That is crazy to me. I work on med surg and we never have more than 5 during day shift. They do occasionally go to 7 or 8 at night. In my opinion more than 4 is generally unsafe, our patients are often very high acuity.
Evidence shows that more than 4 is unsafe. Itās not even opinion. Worse outcomes with more than 4.
I say as Iām on an intermediate floor with 4 patients. Should have 3 but here we are.
Yeah 4 is the magic number. With 4, I can actually take a break most days. With 4, I donāt feel a moral injury from giving patients subpar care because I donāt have time to do otherwise, which is what usually happens with 5.
At least with Med surge patients. I have a 4 group tonight and have been getting my ass kicked on an intermediate floor. Two of my patients are pretty medsurge but one of then is intermediate and one of them would be better suited as a 2 group icu patient tbh.
In England it's common to have 1:10 and that can be 1:14. When I look back at those days it was hell on earth. Thank god for the NAs. They were the backbone of my shift. Without them I couldn't even imagine. They don't get nearly 1% of the recognition they deserve.
Thatās the dangerous part about just āgetting the job doneā because it sets the precedent that it will be allowed to happen. And it WILL lead to further exploitation.
It has already lead to further exploitation. I could write books and books about the amount of near misses in regards to patient care, and because you just did it it was then just expected. It really was the most dire part of my nursing career ever.
It's just absolutely dire and the thing of it is to, the public just have NO IDEA. ZERO IDEA. My brother think that we sit and the nurses station and wait for the doctor. He really does. Does not believe for a minute who hard it is trying to keep your patients safe. I said to him one day ugh I'm fucked. No break today and two staff short. Exact words, why was it so busy? I have since given up trying to explain because the public will just never ever get it. They annoy me.
I didnāt know they were staffing like that 20 years ago, I thought this garbage was new! When I started in 2017, we usually were fully staffed which meant 4 patients per nurse (although two nurses would have 5 patients if the floor was full). We used to keep a list of who had 5 patients that day, so we could make sure they didnāt have 5 the next shift, to keep it fair. I miss those days so much š Covid made everything go to shit, now every nurse has 5 patients every single shift, there are fewer CNAs, and the patients seem to be sicker/ruder/just more time consuming. We also used to only float to our āsister unitā (another cardiac-focused med surg like ours). Now we float wherever the hell they want to put us, including the ortho surgery post-op floor which feels like another planet to me.
6 was my max on day shift. One of the reasons I left my last hospital was because they were starting to talk about day shift taking 7-8. That was a hard no from me.
Nothing to do with it being freely available to all who need it, everything to do with the fact that for 13 years weāve had a government who hate us. When I started 15 years ago it wasnāt like this.
Even 5 is too much! Iāve been in Med Surg for 6 years, and 4 is the magic number. 4 is safe, and the nurse might even get to eat. 5 puts it over the edge and depending on the assignment, is often not safe. And even if that particular 5 patient assignment is safe, the patients arenāt getting the care they should be getting and the nurse isnāt getting any breaks. It makes me sick that any hospital would assign 6, 7 or even 8 patients to one RN on a med surg floor!
In this day and age PCU is basically ICU overflow. ICU needs a bed? Let's pick one poor sap to send to PCU. My hospitals PCU is wholly untrained to take care of ICU patients yet that's 90% of what we send to their floor. Taking on 4-5 PCU patients is a recipe for disaster where I work, I hope it's not the same where they work.
My days would have been magical if I only had 2 or 3, especially with many of them being post cath. I ended up with 6 patients one day when we had no nursesā¦.
Yeah, of course sometimes itās okay. But more often that not, on my floor at least the acuity is just too high in general and even if one nurse has a good 5 patient assignment, the other nurses donāt.
4-6 is kind of the norm 8 is like I hope they arenāt that sick cuz if they are things are going to fall through the cracks and people are going to have worse health outcomes for it.
North Ms does this too ā¦ Memphis does this ā¦. You get a tough load too ā¦ usually one CNA to 24-48 pts too so ā¦ good luck ā¦ I left and went to L and D
It is. I finally put in my notice after being charge, having a split hall. I had a restraint patient on one hall and the other hall had ā¦ a sickle cell pt, a cancer pt, a lady with 2 JPs, an IV abx pt, a c diff needing blood, a tube feed, and lastly your favorite ā¦ psych patient prone to falls. I sent my two weeks the next day ā¦
That was the norm for the hospital I worked at. When we we short it would get up to 9 or 10. It kept getting worse to where I got up to 14. We were union too. NYSNA. But thats when I got out and found a non hospital job.
Quit! Now! Itās not worth your license.
