Published Aug 25, 2012
kaliRN
149 Posts
So I recently learned on allnurses that California is the only state that has mandated nurse-patient ratios. I was honestly shocked and found it educational how hard fought a battle that was and how many other states are trying to pass similar laws. But it sparked my curiosity as to the average nurse-patient ratios in other states? What are the ranges of patients an RN sees on the unit/floor?
In California the ratios are as follows:
ICU, CCU, NICU/PICU, PACU, L&D, and ER patients requiring "intensive care:" 2:1
Step-down units: 3:1
Telemetry, Pediatrics, ER, Antepartum/Postpartum: 4:1
Med-Surg: 5:1
Psych: 6:1
*The only exception is a local or state declared emergency.
I became an RN after this law was in place for some time, so I really would be interested in the experience of others.
DedHedRN
344 Posts
I do long term and rehabilitation care in California and the ratio is 30 pts to 1 nurse on my unit. Some of them can become critically ill fast. I am still expected to get the job done, with no overtime. LTC still has a long hard uphill battle to face. People think we do a bad job..say bad things about us...but you try having 30 pts.
That's 30:1 on day shift...noc shift does 60:1.
Still have foleys, ostomies, tube feeding and IVs.
Miss Lizzie
17 Posts
I live in Florida and work on a remote tele/med surg floor and our ratio is 5 to 1. But a lot of the time we are 4 to 1. I have floated to CCU in my hospital and the ratio there is 2 to 1. There are other hospitals nearby that have 8 to 1 ratios for med surg. I am very grateful to work in a hospital that is well-staffed.
Kay28
122 Posts
I work in Massachusetts. I work on a 30 bed unit, adult acute psych. I work the 3p-1130p shift and my case load of patients can vary anywhere from 5 to 8 patients. It really fluctuates though, depending on how many discharges and admissions I have that shift.
reba2295
2 Posts
I work in Illinois as a Postpartum/Nursery RN, we usually have a 4:1 ratio. But we don't just have 4 patients, we really have 8 patients.. We take care of Mom and baby.
nrsang97, BSN, RN
2,602 Posts
I am in Michigan and have a 2:1 ratio but I am in the ICU. Sometimes we are 1:1 if it is a really high acuity patient.
Pamiesue22
21 Posts
I am in florida and work on a cardiac stepdown unit, our ratio is 4:1.... But the ortho and m/s floor is 6:1... Our ICU is 2:1.
It is refreshing to hear that so many nurses are working with ratios that they feel comfortable with to provide safe care. As I read through so may threads on here - it seems that nurses are being overtaxed at the patient expense for the hospital's gain.
I am sorry to hear that LTC is still being staffed that way. I know an RN who worked before there was a 30:1/60:1 NOC ratio and in a 100+ bed unit he was the only RN on staff. He stayed a week. The current ratio under those comparisons seems monumental. But I also appreciate that the acuity of patients in LTC is ever increasing. Especially as it relates to skilled nursing needs and the RN/LVN relationship.
I simply cannot imagine what 8 patients are like to one nurse.
nurseintx0511
30 Posts
I'm in Texas on a med/surg floor at night.... Typically our ratio is 5:1 or 6:1 (usually 6:1). But it's not unheard of to have 7:1 at night (I did the other night). We don't start out with 7, but if we keep getting admissions, usually 1-2 end up with 7. Day shift is usually 5:1 or 6:1.
86toronado, BSN, RN
1 Article; 528 Posts
Wow! I work in NY where we are trying to get state-mandated ratios. I work ER, where our typical ratio is 4:1 regardless of acuity, but 7 or 8:1 is not unusual. On the med-surg (including telemetry) floors in my hospital 7 or 8:1 on evenings and nights is the norm, with 10 or 12:1 not unheard of. I can't speak to dayshift, as I never work it. In the ICU where I work, they consider themselves lucky not to be tripled, and 1:1 is unheard of.
xoemmylouox, ASN, RN
3,150 Posts
This is ridiculous. Good/Safe care cannot be provided with some of these ratios. My father has been recently inpatient at a local hospital. The care was horrible. With these ratios there is no doubt why..