What is your nurse to pt ratio....and how many is too many?

GooeyRN, ADN, BSN, CNA, LPN, RN · Sep 30, 2006

2 nurses (One RN, and either another RN or an LPN) to 28 pts. One or two CNA's on a normal day.

crb613, BSN, RN · Oct 1, 2006

2 nurses (One RN, and either another RN or an LPN) to 28 pts. One or two CNA's on a normal day.

Sounds pretty brutal to me!

weav16125 · Oct 2, 2006

hi, i graduated in may of this year and am working on a med/surg/pediatric/tele floor. it is a 40 bed unit. nurse to pt ratio is usually 9,10,11. our patients are mostly hips and knees, turps, appys, cardiac, with pediatrics thrown in. we do have lpn's and na's but usually only two of each. the lpn's pass all the p.o. meds and the na's do take the vitals. the majority of the patients are orthopedics and when they come from surgery they have strykers, femoral blocks, pca pumps and usually autology blood to hang. not to mention the tele patients. is this a high nurse to pt ratio or is it that i am just too new. the other day when i came out of report i had two new admissions in the same room, 1 going for an appy, and one a medical patient, 1 fresh post-op knee and 1 fresh post-op hip, 1 going for a turp and none of the or paperwork was done or started, a 14 yr old that surgery the day before for a fractured humerus and was having symptoms of compartment syndrome, oh and of course the patient that was confused and climbing out of bed constantly, and 5 more patients that was just hanging out. now i know that i am not a seasoned nurse but, how in the world can one person be in all those places at one time. i feel this is not safe..... or is this the way it should be?

and this is an everyday occurance these kinds of patients. oh and i forgot to the patient that was having continuous seizures and i had to hang iv depokote stat.

signed thanks for listening

Lisa CCU RN, RN · Oct 2, 2006

2 nurses (One RN, and either another RN or an LPN) to 28 pts. One or two CNA's on a normal day.

Please clarify. IS this LTC?

crb613, BSN, RN · Oct 2, 2006

hi, i graduated in may of this year and am working on a med/surg/pediatric/tele floor. it is a 40 bed unit. nurse to pt ratio is usually 9,10,11. our patients are mostly hips and knees, turps, appys, cardiac, with pediatrics thrown in. we do have lpn's and na's but usually only two of each. the lpn's pass all the p.o. meds and the na's do take the vitals. the majority of the patients are orthopedics and when they come from surgery they have strykers, femoral blocks, pca pumps and usually autology blood to hang. not to mention the tele patients. is this a high nurse to pt ratio or is it that i am just too new. the other day when i came out of report i had two new admissions in the same room, 1 going for an appy, and one a medical patient, 1 fresh post-op knee and 1 fresh post-op hip, 1 going for a turp and none of the or paperwork was done or started, a 14 yr old that surgery the day before for a fractured humerus and was having symptoms of compartment syndrome, oh and of course the patient that was confused and climbing out of bed constantly, and 5 more patients that was just hanging out. now i know that i am not a seasoned nurse but, how in the world can one person be in all those places at one time. i feel this is not safe..... or is this the way it should be?
and this is an everyday occurance these kinds of patients. oh and i forgot to the patient that was having continuous seizures and i had to hang iv depokote stat.
signed thanks for listening

oh my gosh! sounds like we work in the same hospital! 10 is the most i have had, & to me that is just too many. we do all our own meds,(sometime there is a float) & do the pushes for lpn's. i am w/you it cannot be safe. since i have made my feelings known...i have been having 5-7....hope this lasts. we operate w/bare bones staff, no pharm at night, & the charge is really the house supervisor. if someone calls in.. get ready...its gonna be a rough night! most of the people i work with are great, its the admin that is terrible.

tagamargos · Oct 2, 2006

I can't believe that some of the hospitals don't allow the CNA's to blood sugars, I/O, weights, etc! I work on a medical care unit and we do the blood sugars, the vitals, weights, I/O's, and things for the nurses and it really seems to help them out.

