[Proto-Traveller] Starship Design

[Mithras]

Another in my Book 2 fleet, taking some inspiration from the huge Keith class troop transports from GURPS TRAVELLER: GROUND FORCES.

copyright: dissident_zombie

Troop Transport (type TT): Using a custom 3000-ton hull, the fleet carrier is a troop transport and assault carrier able to ferry and then deploy one third of a marine battalion from one star system to another. It has jump drive-Z, manoeuvre drive-Z and powerplant-Z, giving the ship performance of jump-4 and 4-G acceleration. Fuel tankage of 1267 tons supports the powerplant for four week, allows one jump-4 (or a number of short range jumps) and provides reserve fuel for four weeks for all of its small craft. Adjacent to the bridge is Model/6 computer. There are sixty-three staterooms and two hundred and twenty low berths for the transport of the marine personnel. There are twenty triple turrets installed, with fire control; ten mount beam lasers, ten mount defensive sandcasters. Two armed ship’s boats are provided for general transport work. Eight 95-ton shuttles are preloaded with marine vehicles and weaponry and together can drop one third of the battalion onto a world simultaneously. A seventy-one ton reserve loading bay is adjacent to the hanger bays, and allows one shuttle to offload its marine equipment for maintenace or other duties. A briefing room and eleven-ton military assembly area are included in the design. Cargo capacity is 100 tons. The hull is streamlined to allow for gas giant refuelling operations.
The troop transport has a crew of 116, including shuttle pilots and crew for the ship’s boats, technicians to service the shuttles and a full complement of sensor operatives and planners required to allow the ship to fulfil its complicated logistical mission. Twelve of the staterooms are reserved for mission-related passengers or for marine officers who do not follow their troops into the cryo-berths. The ship costs MCr 1340.81 and takes 34 months to build.
Most troop transports carriers of the type illustrated are of the Deneb class. The first ship of the class was named the Deneb, and those which followed carry the names of bright white or blue stars.

 

[robject]

Paul, would it be ok with you if I ported these to T5?

 

[Mithras]

Paul, would it be ok with you if I ported these to T5?

Of course! Is there a lot of compatability, then? T5 is still a mystery to me...

Note, though, the illustrations are off the web, just as off the cuff illustrations of what the ships might look like. If desired I also have full crew listings for the FC and the TT, also detailed breakdown of the marine battalion (which had to be sketched out before the ship was built).

 

[robject]

Of course! Is there a lot of compatability, then? T5 is still a mystery to me...

T5 rationalizes some of the assumptions from Book 2, though prices may differ.

I'd first have to pick a configuration for the hull. If it's not entering atmo, then I'd pick a braced or unstreamlined hull.

Drive volumes are identical to Book 2 and Mongoose.

Bridge sizes are flexible. Spacious bridges like those from Book 2 get an operational bonus. For example, a 60t bridge would be spacious with 30 control stations, typical with 60 control stations, and very cramped with 120 control stations. Offhand I could maybe see 30 control stations on the bridge, but 15 is more likely -- for T5 I would probably cut the bridge size in half. Besides, I'll need the tonnage for other T5-isms: armor and powerplant fuel.

The Model/6 computer is only 1 ton, I think. That's okay though - the extra tonnage is needed.

Powerplant fuel is different - the 3kt P4 ship requires 120t (3000/100 x 4).

Weapons are the same. Notation is compact, but a triple beam laser is a triple beam laser.
Passenger space and smallcraft are the same. The extras are reasonable, and doable.

T5 has armor. I'd probably add an extra layer or two.

In short, some things might be wiggled around, but I think the result and price will be in the same range.

 

[Mithras]

copyright Stefan D

Fleet Courier (type FF): Using a custom 400-ton hull, the fleet courier is the vital naval communications ship that allows commanders to give and receive orders across interstellar distances. Intelligence reports are also vital for the deployment of forces and the fleet courier transmits these as a priority. All fleets have several, and even small naval detachments take a fleet courier along with them. It has jump drive-K, manoeuvre drive-D and powerplant-K, giving the ship performance of jump-5 and 2-G acceleration. Fuel tankage of 250 tons supports the powerplant and allows one jump-5 (or a number of short range jumps). Adjacent to the bridge is Model/5 computer. There are four staterooms. No turrets are installed. A 20-ton cargo capacity for vital freight is included. The hull is streamlined to allow for gas giant refuelling operations and planetary landings.
The strike cruiser has a crew of 6: pilot-commander, navigator, medic and three engineers. All sleep double occupancy. The ship costs MCr 291.39 and takes 16 months to build.

