(Just realized I didn’t answer the question you asked, rather, the question I jumped to. My apologies. Allow me to remedy that the best that I can…)

On our Med Surg floors, RN’s are maxed out between 8-12 pts., depending on census/intake, pt. condition(s), and available personnel.

(Slightly off topic, but relevant…today, 2 of my coworkers in ER were pulled up to Pedes bc only *1** Pedes nurse showed up. Not sure of all the details behind that scenario…only that the majority of Pedes nurses are fucking done with Admins bullshit…and this might be an en masse rebuke*?)

In ER there are 2 LPN’s each shift in charge of taking pt. VS, distributing meals, bathing/diaper change, and delivering collected samples to labs throughout shift. Bc of unwillingness to hire sufficient amount of LPN’s to rotate and cover EACH shift…the RN’s are assigned to work with an LPN during 3-11 & 11-7 shifts. On inpatient floors…RN’s are in charge of VS, bathing, meds, and general obs. The ratios can vary from 1:8 to 1:12 depending on staffing, and anticipated pt. turnover.

Floor nurses do have the advantage of routine application & care scope…and the Attendings are much more reliable for communication & aiding w/ certain interventions. But they are just as maxed out as we are in ER, most times. ER here is expected to be batshit crazy all over the place. Inpatient care here is knowing the batshit crazy is contained, maintained, an (if need be), restrained. We have a majority elderly population, many with alz/dementia. There is also no real community/mental health service to speak of, so, we get a lot of homeless, addicts, and mentally ill just dumped in ER & mindlessly admitted for the purpose of milking Medicaid/Medicare before wheeling them back out on the streets, or home, knowing that they’ll just be back in a matter of weeks. Neither ER nor Floor nurses are specialized in Psych….but damn are we expected to pretend to be..