I agree that it is insane to take up to 24 patients. (My staff thought they had it bad.) We are also a med/surg unit. We hold 28-29 patients and if the floor is full we usually staff with 3 RNs, 3 LPNs, and 2-3 CNAs. We also have either and RN or LPN as a "desk nurse", and they are responsible for taking off all the orders and discharging patients. (The desk nurse position saves us). You need to seriously look at getting into a safer environment. Good Luck