Patient Loads, How many patients do you have?

Specialties Orthopaedic

Published

Hi,

I was wondering what your patient loads are like in the States, I work in an orthopaedic Ward in New Zealand where we have acute and elective surgery. Tonight I had six patients 3 of whom where post op. I will describe a bit about them so you can see what loads we have and compare with your own.

1, Knee joint replacment, post op dropped BP, stat gelofusin, PCA could not start that as Systolic BP below 90had to get IV tramadol started...lots of trouble controling pain. IV antibiotics Post op today my duty

2, Non union, fractur tibial plateau, bed to chair for six weeks, needing to be taken to toilet etc.

3, Spinal Bifida lady with cellulitis, total cares cannot roll herself. on airbed. IV antibiotics. refuses to do alot for herself despite nothing wrong with hands having to constantly irrigate IDC.

4, Day 2 Revision THJR, IV antibiotics.

5, police Officer dog handler injured while apprehending suspect. repair of Patella tendon, post op, unable to mobalise at this stage. reg S/cut Morphine. Post op today my duty

6, long term patient with infected thigh wound and septicemia, post op washout and application of vac dressing. requires to be taken to toilet on commode chair also had heparin infusion running. IV antibiotics via PICC line. Post ob today my duty

these were my patients tonight 3 required total washes. We make up all our antibiotics and have to have all narcotics and any injectible drugs checked by 2 nurses and signed by two also. This takes time and we spend time looking for another nurse to sign and check drugs.

So I was just wondering what its like for others.

We also go down to PACU and pick up our patients and have a handover from the nurse there.

Gosh, I do not know how you guys do it. Our staffing on med/surg is 4:1. They only give you two surgicals if they HAVE to. If I have a CNA with me, we can have up to six patients. If I have a lpn we have 7 or 8. I should consider myself lucky.

That assignment is outrageous. I live in NH in the USA. It is extremely rare for us to get up to 6 pts each. The unit I work on is orthopedics and medsurge. Sometimes we get really busy assignments but it doesn't seem as bad as yours. If I feel that I was given a really unfair and unsafe assignment I speak up. I think that new laws should be done to keep that nurse-pt ratio 1:4 at most. I know that that may be difficult at times, because we have somedays where we may have 12 admissions on one shift. We have a 39-bed unit. Our charge nurses try no to give more than one fresh postop pt and no more than one precaution pt to one nurse at a time. Well, I know that I would definitely not like working in New Zealand. Things should be changed out there for you guys. That is just not safe. Patient safety should be the hospitals priority.

I hope that this helps you! ~Amy~

I hope I don't sound stupid, but what is a en. I have never heard of it and I know that we don't have them in NH,USA. (At least not that I am aware of).

Thanx

Specializes in Medical Surgical.

Wow, you New Zealand nurses sure have a lot of patients! Currently we (a US ortho floor) have 4 or 5 apiece on days, 5 or 6 apiece on evenings, and 6 or 7 on nights. We have one NA for every 8 patients or so. RNS and LPNs carry the same load, which isn't really optimal since the RNS have to give the IVPs, admission assessments, blood transfusions, and care plan changes for the LPNs. I think our staffing is all right. Of course, I gave up trying to eat meals or get out on time years ago. How in the world, and better yet, WHY in the world are some of you nurses trying to handle so many patients?

Wow!! I work on a 25-bed unit (actually, we have 2 floors which each have 25 patients, and the nurses are randomly assigned to each floor, so if you work 2-3-4 days together youre on one floor, but you might come back a few days later and be on the other floor, but it is all run as one unit, using the same RN's), anyway, we have (on days) 3-4 patients each, 4 on evening, 5-6 on nights. We do total pt care--you can delegate little things like open the window or get me milk or help with a fairly easy bath, but in the end, it is the RN's responsibility to do all. We have a lab for am and pm blood draws, but RN's do anything in between.

We have mostly pretty severe trauma (an easy patient is a non-weightbearing pt with only 1-2 limbs involved), but also are the home floor for otolaryngology and OMFS and gynecology, but we generally have one patient from any of those services on either floor at a time. We get medicine and neuro overflow patients also, and we are designated to get the comfort care (ie: death impending no code pts) because we have some private rooms. We have 2 aides per floor on day shift (when we are not short), and 1 charge nurse and one USC to take off orders. Our pharmacy mixes abx for us, and a transportation team delivers pts everywhere. We recently got a lift team set up for our bariatric pts, which seem to be more and more common these days. Even with all these resources, we run a lot!

Well night shift we usually run 9-13pts per RN

Med/surg..5 used to be the norm..now it's more like 7-8.. higher load/acuity =increased risk, for both nurses & pts...sad but true.

.....

Specializes in OR Hearts 10.

Ortho-Medical here. Acuity, what's that? LOL Nurses, RN or LPN

days 5-6

eves 6-8

nights 8-11

We have techs,

ideally (LOL) on days,

there is one tech with one nurse, but the usual for techs is:

days 6-7

eves 7-9

nights 8-11

The hardest part about ortho is the amount of assistance needed to get these fresh post-op ups. But my favorite thing is getting pain meds q1h for those pancreatitis folks. Don't get me wrong, I'm a firm believer in pain control, but it is hard to get anything done when you have to stop every hour.

Yes I work on an orthopedic unit that is currently lacking a nurse manager, we have a total of 10 nurses employed 3 are LPNs and we have 5 techs. We have a full capacity of 28 pt beds. my assignments as a tech on eves are 12-14 pts each night all of which are a part of a joint program that need to be bathed at night on top of the fact there are normally only 2 nurses on the floor 1 unit clerk and one other tech. an RN load varies minumum 6pts on a good night 11-12 ona busy night...that is any shift. ORTHO IS THE HARDEST UNIT!!!! Not even ICU can top our pt difficulties. If u can do ortho u got alot of guts! LOL

:crying2: :uhoh21: :chuckle

Specializes in OB, M/S, HH, Medical Imaging RN.

I work on a Med-Surg floor 7A-7P. We have 6 patient each. We have a mixture of surgical pts, medical pts, telemetry pts, post-op epidurals, peds, geriactrics, total knees, total hips, peritoneal dialysis, aortic anursym repairs, COPD'ers, AIDS pts and plenty of patients who get blood transfusions, FFP, Heparin gtts, Dopamine and Lasix gtts, TPN, Lipids, basically just everything. It is very hectic. With discharges and admissions I can end up charting on 7-10 patients in a 12 hour shift. I get a 30 minute lunch break and get distrubed while eating. We do have great techs and don't have to deal with baths, bedpan's, beds etc... There's no way I could do my job without their help. I am trying to get into case management in my hospital. I am 49 years old and I get so tired. What freaks me out is that on night they have 7 patients a piece and after 2200-2300 they have absolutely nothing to do until 0500. Some of the day nurses have worked some night shifts just to check it out. They are bored to death. It's either feast or fantom when it comes to days vs nights. I have stopped doing the change of shift admission history and assessment when I get a new patient. I don't even feel guilty about it. Don't get me wrong I don't b-grudge them sitting around for hours when there's nothing to do (I'm comfy in my bed) but they claim they are busy for a full 12 hours. Pleeaaassseee !! I think I got off the subject.....sorry. Are day shifts this bad everywhere????

Specializes in Case Management, Acute Care, Missions.

12 hr Noc shift, max of 7 - though usually

I'm blessed!

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