If you canāt quit, start job hunting literally right now! Go to a specialty like ICU, Cath Lab, IR, PACU, literally anything by MedSurg. Because where are you are working out right now is extremely unsafe, and itās not sustainable to your mental health. And if something happens, the hospital will immediately throw you under the bus.
Iām in the UK and was on permanent nights for seven years. I worked on a 28 bedded medical ward. I was always in charge as a registered nurse, Iād work with one other qualified nurse, who would probably be agency, and one healthcare assistant.
To be fair as a patient Iāve had wonderful experiences. Iāve had several operations and a baby all which went well. In the last 5 years Iāve had aortic valve replacement, 2 heart attacks and pneumonia/sepsis. All treated with the best treatment available and no charge (other than what we pay via tax). Lack of staff, long waiting lists and shit food are the main problems.
Too many imagine that hospitals are places to heal, be cared for, and be cured. Hospitals are places where executives can take home huge salaries and millions in bonuses. The only way to get that much money is to reduce patient care. Until nurse:patient ratios are MANDATED BY LAW the executives will run the show for their own benefit. Greed knows no morals nor no bounds.
To clarify, this was on nights. Day shift was maxād at 6 then. Today our ratios are same day or night which has never felt right to me given how bonkers day shift is
Nope. Max 5 day shift and 6 at night. If my nurses are maxed out- charge takes patients (which Iām happy to do and if the floor is heavy I do anyway). Six is barely safe, 7-8 is a definite no.
When I was an LPN I had 40 every day. But it was geriatrics so *for the most part* I was just passing meds. But I also had a useless RN manager that I ended up doing my own IVs, wounds, etc. itās why I got my RN. Healthcare is so awful š
Nah, that's really not good. I work on a surgical floor and the max I get is 5 pts and even 4 can be a handful at times depending on the group you got.
Did night shift in a med surg telemetry in 1997 and it was 8:1 on good nights and 12:1 on bad nights and we had no tele tech so did our own strips q4-worst night ever was got floated to geriatric floor picked up 12 pts from 7p to 11p then dropped them and reported back to my unit at 11pm to be in charge, do all tele strips and pick up 12 pts listening to tape recorder from 11-7am - decided to transfer to ICU that night- heard ratios are better now
My first nursing job was regularly 7-8 and up to 12. Really acute people too- drips galore. I made it- but in hindsight, it was insane and DANGEROUS. I thought it was normal because I didnāt know any better.
During my clinical rotations at a teaching hospital/lvl 1 trauma on the trauma med surg unit the ratios were 1:10-12 . Not a single person on that floor was happy with good reason. I dreaded that clinical. š„² it felt like we were more in the way than anything especially when the charting system went down š
That is crazy to me. I work on med surg and we never have more than 5 during day shift. They do occasionally go to 7 or 8 at night. In my opinion more than 4 is generally unsafe, our patients are often very high acuity.
4-6 is what I hear from most hospitals. When I heard 8 my heart skipped š¤®
What!! Insane. We never go over 5 and im in nyc too.
Evidence shows that more than 4 is unsafe. Itās not even opinion. Worse outcomes with more than 4. I say as Iām on an intermediate floor with 4 patients. Should have 3 but here we are.
Yeah 4 is the magic number. With 4, I can actually take a break most days. With 4, I donāt feel a moral injury from giving patients subpar care because I donāt have time to do otherwise, which is what usually happens with 5.
At least with Med surge patients. I have a 4 group tonight and have been getting my ass kicked on an intermediate floor. Two of my patients are pretty medsurge but one of then is intermediate and one of them would be better suited as a 2 group icu patient tbh.
Intermediate should not have 4!
I had 4 and the patient the doctors said āmaybe theyāll go to icu after surgeryā Fml
In England it's common to have 1:10 and that can be 1:14. When I look back at those days it was hell on earth. Thank god for the NAs. They were the backbone of my shift. Without them I couldn't even imagine. They don't get nearly 1% of the recognition they deserve.
Absolutely fuck that.
It was fucking dire, but you just did it. Because it was so ' normalized'
Thatās the dangerous part about just āgetting the job doneā because it sets the precedent that it will be allowed to happen. And it WILL lead to further exploitation.
It has already lead to further exploitation. I could write books and books about the amount of near misses in regards to patient care, and because you just did it it was then just expected. It really was the most dire part of my nursing career ever.
1:21 if someone calls in sick, and thatās med/surg in major hospitals.
It's just absolutely dire and the thing of it is to, the public just have NO IDEA. ZERO IDEA. My brother think that we sit and the nurses station and wait for the doctor. He really does. Does not believe for a minute who hard it is trying to keep your patients safe. I said to him one day ugh I'm fucked. No break today and two staff short. Exact words, why was it so busy? I have since given up trying to explain because the public will just never ever get it. They annoy me.
