Patient Load

Sounds like you and I work at the same place. (Do the initials H.C.A. mean anything to you? LOL)

The California staffing law has set the following ratios as an acceptable ER assignment:

General ER - 4:1

Critical care. (ie ICU patients.) - 2:1

Trauma - 1:1

My only complaint with that is that I have no problem with having 2, relatively stable ICU patients. But if one patient is unstable such as on a bunch of drips that still have to be titrated to effect, they should be 1:1.

It can truly be frightening at times to be professionally placed in situations like that. But fortunately, at least where I work, we have a pretty good team that works together and watches out for each other. If that were not the case, I would have been gone quite some time ago.

Staffing levels are our worst issue at our facillity. Regular assignments are 7:1, one particular assignment can have 8:1. Our critical care rooms are 4:1--I'll never understand how they think having 4 ICU admit patients, on drips and vents with one nurse is safe, when even in the ICU they have a 2:1 ratio. In trauma your assigned to a bay with 2 beds, but it's not uncommon to have 3 pts stuck in the room. I've worked "regular" assignments with 7 patients, one of which was an ICU admit for a SAH with q 1 hr neuro checks.

It sounds fairly typical to me. I worked at a Level One and before assigned rooms were established, peope woud routienely get these lopsided numbers, one nurse with 6 another with 3 one with 2....

These days we have 4:1 ratios with no hall beds strictly. Its better except when your mistriaged patient ends up having the massigve head bleed or something similar.

yes, we are in the same boat. Sometimes we have 6-7 patients a piece, no matter what their class is. It is really difficult. Lately, I have stopped picking up so many patients, because I just don't feel it is safe. I let my management worry about it, because it does nothing for me to worry alone.

Thank you! I know that I have a great team to work with as well, but when we are all busy on a bad day and getting creamed by EMS coming in, it is hard for us to help each other. I am very fortunate to work with the people that I do work with and I agree with you that it makes all the difference in the world!

How do you get around having no hall beds?! That is GREAT!!!!

this sounds very er typical this past sunday as i was working charge rn i also had to care for lol on vent on levo and on dopamine in addition

to triaging ems--that showed no mercy--as a result i ended up with the hallway pt's--five total--ive exhausted the adjectives to describe

the situation admin on call refused to go on int disaster--even temp--im getting crispy burn-out anyone know of their hospital's acuity rating scale??

5 : 1 is the standard where I work. Yes, It sucks but noone cares! We keep doing it because we need the job.