Published Mar 26, 2008
mamao4
9 Posts
Just wondering...I work in an ER that sees approximately 150+ patients per day. What is your typical patient load? If we are staffed well, we will have 3:1 in our "critical" rooms and then 4:1 in our "regular" rooms. On a bad day, we have 5:1 no matter where you are. Sometimes I feel like my license is flapping in the wind when I have two patients that are ICU candidates and then 2-3 others that are just there for general illness. Just trying to see if anyone else is in the same boat!
workingforskies
103 Posts
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.
mandasueRN
80 Posts
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.
KatieBell
875 Posts
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.
Anagray, BSN
335 Posts
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!!!!
Sarey Gamp 1987
8 Posts
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??
AfloydRN, BSN, RN
341 Posts
5 : 1 is the standard where I work. Yes, It sucks but noone cares! We keep doing it because we need the job.