 

[Mithras]

In White Dwarf magazine issue 49, Andy Slack wrote this article on designing Book 2 fleets, and its my guide at the moment, helped along with references to Marc Miller's Battle Fleets of the Marches, parts of The Spinward Campaign and a section in Rebellion Sourcebook. I'm posting a large excerpt of the article here, since Andy decided interest had dropped off enough and he took it off his own website a couple of years ago to make space for other things.

A FLEETING ENCOUNTER
Book 2 Fleets by Andy Slack
Originally published in White Dwarf 49 - © Games Workshop Limited 1984

A fleet of Book 2 ships is much more deployable and far easier to design. It is also easier
to run; because of the lack of screens and the way the weapons behave, tactics are roughly
similar to modern naval warfare. Even with computer programmes such as those available
to the vast Model/7 machines, lasers and missiles are roughly equivalent in effect
whoever launches them or fires them. Further, because ships are not very resistant to
damage, and because ton for ton a group of ship's boats have more weapons than a
starship or non-starship, there is a strong incentive to having many small units, rather than
a few big ones. From a game balance point of view, this means that instead of being
pursued by a 20,000 ton craft with a meson gun the players' free trader is set upon by a
squadron of fighters or ship's boats. They stand slightly more chance, but the referee has
had virtually no design work to do and can concentrate on the scenario not the rules or
hardware.

Fleet Composition
1 Carrier - a large vessel carrying fighters or ship's boats modified as fighters. 2-12
Escorts - type C or type T cruisers would be perfect. 1-6 Auxiliaries - supply ships,
hospital ships and so on. Type R or M subsidised merchants called up for war service,
probably. 3-18 Scouts - the familiar type S. 1-6 Couriers - fast, long-range vessels for
carrying reports and orders on strategy, future fleet positions, etc. 1-6 Tankers - large
vessels with vast amounts of spare fuel to transfer to other ships. 1-6 Assault Carriers -
large vessels carrying marines and their equipment, possibly in low berths.
Deployment and Tactics
The running costs of warships will be much higher if they are moving around than if they
sit still, so to save money any government in peacetime will keep the fleet in port as much
as possible. In peacetime, the scout ships will roam around space looking for trouble
which requires a fleet's presence, and if they find it they will report back straight away.
The escorts will also patrol randomly in the hope of nipping such trouble in the bud,
blasting pirates, and so on. The rest of the fleet will spend most of its time at a naval base,
strategically placed for quick response to likely trouble areas. Still, sometimes it will go
on exercises to fine-tune crews and equipment; so assume a naval base has a fleet present
5/6 of the time, and if a 6 is rolled the fleet is on exercise. Naval bases will always retain
some fighters to protect them, some scouts for reconnaissance, and some couriers to
report or yell for help with.

When in war or exercise the fleet moves as a whole, the units have the following tasks:
Carrier: The flagship, also responsible for transporting up to a hundred or so
fighters/combat ship's boats between star systems. It is lightly armed as a last line of
defence.
Fighters: They do most of the real work. They attack enemy ships, usually with missile fire;
support ground troops, serving as 'flying tanks' as well as maintaining air superiority; and
attempt to prevent enemy fighters from doing the same things back.
Escorts: Their primary function is protecting the carrier from enemy fighters. If
friendly fighters do not break up an attack, the escorts must do so as the carrier is not itself
efficient in combat.
Auxiliaries and Tankers: Supply the fleet with fuel and other goods. They normally
huddle around the carrier for protection.
Scouts: Primarily responsible for reconnaissance. They will jump into nearby systems
in search of opposing forces and report back if possible. The fleet normally plans its
movements some weeks in advance; this means that the scouts can leave the fleet in
system A, search systems B and C, rejoin the fleet in system D, rather than the whole fleet
sitting idle until a report is brought back. This also makes the scouts prime targets for
capture by enemy intelligence, and since plans must often be changed, scouts are often
lost from the fleet by appearing at the scheduled system to find the fleet absent.
Contingency plans are laid against this, e.g. alternate routes and instructions to 'go to such
and such world and wait for further orders', but even so there are a lot of lost scouts
roaming around in a war. (Good scenario there, perhaps.)
Couriers: Required to carry messages back and forth between fleets and bases. A
quite respectable 400 ton courier capable of jump-5 can be designed at tech level 11 for
around MCr 250, which should be sufficient for most needs. The same comments about fleet
schedules and routes apply here as were made for the scouts above.

