The large patient to nurse ratio is giving us a bad rap.
Patients and their families do not feel well cared for (and on some occasions are actually not well cared for) when we are running in and out of their rooms trying to get to our next patient.
When I was a student, I believed that the patient to nurse ratio should be limited to 5 patients:1 nurse (or less.) I remember that people would chuckle or roll their eyes at the idea.
Now that I am a nurse, I still FIRMLY believe that the patient/nurse ratio should be 5:1 or less.
It's a quality issue.
It's a care issue.
It's a safety issue.
As far as I know, CA is the only state with a limit. This needs to change in the other 49.
$$$$ is the reason things aren't changing. It is a numbers game and the hospitals want to make the most money so they make us deal with all of these crazy conditions and they promise the patient the moon and the stars all the while making nurses work short. As more and more people get sick and medicaid implements more laws in regards to reimbursement...nurses will suffer and suffer. Hospitals no that they are kicking patients out of the bed to soon. They know they will be re-admitted. Being readmitted allows for the hospital to profit more. We don't have a voice. Who speaks for us???
So yes, when I was working third shift, there were two staff members in the building with up to 90 mentally ill, potentially violent clients. Our safety measures were a walkie talkie and a personal alarm. We were NOT allowed to carry cell phones.
Come to the ICU side, we have 1:2 ratios. Sometimes 1:1, and sometimes 1:3 when we are really short, but three patients is the most I've ever had at any ICU job. I swear it's worth moving to ICU just for the ratios. Yeah, those two are busy, but there's still only two of them - so the highest number of people you could have on a call light at one time is two.
Specializes in Palliative, Onc, Med-Surg, Home Hospice.
1:6-7 here on a med/surg unit. One really bad days, a charge nurse could end up with eight pts or more.
It is crazy unsafe.
I used to work at a small community hospital, nights, that didn't seem to care that we were understaffed. No techs, 7 to 9 patients per nurse and caring for ortho, tele, general med-surg, a LOT of ETOH abuse (#1 enjoyment in the county), etc. Most ortho's were hips and knees. we were expected to take out the foley and assist the patient to the bedside commode before our shift ended. AIn't gonna happen. I quit.
I now work where our ratio is between 5/6 with 2 techs. Much easier. I still prefer 5 pt and find that 4 is a dream but at least our ratio's are doable.
I work on an oncology unit and there have been times where nurses were administering chemo to 2 patients and monitoring 2 additional patients with chemo running. That is not safe AT ALL! Something needs to be done to ensure that patients are safe in our care.
1:3 - oncology here. Occasionally 1:4, but only when acuities are low. I feel safe and supported! Can't imagine taking on more with the types of patients we have.
Blessed to be working in a physician-owned specialty hospital where the highest ratio in telemetry is 1:4 by strict policy, and for me in the ICU 1:2 is the rule (1:1 for CRRT/swan/IABP/fresh heart, and 1:3 only if the assigned patients are low acuity and we're very short-handed). I agree with calivianya - ICU ratios are much safer. At my old hospital, there was one night where I had 10 acute care patients and was charge. So glad I left!
This is one of several reasons why I have left nursing to retire at 61. It's just not worth the hassle anymore, it really isn't. I just don't see the situation improving but rather progressively getting worse. I have never yet suddenly seen a hospital start to be more generous with staffing just for the heck of it. Nothing will change until staffing levels are state mandated.
AlwaysLearning247, BSN
390 Posts
I work at a long term acute care hospital in MA and the ratios are 1:4 or 1:5.