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What nurse/patient ratios do you work with?

Specializes in Med/Surg/Oncology.

I'm just curious as to how many patients other nurses have. In my last semester of nursing school, during preceptorship, I had 5 patients, which would be reasonable except that these patients were difficult. Because I have chosen to work in a community hospital, most patients are very sick when they finally get care (because sadly they're uninsured) and have additional health issues other than the reason for admission. Here, in the southwest, we have ALOT of diabetic patients (fingersticks, insulin, dialysis and wound care, especailly on their feet). Often, I'll have an isolation patient. A couple of patients usually have critical morning lab values (that means calls to the MD's before I can even start assessments). And often I'll get one of those patients whom you can set your watch by because they're on their call light wanting their pain meds. And in the afternoon, I usually get a fresh post-op or an admission from the ED. Also we don't have computer charting (all paper!).

I love nursing and I love the hospital I'm at because everyone (from the doctors to the housekeepers) is wonderful. We really feel we're being of service to God. But, as a new nurse, I always feel I'm so far behind in my work. I often eat while I chart or skip lunch all together (and eat a protein bar on the fly). It's not usual for me to stay until 8 pm to catch up on charting. When I was in clinicals (at a different hospital where I got plastic surgery patients and "easy" patients), I had all my assessments done and charted and morning meds passed by 0930

Am I whining or are my patient teams as heavy as they seem? What kind of patient ratios do you all work with? Thanks for your feedback.

Hey, I know how you feel... Being a new grad is TOUGH! I've had 2 1/2 weeks classroom orientation and now I'm on my 4th week on the floor with only 1-2 more weeks of orientation. Then I'm thrown to the wolves!!

For me, each day is an entirely different world. I'm on a heavy Med-surg unit and our usual ratio is 1:6 which is nice. Yesterday we were short so I had 8 patients! Of my entire crowd, I had 2 trach w/vents (suction often), trach collar (suction VERY often), 1 PEG & 1 NG (crush meds...), Pt DNR/DNI satting in the mid-70's b/c she kept on pulling off her non-rebreather, DNR pt with traction to leg who was found with RR of 5/MINUTE!!! - gave narcan stat to reverse the effects of 5 mg morphine, 2 pts who didnt speak any english so had to run around and find translator each time we had s/t to say, pt with C-diff need to change freq. Gave 2 units blood, 4 k-riders, a million meds. Went into the pt who was desatting's room every 10 - 15 minutes to assess... She left this world an hour before shift change so had to do e/t that a death entails (post mortem, organ bank, charting...)

It was a wild day. I took a 5 minute break the entire day. My preceptor who I was with was great. She gave me my independance most of the day, letting me get a grip on the situation, but at the same time she gave me a hand at the end of the day with last minute meds and charting. I came home entirely exhausted and knocked out, but I also felt accomplished.

I dont especially love doing all the monotonous tasks - suction, meds, hang IVs, but I especially do LOVE that I come home very day and say I LEARNT SO MUCH! I love learning, and I feel so much more confident and knowledgeable each day!!

Thats nursing! We'll get through the newness and soon we'll be veterans... =)

SteveNNP, MSN, NP

Specializes in Neonatal ICU (Cardiothoracic).

Wow, so I'm not the only one who has crazy nights!!! I only usually have 2-3 patients in NICU, but last night I barely had time to eat on the run, and I don't think I went to the bathroom all night. My one pt had a head bleed and was seizing about every hour, which required ativan q5-10 min, phenobarb, dilantin, fentanyl, etc.....Then his dex went down to 29 b/c of all the seizing, incr met. rate....fixed that problem. Then platelets dropped to 20k.....transfused....calcium dropped to 5.2......gave cal gluconate. add to that q1h v/s, a mean BP of 24-26......maxed out on dop/dobut, 2 albumin boluses, with frequent desats into the 70's on 100% vent O2. Meanwhile my other pt's 2 IV's infiltrated simultaneously, [hard stick] esp for a baby....restuck, IV infiltrated after 2 hours, platelets were 18, hct was 23, restuck for 2 new IV's, transfused, gave multiple antibiotics, meds, etc.....I finally finished charting at around 8am. And that was some quick charting! My pen literally ran dry last night. And now I get to go back for the next 3 nights!!!!! YAY!! It's a good thing I love my job and my cute babies so much ;>)

Sound like you had a crazy night Steve! How long are you working as an RN for? You seem like you handled everything so well.

I work days so in addition to all pt excitement there's visitors, food, procedures to go/come from, new MD orders flying out of the computer faster than I can read them, discharges, etc.. I'm on the floor 4 weeks and I think I have 1-2 more weeks left with a preceptor. I so dont feel ready to be own. Basic routine tasks I'm fine with, but everything else.... hellloooo I'm too new!!

I went to an accelerated BSN program, so think about this way - 1 1/2 years ago I hadn't a clue about any nursing skills/knowledge. I knew the transition would be tough, and it is, but I try to take it in stride. But there's still so much I dont know... :chuckle

One day...

MackNJacks mom

Specializes in Pediatric neurosurgery/general pediatric.

Wow! You two are making me feel like a slacker. That sure was a lot you guys had going on. Great job handling those situations!