Finally, each fleet must have its own marine force with it in case it needs ground troops,
because it will rarely be able to wait weeks or months for troops to arrive. These too
huddle near the carrier.

As can be seen the fleet has quite a realistic feel, and requires only a few hours work
designing the couriers, carriers, tankers and assault carriers. In fact, most of this work can
be skipped since only the courier is likely to appear in a scenario - a band might well be
hired to hijack it to find the composition and route of its parent fleet.

 

[Jame]

Oh, have you given thought to doubling up drives? Using them to get higher jump numbers?

 

[Mithras]

I thought I'd stick with the limitations of the table, and although I've seen others add extra drives, I'm going to assume that grave-drive physics just mean that big ships suffer from low-drive values ... it means doing some thinking about what you can and cannot design. I'm liking the challenge

Oh, have you given thought to doubling up drives? Using them to get higher jump numbers?

 

[Mithras]

Replenishment Vessel (type ): Using a custom 4000-ton hull, the replenishment vessel is a large fleet cargo carrier, a bulk transport and ammunition supply ship. It has jump drive-Y, manoeuvre drive-X and powerplant-Y, giving the ship performance of jump-2 and 1-G acceleration. Fuel tankage of 1620 tons supports the powerplant for four weeks, allows one jump-2 (or a number of short range jumps) and provides 800 tons of reserve fuel for other naval vessels. Adjacent to the bridge is Model/3 computer. There are eighty staterooms and twenty low berths. There are four hardpoints with four tons allocated for fire control should turrets later be installed. Two armed slow pinnances are provided for general transport work, and extra hanger space is provided for up to 90 tons of small craft. There is a 20-ton area set aside for workshops and repair areas and a 20-ton loading, unloading and assembly area. Cargo capacity is 1500 tons. The hull is streamlined to allow for gas giant refuelling operations.
The replenishment vessel has a crew of 40; commander, executive, 3 admin staff, 3 pilots, 3 navigators, 3 com-techs, 6 loadmasters, 7 engineers, a logistics officer, 4 technicians, fuel pump operator, 2 boat pilots, 2 boat gunners, a doctor and 2 medics. Staterooms allow the billetting of up to 114 military personnel in double-occupancy. These may be marines, naval personnel travelling out to a new station, additional repair technicians and/or fleet courier crews receiving some respite from their cramped shipboard accomodations. The ship costs MCr 1075.86 and takes 35 months to build.
Most replenishment vessels of the type illustrated are of the Capital class. All ships in the class are named after worlds in the Core sector.

 

[Mithras]

My conversion of the Kinunir using straight Book 2 rules for my Book 2 fleet ....a few tweaks needed here and there...

Copyright Andrew Boulton

Battle Cruiser (type BC): Using a custom 1200-ton hull, the battle cruiser is designed for independent patrol and internal peacekeeping within the imperium. It has jump drive-Y, manoeuvre drive-Y and powerplant-Y, giving the ship performance of jump-4 and 4-G acceleration. Fuel tankage of 560 tons supports the powerplant for eight weeks and allows one jump-4 (or a number of short range jumps). Adjacent to the bridge is Model/7 computer. There are forty seven staterooms. Battle cruisers are equipped with twelve triple turrets, all with fire control; ten mount beam lasers and the remaining two mount missile tubes. An 18 ton magazine holds 280 additional missiles. There are five ship's vehicles: a pinnance is carried as a troop transport and general cargo ferry, three air/raft are used by the crew, and a G-Carrier is used by the marines when on a world's surface. A 10-ton troop assembly area is provided for the marines, and they also have access to five drop capsule launchers, each capable of launching three marine drop capsules from orbit. Cargo capacity is 50 tons. The hull is streamlined to allow for gas giant refuelling operations.
The battle cruiser has a crew of 79: commander, executive officer, operations officer, assistant ops officer, chief engineer, flight officer, tactical officer, computer officer, doctor, nurse, medic, 2 pilots, 2 navigators, 2 comms operators, 12 gunners, 7 engineers, 3 admin staff, 2 missile loaders, steward, boat pilot, boat gunner, boat handler and a marine contingent. This consists of a commanding officer (a captain), three squad commanders (all lieutenants), and 30 enlisted men. The contingent is composed of a four-man command section, a 10-man boarding party, a 10-man battle dress-equipped orbital jump squad and a 10-man infantry squad operating from the G-Carrier. Two of the ship's engineers are trained to service the ship's vehicles. The ship costs MCr 831.13 and takes 32 months to build.
Most battle cruisers of the type illustrated are of the Kinunir class.

