I work on a step-down floor (we only have 14 beds total). Used to be about 1:4 or 1:5 and with 5 very critical patients it was extremely unsafe. When we are full at 14 we are supposed to have 2 CNAs, but this often turns into one CNA so nursing tries to help out w/primary care (not always possible). I hate to apologize to families and patients when they cannot get a bath (usu. a bed bath w/many of these patients). Our matrix recently changed for the better and it is now 1:3 or 1:4, but esp. on weekends when they send us multiple admits at the end of shift they won’t try to find an additional nurse to assist. A few weeks ago the charge nurse ended up with 5 patients (I was trying to give attention and deal with family w/ a patient who was actively dying–agree w/post above about not having enough time to do this and the “staffing” office having NO idea how time consuming and important this is)…long story short, we were all swamped and the CNA was trying to assist with all the new admits also and another patient fell because none of us could get to his bed alert fast enough. Ugh. Those situations are so dangerous. Then again, when I used to be a CNA at the nursing home we were required to get up so many patients it was nearly physically impossible and then serve breakfast…the LPNs there were trying to literally “stuff meds” down patients throats. It was a serious nightmare. I will never work in nursing homes again. I’m hoping our improved matrix will help with patient safety (as long as they staff accordingly). The ICU has recently had a huge turnover and many brand-new nurses starting to work…they seem to have 1:2 (normal) but on busy days 1:3 w/one CNA who does baths only. I know it could be a lot worse…(I volunteered at a hospital in West Africa for 6 months even before nursing school and some days there was no electricity & never any running water…those nurses had basics for equipment but were very well trained and knew how to improvise. Weirdly enough, that experience made me want to become a nurse). I’m happy we don’t have to worry about how many gloves we use! 😉 But just because it used to be worse/or still is worse in many places doesn’t mean we shouldn’t strive for safer and better patient care.