PCT ratio to patients 34:1 ..... how is this safe?

Students Technicians


Last night at work I was the only tech on my whole floor. I work on the stroke/pulmonary unit that is currently ccombined with our renal/dialysis floor. So I have lets say very needy patients. I arrived to find that I was tech for all 28 patients. I had six admits throughout the night. So while taking care of those patients I was answering call lights and whatnot. I couldnt do any vitals or finger sticks so the nursrs had to do them which caused missed meds and med errors. plus we had a patient who needed a sitter but we didnt have another so I was running in there ever 5 minutes to keep him from pulling his IV and cath out. I didnt have any time to chart and I was still there an hour late. How is this safe? Its about saving money but I believe this will cost more in lawsuits once people start falling or have major med errors.

Sorry just had to rant


17 Posts

i dont know why but for some reason this seems to be the norm at 2 of the hospitals in my area. some managers seem to be oblivious to the fact that night shift can be just as hectic as day shift and the floor would benefit from 2 techs at night. the patient to tech ratio is usually 24:1. very sad...but true


47 Posts

I agree that is highly unsafe. I faced a similar issue today at work, but my ratio was 19:1; and our nurses where 6:1. I know that its not even double what you had, but I understand the the feeling. All you can do is the best you can do, and if there were issues the people higher up should understand the reasons why. I also see that my job is trying to cut costs by not hiring more techs, but in reality it would be more conducive to just hire more techs instead of running us into the ground!

that's awful! we have that happen frequently where i work, too. but when there is only 1 pca on the floor, the call lights ring to the nurses' phones primary and then if they don't answer them, or if they forward them, they go to the pca secondary. so although we have the whole floor, we don't have as many call lights to answer. And just like aquarius said, you can only do what you can do... you are only 1 person! if they keep up staffing like that, they will find themselves with zero techs!


76 Posts

At the hospital where I do clinical's thats about how it always is when I am there. However, the techs always do their vitals before anything. If they have time they answer call lights and do finger sticks and anything else. You doing all that work just seems horrible and I hope you don't have to do it like that very often.


16 Posts

Not safe not safe not safe! I'm so sorry. I hope your nurses were understanding. There's nothing worse than being slammed AND having to waste ten minutes explaining why you can't check sugars.

Are you in a position where you can go to the charge nurse/nurse manager/respected nurse on the floor and ask to come up with a plan? there are nights when I've said, "Nurse, here is the floor: 6 people on kayexalate, 2 GI bleeds, 8 finger sticks (2 q2s), 1 person in restraints, 3 admissions, 5 rooms to strip and set up, 1 person pulling out there vent and 2 needy families (or whatever). I've already changed 5 people, I spent 30 minutes getting so and so bathed, and now x needs a dressing change. How do you want me to divide my time? What makes the most sense for all of us?" Sometimes, I think our nurses just get so busy and stressed that the forget that I'm one person answering to at least 6 "bosses" and 14 patients. When I spell out for them what I'm doing, and what is on my plate, they are usually great about respecting it or coming up with solutions (e.x.,-- "help the wound nurse, I'll do sugars").

PLEASE remember that you are one person, and assert that! Patient safety comes first-- but you are NOT responsible for missed meds, pulled ivs, etc IF you told the nurses how busy you were and that you were unable to complete vitals, keep a 1:1 watch, etc (which I'm sure you did!). Legally, my undestanding is this ultimately comes down to nurses, though we are there for support. Were they also upset about this ratio? I hope so! They should be advocating for you, too.

If you are consistently not getting the support you need, document document document (including conversations with the nurses), and bring it to your manager AND the nursing manager. Your patients (and you!!!!) deserve decent staffing levels.

I hope you have some allies in this fight. It's such a tough job sometimes, and we've all had those nights where we just want to curl into a ball and never come out (but don't have time!). Hope it turns around for you and hang in there. These phases do pass-- and holiday periods are usually the worst!

Specializes in School Nurse.

Yes I have talked to my manager about this.....And she agrees. So do the nurses! We need more techs! We had a floor meeting last week and the entire meeting was about this issue. And most of the nurses are supportive and will pitch in. At my hospital, though, the nurse pretty much refuse to answer call lights. So that was my main duty and they picked up the q1, q4 vitals and such. I do not know what the average ratio is at other facilities, but our nurse to patient ratio is 1:3. At least at the begginning of the night and never ever goes above 6. To me three patients seems sort of low. The thing is if we have say 21 patients, we are allowed 5 people to work. So the question is, would you rather have 1 tech and a nurse to patient ratio of 1:5, or drop a nurse add a tech and have a ratio of 1:7? I dont know what is right but I know that people will get hurt soon if they expect me to be in charge of everything. I simply cannot be in 8 different places at one time!


28 Posts

Specializes in PCU, LTC.

1 RN to 3 patients? On a Med-Surg floor? Honestly, if I could have a ration like that, I'd be fine with no aide at all. I work in Cardiac PCU and our ratio is usually around 1:5 with 1 PCA for 30 patients. It's not safe, and close calls are common. Management knows, and regularly just tells us, "everyone survived." They have, so far, but close calls are pretty common.

Specializes in LDRP.

i am nearing my end of orientation as a pca on a medsurg floor. we have 22 beds total, and we are often full or nearly full. so far every 3-11 shift ive worked except one had only one pca for anywhere from 16-22 pts. thankfully i was orienting with that one pca and i am pretty confident in my skills for the most part and we were able to split the floor. i am very nervous about when i get off orientation. in my interview they told me i would have no more than 11 pts to myself, but the pcas have told me having the whole floor is pretty common. im thankful that the nurses are pretty understanding and will do vitals for us if we are busy, but its very nerveracking to me!

i cant imagine 34! :barf01:

Yesenia PL

2 Posts

Well I am a PCT in a Hospital in Orlando Florida I work in a PCU floor. The floor has 40 rooms each single occupied when we are short on staff there's only one Tech s/he will have the whole floor and s/he will only be responsible to do in the bath of all the total patients after midnight and patients were not completed by the morning shift before midnight.  when we have two Techs our paper says that we have 13 patients which we have to take Vital Signs every  4 hours Arch(suga level) at 9 p.m. and at 2 a.m. for those who are higher than 200 and then somewhere in the middle of that I had to complete all the bath the we're not done by the morning shift and be responsible for total patient after midnight we have alot of nursing  home patients in out floor all the time.. not to mention answering call lights take people's snacks or water help them to the bathroom a turn off lights when the nurses leave them on so I was just trying to find out how does it work on other hospitals cuz I thought that was a little too much cuz in the paper it may say that I have 13 patients but in reality I have 20 and my partner the other CNAs will have the other 20 cuz not that many of our nurses will help us in the floor and I really think that's a very safety issue I was trying to look up some policies from my hospital but I haven't find them yet.

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