8 replies to this topic

[Bitmo]

Hey Everyone


I am doing a survey and could sure use your input. I work at a 80 bed hospital on a med/surg floor, I am looking for information from similar type settings but any information will be valuable. I am interested in the pt to nurse ratio and what type of assistive staff you have also. Currently at the hospital I am at. A RN on day shift has between 3 and 4 pt's alone and usually 1 aid on the floor to assist all RN's so usually they will take vitals on one of your pt's and assist with a bath. If you have more pt's than 4 they will pair you with an LPN with 6-7 pt's. I would like to know if this is similar to staffing out there or different. We used to do Team Nursing. RN and LPN and now we do primary RN nursing. At this hopital we do not have teams or assist with IV starts or discharges. We do have an Admission nurse that is shared in all deptartments. We usally have higher acuity pt's on the med/surg floor with high rate of discharge and admissions. We average between 7 -12 discharges and around 5-8 admissions most days. So if I could hear from you what type of staffing you have at your hospital that would be great. Thanks for any input offered.

[NawlinsGirl]

HI BITMO,

I WORK IN AN ICU UNIT AND THE LIMIT IS 2 PATIENTS. WE DO NOT HAVE A CNA SO THE RNS HAVE TO RELY ON EACH OTHER TO HELP TURN OUR PATIENTS. IT MAKES IT DIFFICULT AT TIMES BECAUSE THE OTHER NURSES MAY NOT BE AVAILABLE TO ASSIST WITH THIS AND THESE PATIENTS BECOME VERY HEAVY AND DIFFICULT TO MOVE DUE TO THIRD SPACING. I THINK THIS IS PRETTY MUCH THE NORM LATELY IN THE HOSPITAL SETTING. UNDER STAFFED AND UNDER PAID AND MANY TIMES ITS THE PATIENTS THAT SUFFER.

NAWLINSGIRL

[Fran]

Hey Everyone
I am doing a survey and could sure use your input. I work at a 80 bed hospital on a med/surg floor, I am looking for information from similar type settings but any information will be valuable. I am interested in the pt to nurse ratio and what type of assistive staff you have also. Currently at the hospital I am at. A RN on day shift has between 3 and 4 pt's alone and usually 1 aid on the floor to assist all RN's so usually they will take vitals on one of your pt's and assist with a bath. If you have more pt's than 4 they will pair you with an LPN with 6-7 pt's. I would like to know if this is similar to staffing out there or different. We used to do Team Nursing. RN and LPN and now we do primary RN nursing. At this hopital we do not have teams or assist with IV starts or discharges. We do have an Admission nurse that is shared in all deptartments. We usally have higher acuity pt's on the med/surg floor with high rate of discharge and admissions. We average between 7 -12 discharges and around 5-8 admissions most days. So if I could hear from you what type of staffing you have at your hospital that would be great. Thanks for any input offered.

Iwork in a 240 bed facility where the staffing depends on what floor you work on. LATELY the staffing has been terrible to say the least. Often starting out with 3 nurses on the floor, often one RN and two LPNs . Our floor holding 24 patients we would start out with 5-6 pt. apiece with the RN being responsible for all the pushes, blood transfusions and completing NOC on the discharges as well as placement and whatever else they threw at us. We often have 5 to 6 discharges in the day and have people waiting in line for the beds. To say the least if you do all the things they have told you have to do your 12 hour shift turns into a 15-16 hours at least twice weekly. You talk about frustrating. We get promises which just are not being fullfilled.

[Tari]

Wow, if I had only 3 nurses for 24 patients, I would not even accept the job.

I work in a 350 bed teaching hospital. I work on a step-down cardio-thoracic unit that is only 8 beds. We take fresh thoracics, 1-2 day post CABGs, espophajectomies, vents, all drips, etc., so our acuity can be quite high. We typically have 3 nurses...the charge nurses has 2 patients, the other 2 nurses get 3. If we get a 4th nurse, obviously everyone gets 2. We also have one nurses aide, and on a rare occasion, have two....but usually end up floating the second one if we have a second one.

Prior to this, I worked on a 27-bed medicine telemetry unit...very busy, high demand area. Very busy, lots of movement, lots of discharge, 6-10 admits on evening shift alone. 5-6 nurses was pretty standard at the time and still is, and once in a while we were lucky enough to get a 7th. 6 was the usual, so 4-5 patients was typical. 2-3 aides split the floor for vitals/patient care. We also had another aide that was used for transport.

Terri

[Fran]

Wow, if I had only 3 nurses for 24 patients, I would not even accept the job.

I work in a 350 bed teaching hospital. I work on a step-down cardio-thoracic unit that is only 8 beds. We take fresh thoracics, 1-2 day post CABGs, espophajectomies, vents, all drips, etc., so our acuity can be quite high. We typically have 3 nurses...the charge nurses has 2 patients, the other 2 nurses get 3. If we get a 4th nurse, obviously everyone gets 2. We also have one nurses aide, and on a rare occasion, have two....but usually end up floating the second one if we have a second one.

