Staffing Ratios


Hi all!

I'm working on a tele/step down unit and since my last manager has left, we changed from staffing based on acuity to staffing based on number of patients. I work nights now and have anywhere from 4-6pts, usually 6 with no pct and no secretary. It's a 24bed unit, so to qualify for a pct we need something like 16 pts (even if we're fully staffed we only get 1 pct). It's about 1/2 walkie/talkie, 1/2 complete or at least assist. We usually get at least 2 admits each during the night. We take gtts, but no titrating. We have open hearts, fresh caths, chf, mi's, you name it. Just wondering what other staffing for similar units looked like. I'm from the Chicagoland area. Thanks!

Specializes in Rehab, critical care. Has 3 years experience.

I don't know what other units look like, but 6 patients with no CNA, and no secretary sounds unsafe. I could see possibly 6 with a CNA and secretary available possibly, but...

if you're not comfortable doing it, and don't feel safe, then make a transition into another unit in the hospital that is staffed well. Have you been there a year yet? Best of luck to you. It's best to make a change before you're so burnt out that you want nothing to do with nursing. (because there are good nursing jobs, and not every unit is created equal, and not every hospital for that matter).

classicdame, MSN, EdD

2 Articles; 7,255 Posts

Specializes in Hospital Education Coordinator.

recommend you confer with your CNO. They are not interested in how hard you work. But they are interested in HCAHPS and patient satisfaction and turnover and patient safety. Create an argument along those lines. Good luck.


125 Posts

Specializes in ccu.

I live about 45 mins out of Chicago :)

I work on a Cardiac/Neuro IMCU, and we get similar pt's as yours except, that our fresh open hearts go to the ICU for a couple days. We also get all the neuro related pt's (seizures, cva's, etc).

Our ratio is 5:1. It is a 50 bed unit and there are typically 3-4 aides working to help us. We have on secretary until 11pm, and after that there is one secretary for the whole hospital.

I can't believe you get open hearts w/5 other pt's!! Our open hearts are 1:1 in the ICU! That doesn't seem safe at all!


22 Posts

Sorry, let me rephrase. We take fresh caths and open hearts once they leave ccu. Main issue is no pcts and no secretary. Floor has gotten extremely heavy since I started about a year ago, which makes me sad because I really do enjoy the type of patients we get, just not the lack of help and high acuity.

Specializes in ER, progressive care. Has 7 years experience.

I work on a progressive care unit, VERY similar to yours...24 bed unit, staffing ratio used to be 1:4 but it is now 1:5. We get one CNA if we have 13 patients and we usually always have a monitor tech...sometimes our supervisors staff an RN as a monitor tech, but that's once in a blue moon. We take fresh caths and sometimes they will need their sheaths to be pulled, but I honestly haven't seen that in awhile. We do not have open hearts.

Your unit doesn't sound safe IMO...have you spoke to your manager/director? If that doesn't work, go up the chain of with your CNO.