RN to pt ratio @ your hospital?

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There have been other threads similar to this, but I'm wondering solely about RN to pt ratios, not including however many LVNs, PCTs, or CNAs are included in your staffing.

Our hospital doesn't take into account the number of pts 1 RN is responsible for when staffing, even when they have their own pts, and are responsible for the other non-RN staffs' pts, also. It is kinda scary sometimes when you are so busy with your own full pt load (or should I say 'overload'), that you may never lay eyes on another nurses pts that you are 'legally' responsible for, too. There may be 17 or more pts on the floor (med/surg) some days with only 1 RN, and these are acutely ill hospital pts. It's not humanly possible to do what is required or expected of nurses sometimes. Is this very far off from the rest of the country, or is this pretty much normal everywhere? (I hope not.)

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........run, don't walk. :uhoh21:

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I agree with sunstreak. Get the heck out of there. I feel that if Nurses start refusing to work in such a hazardous environment, it will be the only way to force hospitals from piling patients onto us. It is dangerous for you and your patients. As nurses, we have the power to control what is dished out to us. If we take it, they'll keep on abusing us. Nurses need to take care of themselves and put themselves first because if we don't look after us, why should we expect anyone else to? :angryfire

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Well, I guess that answers my question. I really hoped this was not the norm. There are some very experienced LVNs that work with me, but there are also some very inexperienced ones. Those are the days I feel particularly stressed, because I can't really supervise them, when I have the whole rest of the floor to supervise, also.

Thanks for the replies. You've been very helpful.

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In California we have ratio laws; 1 RN to 5 pts, actually 1 RN to 6 pts, but that changes in January. At our hospital on Med/Surg: 1 RN to 5 pts plus an LVN for those 5 plus 10 more (LVN floats) and 2 CNA's for those 15 pts. Did that make sense? So, in other words...15 pt's= 3 RN's, 1 LVN, 2 CNA's. We are really well staffed and LOVE IT!!!

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In California we have ratio laws; 1 RN to 5 pts, actually 1 RN to 6 pts, but that changes in January. At our hospital on Med/Surg: 1 RN to 5 pts plus an LVN for those 5 plus 10 more (LVN floats) and 2 CNA's for those 15 pts. Did that make sense? So, in other words...15 pt's= 3 RN's, 1 LVN, 2 CNA's. We are really well staffed and LOVE IT!!!

Unfortunately, these ratio laws in CA may be changing (for the worse:crying2: ) Hospitals are crying and now accusing the closure of their facilities on NURSES! They are telling the public that they cannot afford these pt/nurse ratios and this is what is forcing the closure of ERs and hospitals. Yup, blame the nurse....not the totally messed up healthcare system in this country. I just read an article in the paper that said, "If nurses would just take 7-8-9 patients, our facilities wouldn't be in the middle of this crisis". It implied that Nurses are just sitting around twiddling their thumbs. What to do, what to do??

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

1:6 or 1:7

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Specializes in Critical Care/ICU.
Unfortunately, these ratio laws in CA may be changing (for the worse:crying2: ) Hospitals are crying and now accusing the closure of their facilities on NURSES! They are telling the public that they cannot afford these pt/nurse ratios and this is what is forcing the closure of ERs and hospitals. Yup, blame the nurse....not the totally messed up healthcare system in this country. I just read an article in the paper that said, "If nurses would just take 7-8-9 patients, our facilities wouldn't be in the middle of this crisis". It implied that Nurses are just sitting around twiddling their thumbs. What to do, what to do??
I don't believe that Au-nuld would let this law change....yet. He supports the ratio law.

The whole purpose of this ratio thing was to allow nurses to do nursing and for safer patient care. Unfortunately since the law went into effect, where I work (at least on the night shift), nurses are observed doing less, not more.

It angers and embarrasses me to find out that some (not all) are found to be taking longer breaks and not really using the precious time that they are now granted to spend with patients...with patients or bettering themselves or their unit.

These are the selfish people who are going to screw it up. The ones who don't appreciate what they've got and the ones who I wouldn't want near me or my family member or friend with a ten-foot pole! They are the ones who are noticed, not the hard working concientious nurses.

I'm sure studies will be underway regarding patient outcomes once the ratio law is in full effect. If patient satisfaction and outcomes are not markedly better since the ratio law went into effect, I personally will place the blame squarely on the shoulders of those who take advantage of this law for their own selfish reasons.