Prior to this, I worked on a 27-bed medicine telemetry unit...very busy, high demand area. Very busy, lots of movement, lots of discharge, 6-10 admits on evening shift alone. 5-6 nurses was pretty standard at the time and still is, and once in a while we were lucky enough to get a 7th. 6 was the usual, so 4-5 patients was typical. 2-3 aides split the floor for vitals/patient care. We also had another aide that was used for transport.

Terri

Well I finally transferred off of ortho/gen med to neuro surgery, though the load is heavy there are lots of back up who help with discharges and other things which has been getting me out with thirty minutes overtime instead of 3-4 hours overtime. Since we live in a rural commuity we only have two hospitals unless you want to drive 100 miles to go to the city. They have us over a barrel. Most of us are from the area and have no idea what goes on out in the rest of the country. All we keep hearing from administration is that they have researched the staffing in a large radius and we are comparable to the rest of the country. I see that is not necessarily so.

[AndreaP]

Our hospital is a 250 bed facility. not counting our psychiatric services. Day shift and night shift staffing ratios vary greatly, and the ratio varies also by department (or better yet depending on department director). The ortho neuro step down unit staffs 5 -7 nurses depending on the census of course with a ratio of about 4-5 patients per nurse. they staff rns and lpns and generally 2 aids on night shift. the day shift gets at least 6-7 nurses and usually has a load of about 3-4 patients. this floor is a high turn over post - op recieving floor. The oncology unit which also takes over flow patients staffs no more than 3 nurses and one aide at night leaving you with up to 6 patients. an extremely acute floor, very difficult. if the census drops to 10 on that floor they have just two nurses and no aide. During the day shift they have up to 4 nurses skimming the ratio down to 4-5 a nurse and two aides. The skilled unit staffs no more than 3 nurses on nights and when full can leave you with a ration of 6-7 patients. they usually staff two aides at night but this floor can also have high acuity with trach patients tube feedings isolation precautions wound vacs etc. the day shift gets up to 4 nurses and 2 aids skimming them down to no more than 5 patients. The worst one is our general med surg unit. this is a 30 bed unit. on the night shift they can staff any where from 5-6 nurses and NO AIDE.. i hate that floor! you end up with high acuity total care on up to 5 patients and can sometimes lead to 6 if under staffed. if staffing decides they are being nice they might staff us an aide at night on that floor but we still do total care our patient load just gets increased is all. the day shift how ever has 7-8 nurses and 3 aides. leaving them at 4 patients a piece and with out total care. our intensive care units allow the nurses to have no more than 2 patients a piece and depending on census a "bath" aide for day shift. the hospital across town from us has worse staffing ratios but they are paid better. we also have to deal with our medication adminstration system intellidot..better known as in-hell-idot to the staff. that adds probably 5-10 minutes on med pass times.

staffing everywhere sucks. my good friend and i have been mulling this over and over. wish there was a way to get passed the shortage huh? lots of nurses on burn out mode. strongly urged against overtime but begged to work extra days with out much incentive. I work my three twelves they call me for a 4th and tell me we'll give you time and a half...well no kidding!! boy i could soap box this one for hours guys

[Fran]

well girl let me tell you, at least they are giving you all 2 aides working at an old catholic hospital they leave ortho with 1 aide to tend for 24 patients on nights and 3 nurses most of the time. On days those poor girls have two aides and we all know ortho is generally a two man job on most of them. And med surg has 4 nurses maybe 5 with no aides, the nurse manager is a witch who is so hard on her nurses the longevity of the nurses on that floor is generally 1-2 years. I am sure things are rough all over but what is sad is young nurses either go on, or drop out. It s not a glamourous job its a hard road and unlike years ago where all you had to say was I am a nurse and that warranted respect, you are questioned about your ability. Now i am not saying all nurses are wonderful people unfortunately they are not. I would like to see a little more respect for my 20 years of experience. Nor only from the patients families but also the big bosses.

[blazes49]

[quote name='Bitmo' date='May 9 2007, 06:43 AM' post='3834']
In the hospital in aus I work in they give you four in am or 8-9 with div 2 then 5 in arvo on own or 9-10 with div 2

We only have 4 nurses on nightshift looking after a 30ish bed ward! We have 7-8 nurses during the morning and 6-7 during the afternoon (so each getting 4-5 am and 5-6 pm per nurse with 8 to look after overnight!)

[mariedavena]

[size=2]I work in a hospital with probably less than 200 beds. I work the med/surg floor, but mainly surgicals. Our unit holds 35 pts, but usually only has 15-20 pts! I usually start with 5-6 pts, might end up with 7-8, but not usually. The surgical unit gets one nurse tech to one nurse, usually, which is really nice; depending on the tech. Right now our unit is closed and all 5 pts moved to the medical/peds floor. Management says they do this so that they can clean the unit a couple times a year. Also this leaves a lot of uneeded nurses, techs, secretaries and housekeepers- lots of time off if low on the totem poll. Does anyone else experience a shut down of a whole unit? We just can't keep our beds full, ever. Most people go to the bigger hospitals 30-60 miles away; of which, never have an empty bed. This confuses me.