Staffing Levels in Psych

ccoombs · Oct 8, 2011

The unit I work typically has 1 rn, 1 lpn, and 3-5 techs. Our census runs anywhere between 10-30. We've had a couple of quiet weeks but I'm sure it will be wild again pretty soon. My unit is an acute male unit, most individuals are actively psychotic, and occasionally violent.

Wabi Sabi, BSN, RN · Oct 9, 2011

For nights, at least there should be 1 RN, 1 Med Nurse (LVN or LPT), and perhaps 1-2 techs. In an ICU where I work, day shifts have 2 RNs, 1 Med Nurse, 3 MHWs. At night, in the same unit, they have 1 Charge RN, 1 Med Nurse, and 2 MHWs.

marshmallowstar, BSN, RN · Oct 10, 2011

https://allnurses.com/psychiatric-nursing/staffing-inpatient-unit-615297.html

HeatherPsychRN · Oct 12, 2011

I work in a behavioral health hospital, so we have pt on different floor for different accutities. I work on an adolescent unit on pms and we have generally 2 rns, and 4 counselors for 19-22 pts. Nights they have 2 rns and one counselor for 20 beds.

Simply Complicated · Oct 15, 2011

That is a common staffing ratio for my facility. We are full at 22 patients. On overnight 11p-7a there are frequently 1 RN and 2 Mental health Assistants. I work 3-11p and we usually have 2 RN's and 2-3 MHA's. Then if we have any 1:1's we have staff for them. Although we frequently run short staffed, and one of the nurses ends up having to do MHA work

NYRN08 · Oct 18, 2011

On my unit it's been 1 RN and 1 MHA for census of 18. Acuity is high on this unit and staffing has been horrible the past few months. I've been putting 5 to 6 days (12 hr shifts) a week. Sunday night into Monday morning, I was the only nurse with 2 pts on 1:1's and a MHA doing the safety checks, etc. I spent time from 1:30 till 5:30 relieving the MHA for breaks, etc but no one to come and relieve me for a break or time to catch up on my nursing duties. I finally called the charge nurse because I had an admission that I barely completed paperwork on didn't call the doctor for orders and needed to do f/s and give out 6 am meds. I finally broke down and filed a grievance report. I worked 5 days this week, I'm tired and stressed out. I wake up this afternoon to my phone ringing, it was staffing asking it I would come in yet again tonight..they tried to bribe me with an incentive..ha yeah right! just when I thought I was in the clear, I get a text from my clinical director asking if I can work a shift for tuesday night as well. Enough is enough!!

xenogenetic · Oct 22, 2011

When the acuity gets high in the hospital (meaning there are an increased number of one to ones) staffing levels can get downright ugly.

I had to transfer out of one hospital due to flat out exhaustion. I ended up being mandated to work four 16 hour days in a row (July 1st, 2nd, 3rd and 4th)! The list of who was next to be mandated turned over every single day. People would call out sick from work because they knew they would be held over for another 8 hours when they went back into work. It was tough psychologically because you would get down to the last 20 minutes (sometimes the last 5 minutes) of your shift and you would get a call from the supervisor telling you that you were frozen to stay another 8 hours because they had a staffing gap for the oncoming shift.

aloevera · Oct 26, 2011

It varies.....depending on acuity, staff call-outs, etc. We try to have 1 RN and 1 LPN (med nurse) and 3-4 Techs for up to 35 pts. They try to staff 5:1....but unfortunately it doesn't always work out that well. If you have a good Supervisor, they will come and help with admissions, LOS, etc.

If not, it makes for a rough day........we have one that will help and one that won't do a thing..........so some days are exhausting......

We do 12 hr. shifts so they would never ask us to do another 8, thank heavens, sometimes another 4 but not often.

misssarahRN · Oct 28, 2011

Wow, all of these facilities are generously staffed!

On our most acute unit shares it's night staff the subactue/step down unit( and everyone else depending on the volume of admissions). If the combined census of the acute unit and the step down unit falls to 20 or lower, the two units combine (closing one unit) and they get 1 RN and 1 tech regardless of acutiy. Otherwise it's 2 Rn and 3 techs(if the combined unit census is over 35) for upwards of 50ish psychotic patients, regardless of acutiy. The only thing that gets extra staff is an MD order for a 1:1 (even then, they get strong administrative pressure to d/c them ASAP).

Grave incidents have and do happen with staffing like this.

curiosity123 · Oct 29, 2011

Friend works on 18 bed psych unit high acuity, 2 RNs and 3 techs per shift.