Nurse to patient ratio

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This topic contains 43 replies, has 38 voices, and was last updated by Avatar of deafrninsc deafrninsc 9 months ago.

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  • #6386
    Avatar of Tammy B. RN
    Tammy B. RN
    Member

    I work on a very busy unit at my hospital. My unit has med-surg, oncology and neurology. The typical nurse to patient ratio is anywhere from 1:6 to 1:10.

    What is it like in your neck of the woods?

    #6389
    Avatar of Jason Hautala RN
    Jason Hautala RN
    Moderator

    1:10? Ouch. We are spoiled at my hospital. Med/Surg has a 1:5 ratio. The ICU is 1:2. The worst ratio I ever had was down in Salem OR where on the TELE floor, it was 1:5, but these were sick patients, sicker than my current hospital’s ICU patients, and it was total care, no CNA help. Glad I didn’t kill anyone back then as a fairly new nurse. I currently work in a small, rural hospital, which I find nice, but the bigger hospital in the city used to have 1:12 ratios on some floors, but I’m not sure if they still do that many or not. I’m glad there are energetic nurses like you out there, but I think this old man will stay in the rural areas.

    #6395

    Such a shame to hear about those super high ratios. I was on a step down unit and we were 1:6 which was a little high, five would have been nice. I’m with my grandma in another hospital in their ICU and their ratio is 1:2-3, ICU was like that at my old job too. The med-surg at my old job went all the way up to 7-8! Nuts! The government should regulate the ratios!

    #6396

    Oh I had a preceptor from England and their ratio was 1:17!!!!

    #6397
    Avatar of Kreynolds40
    Kreynolds40
    Member

    I work at a critical access hospital and generally our max is 1:6 with 2 aids. Sometimes it seems like too much!u

    #6398
    Avatar of Nurse C
    Nurse C
    Member

    I work in pediatric med-surg and we have a max of 1:5, usually it’s 1:4. I can’t imagine having something higher than that!

    #6402
    Avatar of Traci J Hart
    Traci J Hart
    Member

    I know some states are looking at regulating this at the BON level. Anything over 6 on a med/surg floor WITH aides is dangerous.

    #6407

    I have been working as a medical floor nurse for 10 years. When I first started our ratio was 1:4-5 with two CNAs for 20 patients on a night shift. Now we are taking 1:6 and only 1 CNA or at times none. I feel like ratios really should be regulated by the government or we need a union for nurses because I’ve heard rumors that my floor will soon be 1:7. That is just ridiculous and dangerous. I miss the days when I actually had time for ALL my patients. There are times when I’m juggling an admit, chemotherapy and blood transfusion all at once. I am also the charge nurse and am expected to take care of 6 patients. I really feel for the new grads and I can’t imagine trying to do this when I was brand new.

    #6411
    Avatar of Melody
    Melody
    Member

    Our hospital used to have 1:4 maybe five but we had a lot of nurses being on low census a lot because they staffed for 42 patients and generally only had 30. Of course we have now made adjustments and have implemented a resource team and downsized the actually nurses scheduled and we got slammed of course.

    #6413
    Avatar of Chad
    Chad
    Participant

    1:4 with max of 1:5 on an adolescent Psychiatric unit with one CNA on the floor between 20+ patients.. Although sometimes the patients have multiple personalities so does that count?

    This is in Portland, OR

    #6415
    Avatar of Rjohnson
    Rjohnson
    Member

    Work in a rural hospital in Illinois in Emergncy department. No set ratio, but staffing pattern of 2 RNs per shift, so coud be as bad as 1:6 . Not bad if combination of nonurgent with urgent or emergent. If all high acuity, it can be hell.

    #6420

    I used to be charge nurse of a sub a ute rehab and the ratio is 1:16, on a dementia unit the ratio is 1:28! And I worked at a great place! I’ve heard horror stories of much worse. The ratios are aweful.

    #6421
    Avatar of luvmy2doxies
    luvmy2doxies
    Member

    Well, I hate to burst your bubbles kiddioes….when I first started nursing, back in the day..(cue in the shaky voice and let me raise my walker)…the patient ratios on a med/surg/tele unit was normally 8-12, and I had up to 18 patients, with 4 on tele. One aide, and one LPN would sometimes round out my unit. I say sometimes, because I only had an LPN or CNA when it was up to 10 patients. After that I got one or the other as well. So…3 staff for up to 18 patients, only one is an RN, and 4 tele beds. Oh, did I tell you that I was also expected to work in the ER when the ER nurse was overwhelmed?

    It got much better back in the early 2000′s, but now I see a trend that most hospitals are taking to cut their costs…either getting rid of the CNA or PCT, for nurses with up to 5 patients, or have an RN share a CNA with up to 8 patients. This means up to 6 on a busy day shift. I think this cost cutting measure will eventually backfire. Patient satisfaction rates are already starting to slide, and I’m seeing a lot of burnout in nursing. But hey, the CEO’s have to get their pay, right?

    #6422
    Avatar of Verna
    Verna
    Member

    In the Nursing home I work at the ratio is one LPN or RN and 3 CNA’s (if we’re lucky) to 35-40 residents. 7 G-tubes, 6-8 diabetics with sliding scales, neb tx for 5-8 residents, not counting having to do admissions, discharges make rounds or calling doctors and families. Any emergencies (which by the way is usually 2-4 a day. Working evenings or nights is even higher ratio. Just because we choose to work in the nursing home doesn’t mean the work load is less demanding.
    I would give anything to have a ratio that all of the nurse’s in a hospital has. I am not complaining. I choose to work in geriatrics because it is what I love to do. Maybe the residents aren’t as sick as those in the hospital but the stress and dangers are still there.

    #6423
    Avatar of Jason Hautala RN
    Jason Hautala RN
    Moderator

    luvmy2doxies, bubble not burst by that. I remember when I was a youngster and had my appendix taken out, they kept me in the hospital for three days. Today it is a same day procedure. I’m not saying you didn’t work hard back in the day, but many of the patients in the hospital would not even be admitted by today’s standards.

    My greatest fear in mandatory nurse/patient ratios is that this ratio is going to be the only thing taken into consideration. Hospitals can show they can provide safe staffing with X number of patients per nurse, when the nurses have techs, CNAs, RTs, and other staff to help with patient care issues. Once the union agrees to these ratios, the hospital can then take away all of the techs, restrict what a CNA can do in your department, and make the RNs do all of the RT work. There is no magic number that will always work and I’m not convinced legislating a number is the best answer, although it may be needed. I think admin just needs to have a paradigm shift and worry a little less about saving money by cutting payroll and saving money by increasing patient satisfaction, safety, employee longevity, etc.

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