Safe PT to Nurse ratio, what is yours?

Nurses Safety

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Specializes in Everything.

I would like to get an idea on what other hospitals consider a safe Pt to nurse ratio. I work in a small rural hospital, last night we had 14 PTs, 3 nurses until 1am and 2 care techs all shift. This am, I talked with my DON and said it was too much to have 7 PTs, and the PTs were not getting the care they deserve and so on. I had a fresh surgical, bilat TKAs and c-section and abd hyst from the day before and 4 nebs and I could go on. It was crazy the beginning of the night, but did settle down after the 3rd nurse left. We are also responsible for the ER and doing all the paper work, that goes along with admits and ERs.

The point I am trying to make is that I expect myself to deliver a certain level of care to my PTs, and I couldn't do that last night. When approached, the DON, said that according to the accutity of PTs, we have enough nurses and with not having enough nurses to fill in, it would have to do. Monday night, she allowed an inuction to go on with only 2 nurses and 12 PTs, fresh c-section. It was "OK" because we had 2 care techs. I called the doctor and she was mad because, if she had known about the staffing issue, she would have cancelled the induction. The DON got mad because I called her in, she had to cover "on call" Well, it was crazy, almost one of the craziest nights I have had.

I would like some ideas on what you do in these situations. I am at a loss. I am so frustrated with this DON, I could go on and on, she is not a good leader and she is clueless about how to do her job (this is her 1st DON position, and talking to staff at her other hosp, they say she was the same there, but in QA)

HELP!! I am ready to walk away from this job I love and the staff are awesome! We are all in the same boat.

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Specializes in Neuro/Med-Surg.

I usually have 6 patients and I never have the time to give the care I want to give - I rarely have the time to give basic care (meds, treatments, wound care, etc). On the rare day I have 5 pts, it is much easier and one glorious day I had 4 (one early discharge and another pt was gone to sx all day) and I actually was able to provide education and spend time talking to the pts! miracle! lol. sometimes nurses on my floor have 7 pts - I don't think I could swing that.

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Specializes in Med/Surg.

We have 5 usually, no techs/CNAs or other ancillary staff

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At this link: http://www.calnurses.org/nursing-practice/ratios/ratios_index.html

You can find what the California Dept of Public Health decided should be the legal minimum staffing levels for each kind of unit.

It's 1:5 on med-surg. And that is legally supposed to be a minimum and hospitals are supposed to go up from there depending on acuity.

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Specializes in ER, Oncology, Travel Nursing.

Safe Patient / Nurse ratios!?! What are those!?!?!

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I work night shift (7p-7a) on a med/surg floor. We start out with 5,6, or 7 patients but 7 is the maximum number we will ever have to take. Those that have 5 or 6 patients will be the ones to receive new admissions.

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Specializes in CT-ICU, ER, Surgical.

I believe the industry practice is to give nurses just enough patients so that you can barely give safe/quality care... if you are really good at your job. I'd bet most nurses would say they could give better care if they only had less patients.

FWIW, I worked in a busy ED and we usually had 4-5 patients, rarely 6. I now work in a cardiothoracic ICU and we have 1-2 patients. I also work per diem on a surgical floor and we have 5 patients days/evenings and 8 on nights. Each position has different nursing expectations and responsibilities, but in all cases I wish I had more time to give to my patients. The only time I sit down is to chart.

:smokin:

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Specializes in Everything.

I don't mind the 6 PTs, just usually no time to chart and do paperwork, hope and pray that a Laboring mom comes in or that we have a chest pain walk thru the door. It take at least 10 min for our on call staff to get here, even the doctor.

i would love to have 3 nurses on at night, and 0 care techs, then at least you have extra person who can do nurse duties if needed. Our care techs are awesome at night, just wish they could do the admitting part.

thanks everyone for the input.

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Specializes in -.

I start my nursing program this fall 10'. I am currently working as a part time cna in a nursing home on a dementia floor. One night we had 27 patitients with one nurse and one cna. I don't know what nursing things differ from just a nursing home to a hospital, but just as a cna there was no way possible to keep my patients turned and changed as needed through the night. Our nurse was pulled from our floor a few times in the night to assist on another floor. Does this seem crazy to anyone? Are the regulations different for nursing homes versus ER, Crit Care, General Hospital?

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Specializes in -.

Another thought. I am an engineer with a QA background going for my Master in Nursing as a second degree. I see administration making decions all the time based on 'numbers' and the 'bottom line'. My first instinct would be to present the DON with some type of report, research, or list of examples about why more than 5 patients isn't efficient or safe in your department. Depending on the type of personality this DON is, you may be able to strike up a discussion about how patient ratios are determined, what level of RISK they are willing to take, how much of the decision is completely in her hands, is she strapped with any level of 'maximum nurse hours (budget perspective), etc. Maybe I'm naive but if someone came to me and gave me their concerns and could provide clear examples, I would be inclined to listen. I'm sure there are some seasoned nursing laughing at me right now, but I thought I'd throw it out there.

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Specializes in Everything.
Another thought. I am an engineer with a QA background going for my Master in Nursing as a second degree. I see administration making decions all the time based on 'numbers' and the 'bottom line'. My first instinct would be to present the DON with some type of report, research, or list of examples about why more than 5 patients isn't efficient or safe in your department. Depending on the type of personality this DON is, you may be able to strike up a discussion about how patient ratios are determined, what level of RISK they are willing to take, how much of the decision is completely in her hands, is she strapped with any level of 'maximum nurse hours (budget perspective), etc. Maybe I'm naive but if someone came to me and gave me their concerns and could provide clear examples, I would be inclined to listen. I'm sure there are some seasoned nursing laughing at me right now, but I thought I'd throw it out there.

The other day, the accuity even said that we needed another nurse, but she denied we did, and she likes to follow the numbers it has on paper. Right now we are out 3 night nurses and we have 3 full time nights right now picking up the other shifts, all extra shifts are considered "hight needs pay". She has even said, before the "high Need" shifts were out there, that we need to not worry about the overtime, she just doesn't want people to work more than 5 days in a row, but it is ok to do 5 double shifts in a row, mostly talking about the 8 hr shifts. But Since I have been employed there, OT has not been an issue.

Talking to her is like trying to nail jello to the wall. May seem to stick at first, but then it will all be gone after a min.

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Specializes in -.

"Talking to her is like trying to nail jello to the wall. May seem to stick at first, but then it will all be gone after a min"

That's a hysterical analogy:yeah:. It is crazy to think that everyone we are going to work with will be rational. Why do so many seem to get put into management (just kidding - kind of)

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