Staffing Ratios

Here.I.Stand, BSN, RN · Oct 13, 2014

I worked for one that has I think 60 beds. Those staffing levels are pretty similar to what we had. It was hard, especially if our pts needed wound care and weren't seeing the WOCN that day. Our pts had wound vacs changed q MWF, and could take as long as 2 hours to do. :eek: We'd get a lot of pt w/ old SCIs who had 4 stage IV's, all with vacs on them. What was crazy was they didn't take wound care time into account on their staffing matrix...so someone with a 2-hour dressing change had no increase in acuity, but 5+ IV meds in a 12 hour shift did. So hang an antibiotic and give a shot of Dilaudid every couple of hours, and they were higher acuity. I never thought that made sense.

Anywho, WOCN saw pts once a week, and could have anywhere from 8-14 people to see in a day. We had two full-time WOCNs, and if census was high enough they had a bedside RN help them. That's how they were able to see so many pts.

We had two RRTs per shift. CNAs had 8-10 pts each. Sometimes we had a resource RN...but it was amazing how often someone would happen to get sick and need to go home when it happened that we had an "extra" RN on the floor. One of our nursing supervisors was also the procedure RN, so if someone needed a bronch or whatever, he helped w/ that.

Here.I.Stand, BSN, RN · Oct 13, 2014

Oops, forgot the RN assignments! They tried to give 4 pts on the floor if on tele or the vent, but we could have as many as 5. This was on days; nocs could have up to 7.

RNs in the ICU got 3 pts.

RexRN · Feb 27, 2016

I too work in an LTACH. We generally have 6 pts. In the ICU we have 2 or 3.