What nurse/patient ratios do you work with?

Nurses New Nurse

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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.

:idea:i have 7 or 8 pts on a busy, heavy tele floor. if you took one pt. from each nurse on the floor, you could hire one more nurse and give that nurse a decent patient load, and unburden the rest of the staff. who knows maybe this would reduce the ridiculously high turnover. who ever said that 7 patients on a cardiac floor is 'doable'? also this floor happens to have a high turnover rate. something that screams red flag! to me. 9/10 nurses i meet have been there less than one year. that makes me feel like the ratio is too much for sick sick patients on the floor. and im also beginning to think that the support just isn't there. im still fairly new, but i work like crazy and feel like im floating on my own. from seasoned nurses, is 7/8 patients normal, safe typical for a cardiac floor? also those who work on tele- as newbie's do you have monitor techs or anyone you can go to that will help validate whacked out rhythms? i feel like i am more 'encouraged' to figure it out on my own. i am a self motivated learner but the first few 'go rounds' interpreting my own strips i would feel better with some validation. we had about 5 hours of tele interpretation total. anyone give any perspective on this? or is this just par for the course in tele nursing...oh and ancially staff are few and far between. most nights i am doing total patient care, which i do not mind but with a disappearing charge and no monitor tech, spending too much time in one room makes me feel thats a 'no no' im trying to decide if this is just anew nurse thing or a culture thing. i have been literally physically strugglng to help a dizzy unsteady 350 lb pt. get to the bathroom and had ancillary literally look at me in the face and walk right by me and out the room. i always help out and i always will but jeez.

CA ratio is 1:4 max for tele patients ...they don't really follow it, but it is still 10x better than NV where they have 9-10 even on day shift.

Specializes in Oncology, Orthopedics, Geriat., Renal.

On day shift the ratio is 1:5-6, Nights 1:8-10, and we have Oncology, ERSD, Step-down Cardiac, and some ortho.

I'm a new nurse with just 4 months OTJ. I had the pleasure of receiving 12 wks of a preceptor. With was great but needed improvement. Last night was the most pt I have ever had and I didn't clock out until 930am (730am is norm). I started with 5pts which I have been fine with (3 from past 2 nights). I got an admit at 2330 and this pt was my thorn in my side. God bless her but she was from a NHome and was AOx1 and confused (dementia). She was also a walker and very mobile. Thank god the other nurses on my side of unit and also the CN was great and helped out. But when you have a rash of call out (very high right now) and no one to come and cover it was a full moon. We also only had one aide to help out. She was such a blessing last night and all she could do is laugh with us and smile. I do work on a teley unit. We have a medical teley and surgical teley (mostly isolations) that was combined into one unit. Suppose to be 1:4 on surgical side and 1:5 on medical side. I had 5 pt on surgical and 1 medical. All my pts were great. In the long run I had 6 pts. And got 2 hours overtime with no breaks. So much for ratios but I still am starting to like my job and like in previous posts don't wish as much I get in a fender bender before getting there. I am so relived that I am not the only sadistic person out there:innerconf.

Live Well. Laugh Often. Love Much.

I have learned it is not the number...it is the acuity...I always get 5 patients some days are much better than others because of acuity...I sometimes get 3 complete care, nonverbal, very sick, patients on tube feedings with several dressing changes a patient going through alcohol withdrawl which can be hard to manage, and a fresh post op patient...it is rough...it is all about acuity.

I agree, the acuity does play a very important role but 9-10 patients are not managable no matter how low their acuity is. I would never accept an assignment with that many patients. A friend of mine says she routinely has 12-14 patients on a med/surg floor. It's too bad hospitals would rather see more green over adequate patient care. I've read articles that show in the long run it costs the hospitals more with lawsuits and longer hospital stays so I'm not sure why the keep doing it. It isn't always about the nursing shortage either because I've been to a hospital that will send home a nurse when staffiing looks almost managable. They intentionally kept the nurse to patient ratio 1:9 on nights and 1:7 on days +lpn coverage. 1:6 NEVER happened. You either received an admit/transfer within a half hour (just long enough to have the room cleaned) or they sent someone home. This was also primary care.

Specializes in ER/ICU, CCL, EP.

Just started in SICU

Ratio is 1:1-2, depending on acuity. Of course, that 1 patient can leave you no time to eat or go to the bathroom. One of my co-workers had a hellish pair yesterday, and I am pretty sure I never saw her sit down for 12 hours.

What have I gotten myself into? :)

I work on a very busy post-surgical unit with high turnover and high acuity (we get alot of ED admits and ICU transfers as well). Typically days/evening assignments is 1:5, nights is typically 1:6 or 7. But you can pretty much guarantee at least one discharge and admission on your shift, sometimes more. It's nice when you get to keep your whole team the whole shift. The charge nurses do seem to do a good job distributing the acuity of the patients and those that are in isolation but one shift 3 out of my 5 were in isolation, that is a real pitb.

Nursing shortage is there not because the hospitals are unable to get nurses!!!!!!! Firstly, they are unable to keep nurses due to the high nurse patient ratio....they quit and go to some other speciality. Secondly, management wants to save money by not increasing the number of nurses per shift.

As new graduate nurse I have noticed the floor assignment for senior staff is less patient vs the new graduate nurses. Even if the new nurse stays longer to complete her/his assignment the management pays them less vs if a senior nurse would be paid for the overtime.

To me the shortage is a self created one....it is a money saving agenda vs nurse patient ratio.:banghead::banghead:

Specializes in SICU, ER, MEDICAL.

My ratio is 1:2 the max is 1:3. I work a step down ICU and I picked this floor because I knew I would have this ratio.

Walda786, I totally agree with you.... I think administration would much rather save money than staff a floor with another nurse to provide a decent ratio. Definitely a self created shortage.

Specializes in Emergency Room, Cardiology, Medicine.

I work days on telemetry floor/step-down unit. On the regular acute floor, it's normally 1:6, although as of recent 1:5 because of our good staffing. Step-down unit 1:4. Sometimes we perform our own vitals/answer call bells if nursing aide staffing is short.

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