on days/PMs (the 3 pt assignment was up for 1st admit); 5-7 on nocs--same thing, the 5 pt assignment had 1st admit. My floor had a stepdown room where the pts were cardiac monitored, could be on 3% NaCl, needed q 2 hr neuro checks; the RN who had that room had 3 pts on days/PMs, 4 on nocs.
On our unit the ratio is 1:4 on monitors and 1:6 general inpatients eg rehab beds. The ones on monitoring need neuro observations hourly and are stroke admissions.
I work on a neuro/ tele unit as well and typically it is a 1:5 or 1:6 ratio for night shift, and 1:5 for day shift. Nights were the patient loads are a good mix of neuro patients and med surg/ tele patients are not bad to deal with, but nights with 5-6 actual neuro patients, who may or may not be confused can be quite challenging. I hear bed alarms so often that some times when I get home I still I think I can hear them going off. It's a tough unit in my opinion, but for some reason I really like it.
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MissM.RN, BSN, RN
165 Posts
I have to say, 6-8 pt load is too much. I don't know how safe pt care can be delivered, following all hospital policies and unit practices, with even 5 pts. and CNAs who do nothing. and charge RNs sitting at the desk playing candy crush. and.....you see what I mean. how is your pt supposed to be 1. ambulated if possible 2. washed/clean 3. in tact skin 4. all meds on time 5. perfect I/O Q4 or Q8 6. drips drains EVD LD monitored 6. supported/educated/etc ???