Safe Nurse:Patient ratio

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What do you consider a safe nurse-patient ratios for night shift?

I live in WI, and so far I cannot find documented anywhere the maximum patient load a RN can have. The other night we had 18 patients 3 nurses and no nursing assistant. One nurse had to go to the ER because she became ill, which left us with 18 patients and 2 RNs with no help, and an admission on the way. Its a med/surg onc unit with very heavy patients, I have been working for 4 months, and I definitely do not feel safe taking care of 10 patients. I cannot keep up with the assessments, PRN meds, call lights, telephone calls, q 2 hr bed turns, and anything of the unknown that comes up i.e call to the doc, etc. I would like to know if others have experienced patient:nurse ratios like this or worse?

I feel like when I bring this up to people, they say I am complaining because I am new and not use to working yet.

Specializes in Med Surg, ER, OR.

Step-down/cardiac with 8 pts? I am still in school, but where I work, we hardly ever have 8 pts on med-surg. On step-down, acuity is usually higher and would therefore require a lower pt:nurse ratio (1:3 - 1:5), anything higher, I would stay away from. Thats just not safe if it is truly a step-dow unit. Dunno though, just a student.

Specializes in Med-Surg, Home Health.

I am a fairly new nurse. I graduated last Dec and got my license on March 1st. For the first 6 months after I graduated I worked the 7p-7a shift on the med/surg floor in a small, rural hospital. I was on orientation for 6 wks. The day after I passed boards, they took me off orientation. During orientation, I usually had 6-7 patients. After orientation, it increased to 8-12. (It was very uncommon that I would have 8 or 9 pts--usually it was 10-12). One night they gave me 13 patients! As soon as I got home from that shift, I called and talked to the nurse manager. I told her if that happened again, I would refuse the assignment because it was not safe.

I worked with several (very good) LPN's. They each had a team of pts--same nurse to pt ratio. They did basically everything that the RN's did except admission assessments, give blood, and draw blood from central lines. So in addition to the usual 10-12 pts I had, I was expected to do those things too. (If not me, then one of the other RN's who had their own 10-12 pts). Usually at least once a shift I did one of those things for one of the LPN's, who, again, are great nurses.

We usually had 2-3 CNA's on the floor. They always had a lot more patients that the nurses did. Usually about 14-18 patients per CNA. I always felt bad for them because they always had way more to do than time to do it, I tried to help as much as I could.

To make matters worse, we had mandatory overtime.

Seriously, this whole thing is outrageous. I don't understand how the people who are running things can't see how much it is going to cost them in the long run when huge mistakes are made b/c they refuse to have adequate staffing. Not to mention what they are costing pts who can't get proper care b/c there's just not enough people to provide them with the care they need and deserve.:angryfire

I did that for 6 months (I honestly don't know how!) and finally decided I just couldn't do it any more. I was honest-to-God more exhausted than I have ever been in my entire life. I felt like it was impossible to take good care of my patients, and even more impossible to take care of myself.

I didn't work for a few months after that. I was very sad and disheartened by the experience. I was starting to get depressed. I thought I had made a huge mistake by going into nursing. :o

But now, I'm happy to say, I decided to try for, and got a position in a clinic. I have been there since September. The pay isn't as good as it was in the hospital, but it is sooooo worth it! No nights, weekends, holidays, or mandatory overtime. And the best part of it is that I feel like I actually can take care of my patients. I can actually help them and sometimes make a difference in their lives. I love it. I understand clinic nursing isn't for everyone, but I think I may have found my niche.icon7.gif

From just about everything I've heard (from friends and reading posts on here), the nurse to pt ratio is just too high to be safe. Like I said, I'm still pretty new at this, but even the experienced nurses I know say it's just too much. Because of that, I personally, hope I never have to work on med/surg floor again. As a matter of fact, every once in while I wake up in the middle of the night in a total panic, drinched in sweat. I have this horrible nightmare that I am still working at the hospital and I'm suppossed to going in right then. Then I wake up and thank God and all my lucky stars it's just a dream.

Good luck and much thanks and admiration to all of you wonderful nurses out there doing it.

Specializes in RN- Med/surg.

On nights...if it's all RN's we start with 3-4 patients and will take admits to equal 5 patients to each RN. If we have an LPN to team with...and RN/LPN team with take on up to 8 patients. I'm lucky to work at a facility that looks ahead with staffing. If we're not staffed adequately....they will divert patients to other facilities. Then...when management comes wondering what happened...they insist they boost our staff numbers. I couldn't imagine taking care of 7+ patients by myself!

Specializes in Float.

April - what kind of floor do you work and what state?

I work tele and do pretty good with 6 patients. 5 is heavenly. But here lately I've been regulary having 7 and one night 8 and I was in crazy mode and felt like I didn't know WHAT was going on with everyone. Just trying to see everyone and do assessments and pass meds was all time consuming. Heaven forbid someone have a change in status. We do our own VS too which adds to the duties. I'm trying to figure out what is a decent load for my type of pt. We get a lot of CHF, post cardio-thoracic surgeries (usually a few days post op), some CP observation, syncope/weakness, and stuff like afib, post cath, etc.

Specializes in Renal/Diabetic.

I am not yet a nurse, but a PCT on a Med/surg floor. The cap for our nurses is 6. They will not (or i should say have not) given any more than that. So for three nurses we can have a max of 18 pts. For PCT's our max is 10 patients, which is way too much, in my opinion. But from what it sounds like, that is not nearly as much as other places.

I am worried too sometimes about our ratios.....I am a relatively new nurse, I work 7-3 and had 11 patients and and then a transfer from ICU. We are a small community hospital and it sickens me that I feel I can't give the care necessary. Everything is rush rush rush, sometimes I feel like leaving the profession because of this. The dollar is always the bottom line at many institutions. When the census is up they should call in more nurses etc, but it falls on deaf ears.:o

I am worried too sometimes about our ratios.....I am a relatively new nurse, I work 7-3 and had 11 patients and and then a transfer from ICU. We are a small community hospital and it sickens me that I feel I can't give the care necessary. Everything is rush rush rush, sometimes I feel like leaving the profession because of this. The dollar is always the bottom line at many institutions. When the census is up they should call in more nurses etc, but it falls on deaf ears.:o

Yep, this seems to be a consistent theme throughout the threads on this site: understaffing, understaffing, understaffing, to serve the almighty dollar.

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