To answer the question posed by the OP, the ratio in my ICU is never, at any time (including breaks) more than 1:2 and is usually 1:1 due to the acuity on the unit. It's been like this for many many years due to a law that was in existence even before this newest law. The new law didn't really affect us.

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Unfortunately, these ratio laws in CA may be changing (for the worse:crying2: ) Hospitals are crying and now accusing the closure of their facilities on NURSES! They are telling the public that they cannot afford these pt/nurse ratios and this is what is forcing the closure of ERs and hospitals.

Give the public a little bit more credit. Hospitals have been giving this same ole song and dance since 1999 when the ratios first came into reality. The public understands when the nurse to patient ratio increases, so do the number of complications, including death per patient.

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It burns me up that they try to place blame on nurses! How dare they!

I hope the ones that feed those lines to the media will some day have their beloved family members in a hospital somewhere, where the ratios are 1:9, and will see the error of their ways.

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Intensive Care

1:1 - 1:3 depending on acuity.

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In California we have ratio laws; 1 RN to 5 pts, actually 1 RN to 6 pts, but that changes in January. At our hospital on Med/Surg: 1 RN to 5 pts plus an LVN for those 5 plus 10 more (LVN floats) and 2 CNA's for those 15 pts. Did that make sense? So, in other words...15 pt's= 3 RN's, 1 LVN, 2 CNA's. We are really well staffed and LOVE IT!!!

Whoa. I am moving to CA.

Actually... I seriously am! If anyone has any info on how I can go about applying for a license there, and agencies OR hospitals that are nice to work for in southern CA (within an hour-ish or less of San Diego?) I would LOVE to get some help! My boyfriend is in San Bernardino (sp?) and I'm heading that way when I graduate with my RN in May.

Right now I work on a Med/Surg/Pediatrics floor. We are staffed with RNs, LPNs, and CNAs.

On a FULL night, RNs OR LPNs can have up to 8 patients (and have a CNA responsible for patient care, vitals, blood glucose checks, etc). We generally have a "Resource Nurse" (charge nurse) also who helps with anything from giving meds to hanging or starting IVs to admissions.

I am working as an LPN right now and let me tell you, I am liking this place less and less. Last night I started with 6 patients. The most time-consuming of all of those 6 was a person who had gone for an exploratory lap, open and close because they found he was full of CA. So at the time I took him and the rest of the team on, he had an NG, foley, PSI, t-tube, and subclavian multi-lumen. Going through the subclav were lipids, hyperal, and 0.9NaCl (along with IVPB antibiotics). Orders were written an hour into the shift to D/C his NG and foley, T&C for 3 units of blood, hang one unit that night and hang 2 the following day. AHHH! As an LPN, what part of that am I actually qualified to do? This is 1 of 6 patients, and on top of that 6-patient team, I had 2 admissions before 6pm (I work 3-11pm)! Give me a break. I left work at 1:30am. I know that I am pretty intelligent, experienced from having worked there for a few years as a CNA prior to being an LPN, and I'm thorough. But when that much insanity is going on with ONE patient and you add on 5 patients, 2 of which were receiving IV push narc's for pain every 3 hours (NOT at the same time, of course), and then add 2 new ones.... well, I think I forgot to breathe a lot last night, and I don't remember peeing once in the 10+ hours I was there.

I guess all I can say is thank GOD the nurses I work with are a TRUE team -- we work together, and people are very willing to lend a hand and help out whenever they are able. I think 8 is really pushing it -- they do NOT group by acuity, so it's basically anything goes. One wing goes from 439-449. They split at 445-ish. If 439-443's team happens to have 4 confused patients with bed alarms, 2 of those being in isolation for MRSA of name-your-favorite-body-fluid, then that's just the way the cookie crumbles. I don't like the way things are being run, but the 2 women responsible for managing the floor are new and choosing to make changes to EVERYTHING whether it makes the nursing staff miserable or not. I have offered constructive criticism, suggestions... they basically have the attitude of, "If you don't like it, find another job" and so I am biding my time until I graduate and can do just that. :p It sucks that they are creating an unsafe environment where nurses are very unhappy, because I love my work, I love my patients, and I love my co-workers -- I just don't love it all enough to risk my license staying there!

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