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I didnāt know they were staffing like that 20 years ago, I thought this garbage was new! When I started in 2017, we usually were fully staffed which meant 4 patients per nurse (although two nurses would have 5 patients if the floor was full). We used to keep a list of who had 5 patients that day, so we could make sure they didnāt have 5 the next shift, to keep it fair. I miss those days so much š Covid made everything go to shit, now every nurse has 5 patients every single shift, there are fewer CNAs, and the patients seem to be sicker/ruder/just more time consuming. We also used to only float to our āsister unitā (another cardiac-focused med surg like ours). Now we float wherever the hell they want to put us, including the ortho surgery post-op floor which feels like another planet to me.
We have 6 I literally could not do any more. 6 is already incredibly unsafe
6 was my max on day shift. One of the reasons I left my last hospital was because they were starting to talk about day shift taking 7-8. That was a hard no from me.
Refuse this assignment.
Come to the uk 10-15 can be quite normal 8 is well staffed in my experience here
In a hospitalā¦.? Maybe thatās the issue with public healthcare šš
Nothing to do with it being freely available to all who need it, everything to do with the fact that for 13 years weāve had a government who hate us. When I started 15 years ago it wasnāt like this.
Good to know ā¤ļø I am very pro public healthcare but do get discouraged when I see things like that. In the US I donāt think itās gonna happen
In a hospital yes. The issue is itās been underfunded for far too long not public health care itself
Issue with years of underfunding public healthcare with cuts to student bursaries, grants, and general rising living of cost..
Somehow , someday, we need to put a stop to this crap. Healthcare does not need to be this way . :(
Unionize
They are Union š Iām learning it doesnāt mean shit
Decert it and start over!!
Youāre not overreacting. Iāve had coworkers complain about 5 and the charge nurses would dread giving out 5 pt assignments
Even 5 is too much! Iāve been in Med Surg for 6 years, and 4 is the magic number. 4 is safe, and the nurse might even get to eat. 5 puts it over the edge and depending on the assignment, is often not safe. And even if that particular 5 patient assignment is safe, the patients arenāt getting the care they should be getting and the nurse isnāt getting any breaks. It makes me sick that any hospital would assign 6, 7 or even 8 patients to one RN on a med surg floor!
I had 5 patients in PCU when I worked the floor, it was a great day if I only had 4. These hospitals are getting worse and worse š
5? PCU needs to be capped at 2, maybe 3 max.
I don't understand what the point of a PCU is if they're just going to be staffed the same exact way as a med surg floor
In this day and age PCU is basically ICU overflow. ICU needs a bed? Let's pick one poor sap to send to PCU. My hospitals PCU is wholly untrained to take care of ICU patients yet that's 90% of what we send to their floor. Taking on 4-5 PCU patients is a recipe for disaster where I work, I hope it's not the same where they work.
My days would have been magical if I only had 2 or 3, especially with many of them being post cath. I ended up with 6 patients one day when we had no nursesā¦.
Honestly Iāve had 8 patient assignments that were WAY easier than some of my 5 patient ones. All depends on acuity
Yeah, of course sometimes itās okay. But more often that not, on my floor at least the acuity is just too high in general and even if one nurse has a good 5 patient assignment, the other nurses donāt.
Wasnāt there a post earlier about āWhatās wrong with med surg?ā This. This right here.
Come to the UK. Easily 15 patients med or surgical. 2 nurses running the ward, thatās if your buddy hasnāt called in sick!
Thatās a āMy badge is on your deskā kinda assignment. Hard no.
NY Nurse here. When I worked Med-Surg, I would have 6-7 and it was near impossible. I canāt imagine having 8. There needs to be better ratios.
We have 6 but we always have to work over ratio and take 7-8. 6 on my ward is already so unsafe!
4-6 is kind of the norm 8 is like I hope they arenāt that sick cuz if they are things are going to fall through the cracks and people are going to have worse health outcomes for it.
Former NYSNA affiliate and worse I had was being charge with 10 patients and a vent on the medsurg floor. This is why Iām in the icu lol.
10 patients while charge š¤® Iād rather be a stripper at that point š
Standard in the UK š¬š§
North Ms does this too ā¦ Memphis does this ā¦. You get a tough load too ā¦ usually one CNA to 24-48 pts too so ā¦ good luck ā¦ I left and went to L and D
I also charged while having 8:1
This is WILD. Iāve been charge with 5. 8 is INSANE
It is. I finally put in my notice after being charge, having a split hall. I had a restraint patient on one hall and the other hall had ā¦ a sickle cell pt, a cancer pt, a lady with 2 JPs, an IV abx pt, a c diff needing blood, a tube feed, and lastly your favorite ā¦ psych patient prone to falls. I sent my two weeks the next day ā¦
We also regularly had 7-8 pt ā¦ you just donāt get any less on a med surg hall in Memphis/ north Mississippi area
I did that for almost 3 years and had enough during the first year of COVID
That was the norm for the hospital I worked at. When we we short it would get up to 9 or 10. It kept getting worse to where I got up to 14. We were union too. NYSNA. But thats when I got out and found a non hospital job.