I work on a pedi neuro floor with 1:4 or 1:5 if short staffed. If all that had happened to me, I would have called in the charge nurse to help me out with some patients. :uhoh3:

heather1999

Specializes in Med/Surg/Oncology.

Thank you all for sharing your experiences...I also feel like a slacker now (LOL). It's very encouraging to know that other new nurses are dealing with heavier patient teams and they're surviving.

I was talking with a traveler and he said that in some states he's had 8 patients!

Happy Holidays to all!

shyne

Specializes in Telemetry, Stepdown.

1:4 and 1:5 on a stepdown floor

chip193

Specializes in ER.

On my second day off orientation, I took report on 14 patients in an ER.

It sucked. It really sucked.

Usually, the assignment is 1:4 or 1:5. Days and Evenings range from 1:2 to 1:5. Nights gets screwed again :).

Chip

DutchgirlRN, ASN, RN

Specializes in OB, M/S, HH, Medical Imaging RN.

5-6 patients, day shift, acute care med/surg telemetry. No wonder there is such a nursing shortage!

5:1. 6:1, 7:1 I have even at one point managed 9 patients. It happens. the week I was on vacation I heard 12:1, thank god I was on vacation.

Adam, RN

HappyJaxRN

Specializes in Transplant, homecare, hospice.

Liver, Kidney, and Pancreas Transplant Unit...checking in....If they are fresh post ops, it's 1:1. If not, then we can have anywhere from 1 to 4 patients. Never more than 4. Usually 3. :nurse:

usually 4:1, but it's a tele floor (where it's ANYONE with a cardiac hx - whether it's psych or resp or post-op, tele is where they end up...), I've had five on my first week off a 7 week preceptorship of being a new grad. And it's so much fun monitoring for those "new" s/e when put on a cardiac med ....

:-)

but I am learning SO MUCH ....and the people I work with ARE THE BEST.

christvs, DNP, RN, NP

Specializes in ACNP-BC.

Our team of an RN, LPN & aide take care of 8-10 patients on our med/surg/tele unit.

Indy, LPN, LVN

Specializes in ICU, telemetry, LTAC.

Telemetry unit (stepdown is a separate unit in my facility, thank god) and usually 1:4, sometimes 1:5. I've found out 1:3 can certainly be a nightmare once in a while. And on this unit, at night the charge nurse has a load that's equal to the other nurses, usually. That's a contrast to days where I saw charge nurses take 1-2 patients as a norm while on the first part of my orientation.

raynefall

Specializes in ER then CVICU now.

I work in a post surgical unit, and unfornately, it's not rare to have 9 patients at night.

jenrninmi, MSN, RN

Specializes in L&D.

Neuro/Trauma/Tele floor. I work 7p-730a. 6-8 patients is my norm. Usually 7.

I work on a Medical floor and have usually 4 pts. sometimes 5. That sounds pretty good but we are total care...no tech to do VS, I&O's, wts, diaper changes, etc. The nurse does it all...gets pretty rough sometimes with 3 or 4 total care pts. in diapers, need to be turned q2h, etc. Rumor is that nurse:pt. ratio is going to 7:1 beginning sometime this month. If it does and they do not hire techs, I might be looking for another job.

Med-Surg floor at a small rural hospital - 5:1

We always have 2 RN's, or one RN and an LVN, and a CNA.

Never more than 10 patients. We can't legally take more than that plus we don't really have room for much more than 10.

steph

I work on a busy oncology unit we can have 4pts on days and evenings and up to 6 on nights. or less if somone is getting chemo. that's enough for me.

Deb

OMG THAT SOUNDS LIKE THE WORSE DAY EVER!!! I congratulate you on getting thru it.

Hey, I know how you feel... Being a new grad is TOUGH! I've had 2 1/2 weeks classroom orientation and now I'm on my 4th week on the floor with only 1-2 more weeks of orientation. Then I'm thrown to the wolves!!

For me, each day is an entirely different world. I'm on a heavy Med-surg unit and our usual ratio is 1:6 which is nice. Yesterday we were short so I had 8 patients! Of my entire crowd, I had 2 trach w/vents (suction often), trach collar (suction VERY often), 1 PEG & 1 NG (crush meds...), Pt DNR/DNI satting in the mid-70's b/c she kept on pulling off her non-rebreather, DNR pt with traction to leg who was found with RR of 5/MINUTE!!! - gave narcan stat to reverse the effects of 5 mg morphine, 2 pts who didnt speak any english so had to run around and find translator each time we had s/t to say, pt with C-diff need to change freq. Gave 2 units blood, 4 k-riders, a million meds. Went into the pt who was desatting's room every 10 - 15 minutes to assess... She left this world an hour before shift change so had to do e/t that a death entails (post mortem, organ bank, charting...)

It was a wild day. I took a 5 minute break the entire day. My preceptor who I was with was great. She gave me my independance most of the day, letting me get a grip on the situation, but at the same time she gave me a hand at the end of the day with last minute meds and charting. I came home entirely exhausted and knocked out, but I also felt accomplished.

I dont especially love doing all the monotonous tasks - suction, meds, hang IVs, but I especially do LOVE that I come home very day and say I LEARNT SO MUCH! I love learning, and I feel so much more confident and knowledgeable each day!!

Thats nursing! We'll get through the newness and soon we'll be veterans... =)

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