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Hi, I was interviewed and offered an RN position at a hospital in California. The nurse manager told me that the patient to nurse ratio to the floor that I am assigned to (telemetry)is 8:1. Do you think it's a safe ratio? Also, she told me that 5 of those 8 patients will be assigned to LPNs (I only have to cover their IVs) while I will have 3 patients of my own that I will be fully responsible for. Do you thinks that's a fair deal, I mean I will still be responsible for those LPNs too right? What if those LPNs called in sick, then I will be stuck with 8 patients all together?

I am a new grad RN with no hospital experience and I am just a little anxious/nervous about working there. Any advice. Have you worked at that condition before? Do you recommend a new grad work in those conditions? I was also informed that orientation is only 6 weeks. Do you thinks that's enough time to be competent in telemetry nursing? thanks for taking the time to reply

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I'm not a med/surge nurse but I think those ratios are too high for a new grad to manage...

Questions I would ask:

1. What training will I receive?

2. How long will I be precepted before I "need to step up to the plate?"

3. How is acuity balanced?

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Specializes in ED, ICU, PACU.

What I understand is that California has mandatory ratios and that seems too high to comply with the law. Best ask you manager about that.

Yes, you are right when you say that you will be responsible for the LPNs patients. I think that is how your NM is getting around the staffing law. LPNs cannot do an initial assessment, so, if there is a change in status or a new admit, you are responsible for the assessment & the LPN supervision of each patient. Also, you may have to be responsible for every IVP drug (depends on your state's nurse practice act)-and, I suspect it is true because of you saying that you are going to be responsible for the IVs.

Another thing to consider is that you are not allowed to be supervised by an LPN & run this risk if you are new and working with seasoned LPNs. [bTW, this is not meant to offend LPNs, since I find their skills equal to RNs-this statement is based upon the BONs' position]

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I am a telemetry RN and 8:1 ratio is high. Telemetry pts require a lot of IV meds. I would not choose to work with that kind of ratio on a telemetry unit. Good luck.

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Specializes in A myriad of specialties.

I've never worked in telemetry but I from what I've read and heard, it sounds like way TOO much for a new RN to walk into. I'd recommend a year or two of med-surg experience, some float experience in telemetry before jumping into that kind of position.

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Specializes in Medical Surgical.

That is ridiculous staffing. You would probably have to take the hardest three patients too. Also hang blood, etc. It would be very hard for a seasoned RN. And if they say 8 patients , they probably mean 10 at times. And six weeks of orientation is not nearly enough for what they're asking of you. Don't take it.

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Specializes in Transplant/Surgical ICU.

8:1 in California?!! :nono: What hospital is this, have they not heard of the ratio laws? I think someone is trying hard to take advantage of your new and hard earned license

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I personally wouldn't touch it with a ten foot barge pole. Having worked tele in the past 8:1 is wayyyy too many. Doesn't matter how good the LPN is you'll ultimately be responsible. Tele pts can need a LOT of IV pushes and can change condition quick.

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I live/work in NY and in telemetry unit of my hospital, the ratio is 8-1 and there is no LPN to cover any of the pts for the RN. I don't work on that floor, but if they they made the ratio 8-1 for RN/LPN, I would tranfer to that unit.

Good luck to you.

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8:1 in California?!! :nono: What hospital is this, have they not heard of the ratio laws? I think someone is trying hard to take advantage of your new and hard earned license

It's a hospital in Los Angeles of all places. I've always thought LA is a progressive city and "pro-nurse." Boy I was wrong. BTW, I did not take the job. I got hired in a new grad program somewhere else. I will start Feb.

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Specializes in Geriatrics, Home Health.

I'm still looking for my first RN job. Every unit I've applied to (except 1) had a ratio of at least 1:6 on nights. One had a ratio of 1:10 on nights, with 3 Aides and no LPNs.

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