The hospital I'm working at right now I think is one of the well staffed hospital. Medsurg/Tele 4:1, Our nurse techs have 8:1, they do the blood sugars, weights, charting (in computer) I&O's. And this is night shift. We have the same staffing ratio with day shift.

And I can't believe STILL some nurses complain!

Shell5 · Oct 7, 2006

I live in Texas. On a slow day, we have 3 or 4 patients. On a heavy day, we have 6 or 7 patients. We get very busy and very stressed. Making a serious error can happen. Finding a patient dead can happen. The most important thing I try to do it prioritize. I try to remember my ABC's. Sometimes it seems everything is important, but if your extremely busy with patients like this think....breathing problems, heart, circulation comes even before someone in pain. First things first. That helps me. If it gets real heavy you can always fill out a form called Safe Harbor. You may want to check to see if you have them where you live. You need to check with your state board of nurse examiner to download. If safeguards you in an unsafe situation. Hope this helps.

crb613, BSN, RN · Oct 8, 2006

I live in Texas. On a slow day, we have 3 or 4 patients. On a heavy day, we have 6 or 7 patients. We get very busy and very stressed. Making a serious error can happen. Finding a patient dead can happen. The most important thing I try to do it prioritize. I try to remember my ABC's. Sometimes it seems everything is important, but if your extremely busy with patients like this think....breathing problems, heart, circulation comes even before someone in pain. First things first. That helps me. If it gets real heavy you can always fill out a form called Safe Harbor. You may want to check to see if you have them where you live. You need to check with your state board of nurse examiner to download. If safeguards you in an unsafe situation. Hope this helps.

Thank you for your reply. I am very worried that while I am busy w/the ones that appear to be most in need....something will happen. The quite ones worry me the most.I like the Safe Harbor idea but as far as I know Kentucky does not this. Once again thanks for your very good advice!

cshell · Oct 8, 2006

I work on a Telemetry Med/Surg with specialty renal and hemodialysis. Our ratio is 1:6 with a tech. Hard stuff!

trixytop4 · Oct 20, 2006

I would think about changing hospitals. My nurses have 6:1 to 7:1 patients. They document on there patients and they do their own graphing of vital signs so they can see the changes the patient may be making. Our CNA takes the vital signs and notifies if there are any high values. They also do the blood sugars. The ward clerk documents all the vital signs and the house supervisor (myself) does the chart checks. I do rounds every 2 hours opposite of what the nurses do. This ensures continuous care. I also get in there and help with bathes, turning patients and if the nurses get really hectic I help them pass medications. It doesn't sound like you have a team effort where you work at. I would definitely think about changing where I work. :monkeydance:

am17sg05 · Oct 20, 2006

in med-surg tele, ideally, is 6-7 pts. in er, 3-4 rooms to be covered. in psych, 5-7 pts.

crb613, BSN, RN · Oct 21, 2006

I would think about changing hospitals. My nurses have 6:1 to 7:1 patients. They document on there patients and they do their own graphing of vital signs so they can see the changes the patient may be making. Our CNA takes the vital signs and notifies if there are any high values. They also do the blood sugars. The ward clerk documents all the vital signs and the house supervisor (myself) does the chart checks. I do rounds every 2 hours opposite of what the nurses do. This ensures continuous care. I also get in there and help with bathes, turning patients and if the nurses get really hectic I help them pass medications. It doesn't sound like you have a team effort where you work at. I would definitely think about changing where I work. :monkeydance:

WOW! Sounds like you are a great supervisor. We do our own blood sugars, chart, & MAR checks as well as our own documentation. I have been looking at other hospitals trying to find one that I think will be a good fit. Teamwork at my hospital depends on who you work with. I thought it was getting better.....then I was called in to work another shift. Promised there would be 3 nurses on the unit...get there & we only had 2! Myself & another nurse took care of (kinda) a total of 21 pts. that day. There was constant discharging & admitting all day long....while also getting some of them back from surgery. It was horrible we had pt's charts throwed up in a pile because we did not have time to dc them nor take off any orders. We went in at 7a & left at 10p....We started charting our initial assessments that night around 8p. I am definately on my way out the door!