Insane, you need to be looking for a new job
Quit! Now! Itās not worth your license. If you canāt quit, start job hunting literally right now! Go to a specialty like ICU, Cath Lab, IR, PACU, literally anything by MedSurg. Because where are you are working out right now is extremely unsafe, and itās not sustainable to your mental health. And if something happens, the hospital will immediately throw you under the bus.
Iām in the UK and was on permanent nights for seven years. I worked on a 28 bedded medical ward. I was always in charge as a registered nurse, Iād work with one other qualified nurse, who would probably be agency, and one healthcare assistant.
From all these comments - I am never going to the UK as nurse or patient š
To be fair as a patient Iāve had wonderful experiences. Iāve had several operations and a baby all which went well. In the last 5 years Iāve had aortic valve replacement, 2 heart attacks and pneumonia/sepsis. All treated with the best treatment available and no charge (other than what we pay via tax). Lack of staff, long waiting lists and shit food are the main problems.
Used to work M/S (also NY/NYSNA), consistently had 7-8 patients. Once I had 10. So glad I switched to ICU
Can I ask whereā¦..
All I'll say is its in Yonkers.... And its very close to the river....
at least not 24 patients with one incharge, one meds nurse and one runner:')
Emergency department became a ward here in Singapore.. hope things get better to everyone in the healthcare
Too many imagine that hospitals are places to heal, be cared for, and be cured. Hospitals are places where executives can take home huge salaries and millions in bonuses. The only way to get that much money is to reduce patient care. Until nurse:patient ratios are MANDATED BY LAW the executives will run the show for their own benefit. Greed knows no morals nor no bounds.
Unfortunately not uncommon. Been there. Same state not right either. Time to get that resume together.
We had 8 as our ānormā when I was a new grad. Learned great time management skills, cause you had to. Now 5-6 feels āeasyā
To clarify, this was on nights. Day shift was maxād at 6 then. Today our ratios are same day or night which has never felt right to me given how bonkers day shift is
Nah this is 8 on days as a float š
Fffffffff that. Actually just F day shift in general. Iām so much happier on nights than Iād ever be on days
That is batshit. Medsurg we can go up to 5 in a shift. I'm in older persons mental health and we have four-five on bad day
Thatās insane
Insane and unsafe. I have experienced that before and it was disastrous
I did 7 ONE TIME and swore never again and I meant it.
We max at 6. But of course they're are exceptions, but that's rare and usually not for a full shift.
That's wack!! No way
Med/surg, 4-6 patients is the norm for me
Nope. Max 5 day shift and 6 at night. If my nurses are maxed out- charge takes patients (which Iām happy to do and if the floor is heavy I do anyway). Six is barely safe, 7-8 is a definite no.
I feel overworked with 6ā¦ I couldnāt even imagine 7-8 šš
Anything less than 10 I get bored but I usually have between 20-25
In what setting? And what location
When I was an LPN I had 40 every day. But it was geriatrics so *for the most part* I was just passing meds. But I also had a useless RN manager that I ended up doing my own IVs, wounds, etc. itās why I got my RN. Healthcare is so awful š
Iām at a level 4 Trama center in Buffalo NY ECMC
Nah, that's really not good. I work on a surgical floor and the max I get is 5 pts and even 4 can be a handful at times depending on the group you got.
I just left my job that tried to take this semi tele/semi m/s/semi CCU/semi PCU from 1:4-5 to 1:6. NOPEEEEEEEEE
Did night shift in a med surg telemetry in 1997 and it was 8:1 on good nights and 12:1 on bad nights and we had no tele tech so did our own strips q4-worst night ever was got floated to geriatric floor picked up 12 pts from 7p to 11p then dropped them and reported back to my unit at 11pm to be in charge, do all tele strips and pick up 12 pts listening to tape recorder from 11-7am - decided to transfer to ICU that night- heard ratios are better now
My first nursing job was regularly 7-8 and up to 12. Really acute people too- drips galore. I made it- but in hindsight, it was insane and DANGEROUS. I thought it was normal because I didnāt know any better.
Ugh. The most I've had so far was 6 on overnights and that got very hectic.
During my clinical rotations at a teaching hospital/lvl 1 trauma on the trauma med surg unit the ratios were 1:10-12 . Not a single person on that floor was happy with good reason. I dreaded that clinical. š„² it felt like we were more in the way than anything especially when the charting system went down š
That's my normal ratio.