Staffing levels

Specialties Psychiatric

Published

The question of adequate staffing levels has come up recently, and I've done some research online as far as regs go, but I'd like to get some feedback from the forum members. What are your current nurse-patient ratios? Do you include attendants in the ratio? Thanks!

Specializes in Psych, Extended Care, Med/Surg.

At current we have 23-24 beds per unit. We always have at least 4 staff per unit. At least 2 what is considered licensed staff, at least one being RN, the other could be RN or LPN, and then the other two could be RN, LPN or CNA. RN is charge then someone to pass meds (RN OR LPN) and then two others. Depending on days of the week or number of precautions, etc. we could have up to 6 staff. We also have a Sup. but they are usually to involved in their own things...

Hi, we have a 22 bed unit and we generally have 6 staff on an am shift, 5 on a pm shift and 4 on night duty. We usually have a CN, and a mixture of RN's and EN's

15 bed admission unit

AM - 3 staff + 1 RN

PM - 3 staff + 1 RN

NOC - 2 staff + 1 RN covering 2 units

Specializes in Psychiatric and Administration.

Hi,

Staffing is ALWAYS a struggle. I work in a 210 bed free standing Psych facility and our units are 36 beds with the exception of our child unit (22) and 2 overflow units (12 and 24).

Our facility is a for-profit organization so staffing is tightly regulated. We us a grid that calls for anywhere from a 1:5 ratio to a 1:6 or 7 ratio depending upon the population. We generally assign anywhere from 2-3 RNs or RN/LPN combination with the rest of our staff being mental health techs.

I'd love to discuss more about psych care in Canada to see if you are experiencing similar challenges!:smilecoffeecup:

Hi

I work in a Canadian pediatric hospital. Our psych units (thanks to a commitment to care by our managers) have great staffing. Our adolescent unit is 1:3 and our children's unit is 1:2, occasionally 1:3. We also have 1:1 staffing as needed. Our acuity though is very high with complex and acutely ill kids in crisis. On the 15 bed adolescent unit we have 3RN"s and 2 Youth Counsellors on the Days and Evenings shifts (10 bed Children's Unit is 2 and 2).

We are fortunate...although still often hear complaints of feeling short staffed...

Our unit is a combined adolescent/adult acute care unit within the hospital. We have 17 adult, 3 adolescent, and 3 emergency assessment beds. We have 2 seclusion rooms for the entire population. Assuming a full census with no high risk, aggressive, or constant observation patients we would typically have 5-6 RNs and 1 male LPN, weekdays. Weekends we have 3 RNs and 1 male LPN. If a pt requires seclusion and constant obs, the male LPN is often assigned to this task. Considering this, and because males are tasked to provide crisis intervention for this and other units in the hospital, I am the lucky winner some days.

The subject has been on my mind a lot lately. We had a crisis on the weekend. A pt attempted strangulation on the unit, and for a brief period, only myself and one other male RN were available to directly intervene. The charge RN had to try and help us plus call for orderlies, get orders and prep meds. Apparently the only orderly in the whole hospital was tied up with another pt, and our male LPN had to run back the the unit, after having responded to a pt crisis in ER. Anyway, we spent quite a long time on the floor restraining this pt until the level of aggression decreased.

My worry was, in all that, if anything else had happened on the unit, who could have responded? Or what if we could not have restrained the pt, what about our safety? I have NVCI training, but I am not very experienced or physically capable of handling a violent pt without adequate assistance. I just wanted to know if my situation and experience is common to this field. I appreciate all the information being shared, it is very helpful.

Days: 2 nurses (1 or 2 RN's) + 3-4 aides

Eves: 1.5 - 2 nurses (1 or 2 RN's) + 3-5 aides

Graves: 1 RN + 2 - 4 aides

25-28 patients

long-term psych "rehab" facility

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