What is your Nurse to Patient Ratio

[dRN1]

We have a 4 : 1 rato that we try to stick to. Occaisionally we end up with 5 if we are short a nurse. But as you know that you may have HAD 6 throught the shift if you had 2 discharges then got 2 admits. (aaahhh day shift)

[solneeshka, BSN, RN]

the idea that certain numbers of patients = one nurse bothers me. That is like saying a nurse is a nurse is a nurse. The acuity of the patient is as important as the ability of the nurse. There are some patients I will not assign to certain nurses. Let's not get hung up on numbers. It does not benefit the nurse in the end.

Oh, if only management thought as you do!

[wannabemw]

I wk d/s on a full-service med/surg unit: GI, Onco, Tele (Cardio), Resp, Hospice, pre & post-op's, Ortho, Psych... yea I think that's it!

Typical = 1:6. but over this last week I had 1:7. And if I dc home 3 & I started with 6, I usually get back 3 more new admits & IMC transfers. So, at the end of my shift I may have had & charted on as many as 10 patients!

Our CNA ratios are much better then most facilities 1:14 & sometimes 1:18 if we're short-staffed.

And BTW I agree about the accuity vs care... some total cares are = to 2 or even 3 patients! And med lists.. geeze! It's not unusual to have 3-4 pts w/numerous po & IV meds and antibiotics. All these factors should be considered!

~MJ

[nightshiftnut]

Days is usually 5 patients and 1-2 nursing assistants. Evenings 5-6 w/one aide. Night shift (oh,glorious nightshift) is 8 patients with one aide. Forget about your pee break! Med/Surg/Oncology Unit.

[nightshiftnut]

Oh, the sad point is you can end up having a heavier load with a high acuity and the other nurse has a cake walk. I sincerely believe in using a acuity tool. I used it as a charge nurse on a previous 31 bed unit before. Works well.

[VU RN BSN]

I work night shift on a med-surg/tele/neuro floor. Our nurse to patient ratio is 6:1 and the day shift ratio is also 6:1.

Our charge nurses really don't look too closely at acuity, they do the assignments more based on blocks of rooms, trying to keep you in 3 rooms that are next to eachother (all of our rooms hold 2 patients). If there are a bunch of empty rooms at change of shift, then everyone gets assigned 5 patients plus an empty bed, with the understanding that you will most likely get an admission from the ER or maybe a transfer from the ICU.

Also, our hospital staffs the floors with a lot of LPNs. When our med-surg/tele/neuro floor is full or almost full, then we are allowed to keep 6 nurses. It is not uncommon for us to have 4 RNs and 2 LPNs. We do not do what I think is called "team nursing". Instead those LPNs are assigned 6 patients, just like the RNs are each assigned 6 patients. There is some rule that says in a 24 hour period a hospitalised patient must be cared for by an RN for 12 hours, so an LPN can not give change of shift report to another LPN. So, that is often what our charge nurses focus on the most. If the day shift had 2 LPNs and 4 RNs, and now the night shift will also have 4 RNs and 2 LPNs, the charge nurses sometimes find it a bit tricky to make everyone's assignment. The charge nurses try to find out which patients require a lot of IV push meds or require a blood transfusion, so that they can be assigned an RN, but it doesn't always work out that way.

When we are lucky, we get to keep 3 CNAs/PCTs. But sometimes our large floor only gets 2 CNAs/PCTs, especially 11p-7a.

[AngelsRN]

my last shift, which was day shift 12 hours, I had 9 patients (all at one time)! Everyone else had either 8 or 9 as well. Then I had 2 discharges, and got 2 admissions or transfers right back. And these were patients who had a high level of acuity . . .not icu level of course, but not just hanging out in the bed and self care.

[nursevl]

I'm curious as to what state everyone is working in? I went to nursing school in California, as far as I know they are the only state that has a nurse:patio ratio law. I wish every state had that. Med/surg was 5-4:1 in cali. I'm in Louisiana and the hospital I work at does 6:1 with no regard to pt acuity.

[BlessedRoseRN]

At the hospital I work for in Texas our nurse patient ratio is 1:5-6 depending of if we are full or not. I don't like it all our patients have multiple morbidities and it's hard. Our charge nurses are lazy and don't know how to organize the patient nurse ratio.

[spongebob6286, BSN, RN]

6-7 pts. i think the the nurse to patient ratio should also depend on acuity of the pts.

[elprup, BSN, RN]

I am in California. When I did my orientation I'd have 6-7 patients on my own. And several times I'd have two different patients in isolation (One for CDiff, one for MRSA). I am going to double check CA ratios, because hosp was telling me it was 6-7 and that it was ok because I had a preceptor (whom was never around because he always was being pulled into different part of hospt!) . I was on medsurg floor with some very needy patiets.

[starletRN]

ITA that the patient ratio should have to do with pt acuity. On more than one occasion, I have had 5-6 patients and 3 of those were high acuity patients. It's scary and I get nervous just typing it. LOL

[hes2371]

Im from Cincinnati, OH and i work on a renal failure/kidney transplant 7a-7p. from 7-3 we have 3-4:1 and from 3-7 we have 4-5:1. I know the night shift can have up to 6:1 starting at 11p.