What State are you in and nurse/PT ratios

[hppygr8ful, ASN, RN, EMT-I]

I see a lot of posts where people are saying they are caring for up to 28 acute care patients with 1 RN, 1 LPN and 1 aid. What states do this in acute care? I live in California which is the land of safe ratios for acute care!

LTC care is a different animal as it does not fall under the umbrella of acute care. LTC's in California is licensed under County Departments of health services and are considered intermediate care facilities so ratios are higher 15 to 20 per RN, LPN and CNA team. On out shift 3-11p we have 1 RN (charge), 2 LPNS who pass the meds and do treatments, and ideally 2 CNAs. The RN is expected to handle the desk, perform assessments, managed IV's and help the LVN/LPNs as needed. This is if we have a full census of 38 patients.

Day shift has more staff because all the residents are awake, there are more meds to pass etc...... NOC when most of the residents are asleep it usually goes down to 1 RN 1 LPN and 1 CNA but again that depends on census.

I am just wondering if any of you really have 20 or more patients in the acute care environment?

Hppy

[Seaofclouds, BSN, RN]

I've worked in hospitals in three different states (DE, PA, TX) and have never seen a nurse in the hospital (on any unit) have 20 patients. In each of those, I'd say the most I saw was 8:1 on a Med-Surg unit on night shift.

[Tenebrae, BSN, RN]

I'm from NZ.

I work elder care, I also work as a per diem in many different places.

Elder care:I have oversight for all 35 patients on my unit. The majority of cares are done by the healthcare assistants however I'm responsible for 1/2 the meds and all nursing care.

Rehab 1:3

Acute med surg 1:3-4

Acute mental health 1:3-4

[Dranger]

Icu 1:2

pcu 1: 3/4

m/t 1:5

[nrsang97, BSN, RN]

I am in MI. I can say that in our hospital our ratios are as follows:

1RN to 1-2 patients ICU/CCU

1 RN to 3-5 patients Step Down

1 RN to 4-6 patients Med Surg Tele

1 RN to 5-8 patients Med Surg

1 RN to 4 patients (total care) Ortho

1 RN to 8-10 patients inpatient rehab

I am not sure the ratio on our inpatient psych unit.

I believe that some of the ratios the OP describes are in nursing home type facilities.

[hppygr8ful, ASN, RN, EMT-I]

I am in MI. I can say that in our hospital our ratios are as follows:

1RN to 1-2 patients ICU/CCU

1 RN to 3-5 patients Step Down

1 RN to 4-6 patients Med Surg Tele

1 RN to 5-8 patients Med Surg

1 RN to 4 patients (total care) Ortho

1 RN to 8-10 patients inpatient rehab

I am not sure the ratio on our inpatient psych unit.

I believe that some of the ratios the OP describes are in nursing home type facilities.

Thank You, I have worked psych where staffing depends on census and acuity but ratio is usually high. Also LTC where ratios are insane.

I too get the idea that most of the people staing 35+ patients to one nurse are talking about LTC but one OP said they are in charge of 60 acute patients on a night shift. Most LTC patients are not acute and at least here in California we don't call them patients we call them residents!

Hppy

[nynursey_]

I'm in upstate NY and our ratio on a M/S floor (to which we have several M/S floors depending on specialty) is 1:5 on days/evenings. I can't necessarily speak for nights. I, however, feel this ratio is even too high sometimes. Our ideal is 1:4 which we are able to accommodate on some shifts, but not often. Our M/S patients are often extremely ill and many are "transfers" from the ICU (my opinion on most of these transfers are that they are not ready for the downgrade, but our ER is extremely full and often times ICU patients get bumped due to an ICU admit in the ER).

NY has no nurse to patient ratios in place currently although the ANA is working diligently to change that.