RN to patient ratios in the ED

[biker momma]

ED RN's I could use your imput. During a recent survey in our ED one of the "dissatisfactions" that staff indicated was our staffing ratio - RN to patient. Could you share with me how your department staffs?

Specifically: # of RN's to patient

# of techs/CNA's per patient or RN

# of ED beds

daily # of patient's seen

type of area you serve: rural, suburban, urban

Trauma designation

Adult/Pediatric/mixed

Your imput will help us in our development of a plan to improve our staff satisfaction regarding this issue.

Thanks, Diane

[Lunah, MSN, RN]

In general, each nurse can/will have up to 5 pts -- we do zone nursing, and each nurse is assigned to a 5-bed zone. Every now and then, depending on zone, we can get a "two-fer" in one of our private rooms -- you know, like a parent brings in two sick kids, that kind of thing.

We have one tech, if we're lucky, for the whole ED. We have 15 beds, and usually see anywhere from 50 to 70 pts per day. (70+ is a very busy day for us. We've had them.) We're a mix of suburban and rural, with some spillover from the urban areas that aren't far from us. We see adults and peds. We are NOT a trauma center of any sort, with our 15 beds, but we do see some nasty trauma from time to time, when choppers aren't an option (legs vs. tractor, that kind of thing).

[ERRN324]

In our ER we have 14 beds, this includes four express beds that are typically seen by NP's. We usually have one two nurses that handle five beds each and one that handles four. Some days from noon to midnight we have a charge nurse on top of the three staff nurses, and some days we have a noon to midnight tech. Sometimes we get really lucky and have both. We always have a dedicated triage nurse.

[bill4745, RN]

20 beds, 5 RNs with 4 pts. A charge RN with no pts, a float RN with no pts, and 1 or 2 techs (blood draws, ECGs, stable pt transports, etc. Most of the time, sometimes with no float and 1 tech.

[Lunah, MSN, RN]

We used to have a float nurse, but that position was eliminated (too bad, because it was excellent and helpful). On a good day we have 5 RNs -- one charge without an assignment, one triage, and then the other three take 5 beds each. If we're short, our charge takes an assignment. At night after 11p, they go down to four RNs, and down to three RNs at 3a.

[danger]

urban level 2 trauma center w/ 40 beds and 160 pt.'s/ day. our "acute" side has 12 rooms w/ four of those set up for trauma and we staff these w/ 4 nurses ideally (3 rooms/ nurse). our less acute side has a 4-1 ratio. and we're just now trying out team nursing where we pair a nurse w/ a tech and take 5 rooms.

[emtb2rn, BSN, RN, EMT-B]

Generally speaking, our staffing is:

Emergent - 4:1 can go 6:1 with hallways

Urgent - 3:1 can go 7:1 with hallways

Fast track - 6:1 no hallways (usually)

Psych - can go 12:1 depending on the moon....

Each area will have at least 1 tech, urgent may have 2 primetime 3-11.

50 rooms plus 17 numbered hallway beds with curtains. When all full improvise as needed.

Avg 200 pts day

Not a trauma center. Doesn't mean we don't get ' em tho.

My youngest pt was 10 days old. My oldest was 104 y/o

Suburban

[Virgo_RN, BSN, RN]

40 bed regional Level 2. Nurses assigned to halls. Typical load 3-4. One tech per hall.

[FlyingScot, RN]

47 bed, suburban (but really on edge of very large city), not a designated trauma center (but get plenty of them), patient load of 4 sometimes 5, one medic and one tech on each zone (3 zones total), usually 2 RTs. 24 hour census 200-220. 4th zone is fast track. One nurse, one tech or medic- 8 beds (open 1p-1a). Second smallest ED in city, third busiest (two busiest have 100 beds in their ED's). 8 total EDs in city. It's NUTS!

[MedicVeronica]

Specifically: # of RN's to patient: depends on acuity 1:1 or 8:1

# of techs/CNA's per patient or RN: techs vary, some days we have 1 per team (3 teams in the ED), other days 1 for the whole place

# of ED beds: 40 on the regular side, plus "fast track" or ambulatory care area

daily # of patient's seen - just above 200/day, but we have had several days of 300

type of area you serve: rural, suburban, urban: all urban

Trauma designation: level 1, but they are a separate area with 3 or 4 bays of their own.

Adult/Pediatric/mixed - adult, we have a full children's hospital across the driveway

[LilgirlRN, ADN, RN]

31 beds level 3 trauma 6 trauma, 1 holding room aka the crazy room, 6 fast track with a PA, 17 regular beds. We don't usually put pts in the hall anymore, we used to before our ER was expanded.

We're suburban, only hospital in the county. usually see about 120/24 hours but we have seen 170/24 hours.

Trauma rooms, each nurse has 3 bays but we also have 2 itty bitty rooms that they may have to see one in and out kinda thing but not usually. Reg rooms nurses can have 5 each but may also get 2fers too. Fast track = PA, nurse, tech.

Most days have 3-4 techs for 7-7 days and 2 at night.

Oh yeah, one triage person and one charge nurse. And... only one secretary per shift!

[GretaLou]

Suburban ED - 9 fast track beds from 8a-10P 19 bed main ED - with 9 hallway spaces

The main ED has 1 triage, 1 charge and SHOULD HAVE 4 nurses for the floor - usually only three -

avg pt load 100

usually ratio 1:7, twice this week I had a 1:9 ratio - it was awful

usually 2-4 techs per shift - they don't start lines