nurse-pt ratio

vintagemother, BSN, CNA, LVN, RN · Sep 3, 2015

I am working on a psych unit that has two nurses per shift. The unit can hold over 30 pts. This is in Florida - does anyone know if this is a usual set up for down here?

Is the unit acute or long term psych?

We were 1:16 plus a charge nurse on acute. 1:30 sounds like a lot for an acute unit.

1:50+ on long term psych.

HTH!

Meriwhen, ASN, BSN, MSN, RN · Sep 3, 2015

I am working on a psych unit that has two nurses per shift. The unit can hold over 30 pts. This is in Florida - does anyone know if this is a usual set up for down here?

So basically 1:15 or so. For acute care or detox, it's too high. Depending on the acuity level, 1:6-1:10 is a good ratio.

Sadly, such crazy ratios are all too common, especially if there are no ratio laws or unions around.

Laurel32 · Sep 4, 2015

My unit's ratio is 1:5. We are always full so it is not common to have less than 5 pts. This is acute psych.

Jules A, MSN · Sep 4, 2015

I was pretty quick and comfortable but think anything over 1:8 is usually too high. Long term state hospitalization, is there even such a service any longer? would be higher and doable at 1:15 imo but no way would I do 1:15 on an acute unit on a regular basis. We seriously need to start refusing unsafe assignments and finding other jobs. It doesn't make sense to me to allow hospital admins to dictate safe patient care ratios.

Jules A, MSN · Sep 4, 2015

My unit's ratio is 1:5. We are always full so it is not common to have less than 5 pts. This is acute psych.

VA is the only place I ever saw staffing this sweet. :)

adnrnstudent, ASN, RN · Sep 10, 2015

We are 1:8 and can get 2 admissions on a 12 hour shift bringing us 1:10.

If we start with 10 patients we won't get any admissions.

Our MHS staff are 1:6-8

Mandychelle79, ASN, RN · Sep 10, 2015

Our overall staff: patient is 1:4, minimum staff is 3 to make sure there are always 2 staff on the floor at all times. We usually staff 2 nurses per shift so we could have 4 nurses for 16 pts or 2 nurses 2 therapists or 3 nurses one therapist. We are all required to do all aspects of the job except therapists cannot give meds or do physical assessements.

elkpark · Sep 11, 2015

I've worked on a busy, tertiary level adolescent acute inpatient unit (truly tertiary care -- kids sent from all over the Eastern US because they couldn't be helped elsewhere, usually v. intense and busy), and we routinely had 1 RN and 1 LPN (with 5-6 good, experienced techs) on a 28-bed unit (usually full or close to it). That was v. do-able. If it worked on that unit, I can't imagine it wouldn't be do-able (or even a slightly higher ratio) on ordinary psych units.

Jules A, MSN · Sep 11, 2015

I've worked on a busy, tertiary level adolescent acute inpatient unit (truly tertiary care -- kids sent from all over the Eastern US because they couldn't be helped elsewhere, usually v. intense and busy), and we routinely had 1 RN and 1 LPN (with 5-6 good, experienced techs) on a 28-bed unit (usually full or close to it). That was v. do-able. If it worked on that unit, I can't imagine it wouldn't be do-able (or even a slightly higher ratio) on ordinary psych units.

You were nicely supplied with techs and I agree that adolescents especially with all the fights require more staff than most adult units. I haven't ever worked a unit with more than 4 techs and most times now 2 techs per unit is more common. This specialty is rapidly changing and there is a push not to seclude, restrain or give prn medications for behavioral reasons. All well and good but what I have found is the patients are far more defiant and without seeing the negative consequences peers receive when unsafe, because there are minimal consequences now, this sets up an environment of disrespect and chaos. And how many actually have worked with a full team of experienced techs lately? Ours seem to be a few oldies but mostly newer techs with minimal training due to staff turnover. I'd love to see statistics because it seems as if staff assaults are on a marked rise in the past three or four years. Its a tough specialty at best and getting more difficult each year, or maybe I'm just getting older and softer?

wingding · Sep 11, 2015

Our ratio varies as staffed -- a lot of call ins = short staff 1:11 with 1 tech --- we do our own discharges & admits, which makes our acute care unit a machine rather than a therapeutic venue when we discharge 6 & admit 8, move patients around like a chessboard to accommodate. It can be way too heavy of a load especially when you have several with active psychosis & or violent tendencies. Sometimes you just have to get through your day as best as possible.

lynnpsychrn · Sep 12, 2015

This an acute psych unit. Such an unsafe set up. Surprised nothing bad has happened there!