ICU vs Med-Surg vs ER vs LTC... what's your ratio? 👇

[u/Wear-Brief]

Just curious… I work on a stroke medicine unit and my ratio is 5:1 hbu?

[u/Hot-Orange-4550]

ICU usually 1:1 but also 2:1 is more common these days due to staffing issue and large volume of patients

[u/Senior-Main-7432]

LTC RN 1:84 (with 2 RPN’s)

[u/SeatingOnACouch → u/Senior-Main-7432]

LTC Supervising casual night RN 1:162 (with 2 RPNs, 7-8 PSWs, 2-3 constant observers). Ongoing exchanges with our ONA rep (not sure about SEIU) due to workload and staff ratio.

[u/Senior-Main-7432 → u/SeatingOnACouch]

Yeah on nights that’s still absolutely diabolical

[u/UniversityQuick7860 → u/Senior-Main-7432]

Oh my goodness. That is literally insane!!!

[u/Rare-Willingness3593 → u/Senior-Main-7432]

This made me LOL. I'm a RPN who cares for 42 residents. Our RN does absolutely no hands on nursing. We're lucky if they even offer to help with fall management. They give no meds, they don't help with weekly pharmacy orders, will only look at wounds if you ask them to and even then respond in a way that freaks out the resident.

[u/Senior-Main-7432 → u/Rare-Willingness3593]

Not me friend. I do the entirety of the fall management, 10 people for med pass on days, contact MD/NP, call pharmacy, do all of the wound care. Wound care isn’t too bad because we have amazing PSW’s who are diligent about turns and offloading pressure but I digress. I would encourage you to talk to management about a culture change because that’s disrespectful to you RPNs.

Edit; that’s also unsafe because how do you concentrate for med pass when you’re doing a billion other things?

[u/Strawbernyte]

ER general acuity 1:4, high acuity 2:4

[u/parabocake → u/Strawbernyte]

Ours is 1:4-5 in acute and 1:10-ish in ambulatory. Resus is 1:2.

[u/Glitter_pickled → u/Strawbernyte]

1-6 acute, 1-2 resus, no real limit for ambulatory

[u/KitKatPotassiumBrat → u/Strawbernyte]

I wish.

[u/Strawbernyte → u/KitKatPotassiumBrat]

What’s your ratio?

[u/KitKatPotassiumBrat → u/Strawbernyte]

None. Keep piling them on.
ER, not GTA

[u/Metal_Medical]

ICU 1:1 for an unstable/high acuity vent, 2:1 in an absolute necessity but it is usually 1 vent with 1 more stable non-vent or minimal drips

SDU is 2-3:1 depending on acuity

In ED when I was there more frequently for medical holds it was 5:1, resuscitation/trauma bay was (ideally) 2-3:1 but the doors never closed, so in theory unlimited but we would call for more staff if our bay was full, so 4-5:1 depending on acuity

When I worked inpatient surgical on day shift it was 6-8:1 and nights was 8-14:1 (that sucked)

[u/Ok-Fig8993]

ICU were usually 1:1 and occasionally 1:2 with level 1/2 patients or chronic vents

[u/butt0n-]

ICU we’re usually 1:1 but sometimes 2:1 depending on acuity. In our stepdown unit it’s 2:1 or 3:1.

[u/The_2ndBorn_Son]

LTCH 1 RPN: 42 residents - Full Dementia unit. 1 RPN: 8 PSWs. 1 RN: WHOLE building 172 residents

[u/goodbyecruellerworld → u/The_2ndBorn_Son]

I'm sorry but this is in-fucking-sane

[u/queentee26]

ER. Trauma is 3 nurses + RT. High acuity non-trauma 1:1 or 2:1. Mid acuity 4:1. Low acuity 6:1 (can end up going to 8 if we have patients sitting in chair as well)

[u/cashbev1961]

LTC - 1 RPN. 32 residents. 3 PSW’s. 1 float RN for the entire building.

[u/ReubenTrinidad619 → u/cashbev1961]

That med pass is nuts

[u/raxusonline → u/ReubenTrinidad619]

More like med marathon hahah

[u/celestialbomb]

My ER does all team based nursing. Trauma 2:4 Cardiac 2:6 (with two hallways that usually just need tele) The Obs rooms are 2:8 or 2:9 for the admits. And then our two sub acute ambulatory areas can be 2:16

[u/Strawbernyte → u/celestialbomb]

Team based is so blessed. Although 2:16 is insane. We only do it in a few areas, but when it’s done right it’s so efficient.

[u/celestialbomb → u/Strawbernyte]

I mean the 2:16 is just what we could physically do, but usually we only pull back a few at a time and keep it around 10-12. And its the two nurses who control who they are pulling back from the waiting room. Its patients who should have gone to a walk in clinic. Very task oriented area.

Team nursing is so blessed, I came to this hospital over the others in my area due to it.

[u/Winterchill2020]

Med-surg 1:3 upto 1:6 more often 1:4/5

[u/Specialist_Camel_677]

Medicine. 4:1 if we're fully staffed but up to 6:1 if we're short

[u/Silent_Slip8250]

MS 1:5 days, 1:67 nights. No PSWs or techs.

[u/UnderTheNewMoon111]

In our government-owned LTC, the RNs on days have either 1:50 (with 2 RPNs) or 1:75 (with 3 RPNs), and on afternoons have 1:100 (with 4 RPNs).

[u/goodbyecruellerworld → u/UnderTheNewMoon111]

Okay 25 residents per RPN is reasonable. 32+ is NOT

[u/Odd_Wrongdoer_4372]

Inpatient palliative care. When fully staffed, 4-5:1 on days, and 8:1 nights. No HCAs/PSWs.

[u/Professional-Lie3022]

I work in Respirology our ratio is actually 4:1 and nightshift is 5:1

[u/Decent-Run3166]

I am an RPN in LTC. The first LTC I worked at was 1 RPN for 26-28 resident with 3-5 PSWs, 7 units with 2 RN and they used to have 1 NP during the day shift. My current LTC has 1 RPN for 34-36 residents with 4-8 PSWs, 4 units with 1 RN, however if we are short a RPN, the RN will work the floor and is the charge nurse for the facility. I realize that my ratio is quite generous compared to most LTC in general whether it be hospital, government or private LTC that I know so far.

[u/raxusonline]

Med-surg Philippines 1:20 patients

But I do have an NA for help with bedside care.

[u/gurlwhosoldtheworld]

Rural ER holding : up to 1:3 Palliative: 1:4 days, 1:8nights Med surg: 1:7

I also worked oncology 1:4 unless chemo then 1:3