What's your patient load?

Altra, BSN, RN · Dec 7, 2012

That is a heavy load. 3-5 patients is typical at my Level I trauma center ... even urgent care assignments are generally no more than 5 unless it's a very bad day.

thelema13 · Dec 7, 2012

The level 2 I am transferring to is 4:1, my current ED is 4:1-6:1, depending on flow and staffing.

Prettyladie · Dec 7, 2012

Level 1 in Texas at my facility 4:1 with no trauma room. 3:1, if you are assigned to trauma that day.

germsjackson · Dec 7, 2012

Dang. sounds nice

humanity · Dec 8, 2012

Level I Trauma primary care nursing

Med surg 5 max

ICU 2 max

Oncology 4 max

Multiple Myeloma 3 max

Progressive Care 3-4

hiddencatRN, BSN, RN · Dec 8, 2012

Inner-city pediatric Level 1 ER: 4:1 or 3:1 with good staffing in ESI 2/3 areas. 7:1 urgent care. 2:1 critical/ trauma bay. If a family brings siblings in to be seen they count as 1 patient unless they are very sick or there are a TON of them.

Regional Level 1 pediatric ER: 4:1 regardless of acuity.

Community all ages non trauma center ER: 5-6:1 depending on time of day.

BelgianRN · Dec 8, 2012

For every ABC-unstable patient we go 1:1, means the other nurses go up at the same time taking over your load.

Medsurg anywhere from 3:1 to 6:1 depending on available staff.

Peds generally 3:1.

Small surgical cases: task oriented nursing, everyone with available time pitches in, assessment/primary diagnostics ordered by the triage nurse or dedicated ER physician.

In general our patient load is very variable throughout our shift since we are involved in prehospital care as well. So if all other nurses have to go out on prehospital assignments and/or in-hospital codes, the ER falls back on 1 - 2 nurses for everything and everyone. All remaining patients fall under the responsibility of the remaining nurse, including ABC-unstable ones that get dropped off in the mean time. Luckily we have pretty amazing ER docs that will do many of our tasks themselves if we are too busy.

That Guy, BSN, RN, EMT-B · Dec 9, 2012

Trauma or trying to actively die 3:1

High acuity but not dead yet 4:1

Maybe should be here 5:1

Really shouldnt be here 6:1

Granted that is with perfect staffing and not having to use any of our hall beds for bambulances.

whichone'spink, BSN, RN · Dec 9, 2012

Holy s*** that's a lot of patients, even if they're less acute. I only have three at a time at the most.

TheSquire, DNP, APRN, NP · Dec 9, 2012

One of the docs in my ED who did his residency in NYC describes the EDs there as "like being in the third world," and based on the staffing ratios reported time and again by NYC ED RNs, I believe him. It sounds like understaffing has become an institutionalized standard in the city.

As far as my hospital, I'm at a surburban "comprehensive community" hospital (read: Trauma III) that gets most of its patient load from the neighboring low-socioeconomic-status urban neighborhood. Ratios are 3-4:1 during the day in the "Acute" side, assuming proper staffing and no Boarders, but can reach as high as 5:1 on nights when we're understaffed, have a high acuity night, the house is full, or when combinations of all three occur. When fast track is open, staffing is ideally still 4:1 to facilitate pt clearance but can reach as high as 10:1 if we're short-staffed.

applewhitern, BSN, RN · Dec 9, 2012

Our standard med-surg load is 1:8. ICU is 1:3. Really tho, it is rare for us to have that many; they make every effort to staff us well. I have no idea what it is like in any other departments, as I don't work them. I have worked in ICU's where we had to take 4 patients, regardless of acuity.