 

[Mithras]

Salvage Tender (type NT): Using a custom 800-ton hull, the salvage tender is employed by military fleets to repair or recover damaged warships. It carries fully-stocked workshops, and with extendable grapples and external airlocked work bubbles it can repair almost any vessel. With its powerful drives, the salvage tender can also act as a recovery tug. It has jump drive-H, manoeuvre drive-W and powerplant-W, giving the ship performance of jump-2 and 5-G acceleration. Fuel tankage of 210 tons supports the powerplant and allows one jump-2 (or two jump-1’s). Adjacent to the bridge is Model/3 computer. There are twenty staterooms and four low berths, in addition 100-tons of cargo can be carried. There are four double turrets installed, with four tons of fire control. Two turrets mount defensive sandcasters, two mount pulse lasers. An internal hanger can accomodate 100-tons of small craft for repair, while other mission components include a 50-ton docking clamp for tug operations, two grappling arms, extending airlock tunnels and two expandable airlocked bubbles for repairing the external areas of a damaged warship. All repair activities are supported by a 40-ton workshop and repair bay. A 20-ton launch acts as a general cargo transport, whilst three 4-ton work buggies allow transport to external locations around a damaged ship. Unique to the ship is a 5 ton auxiliary mobile powerbase, which, once deployed, can transfer power across to a damaged ship moored alongside. Hooked up to the stricken vessel, the AMP provides power, allowing other systems to come online and allow the crew and tender technicians to more easily affect a repair. The hull of the salvage tender is streamlined to allow for gas giant refuelling operations and planetary landings.
The tender has a crew of 36: commander, executive officer, 2 pilots, 2 navigators, chief engineer, 3 engineers, ship’s doctor, medic, logistics officer, assistant logistics officer, 4 gunners, technical operations officer, asst. technical operations officer, 16 technicians. The ship costs MCr 511.06 and takes 28 months to build.
Most salvage tenders of the type illustrated are of the Horizon class.

photo: copyright Robert LePine (his model of Nostromo)

 

[Mithras]

copyright Andrew Boulton

Medical Support Ship (type NM): Using the hull of a standard 600-ton subsidized liner, the medical support ship is a military refit of a common passenger liner. It allows military casualties to be treated in-system, and evacuated out of a combat zone for further treatment. It has jump drive-J, maneuver drive-C, and power plant-J, giving performance of jump-3 and 1G acceleration. Fuel tankage of 210 tons supports the power plant and allows one jump-3. Adjacent to the bridge is a Model/3 computer. There are thirty staterooms and twenty low berths. The ship has three hardpoints and three tons set aside for fire control. Part of the forward cargo hold has been refitted as a laundry, medical lab, hygiene station and medical store/dispensary (total 11 tons). Tonnage normally devoted to passenger comfort within the subsidized liner has been turned into two operating theatres, a consulting room, a scanning suite and a small patients' lounge, this causes additional cost. No weapons are installed. A single 20-ton launch serves as an ambulance, bringing casualties to the hospital ship. Cargo capacity is 118 tons. The hull is unstreamlined.
The medical support ship requires a crew of eighteen: commander, pilot, navigator, chief engineer, two engineers, two ambulance crew, pharmacist, three medical technicians, four nurses and two surgeons. The ship can accommodate forty patients in double occupancy rooms, and twenty patients carried in low berth. The ambulance crew includes a pilot and a medic, but usually takes on board a medical technician from the medical support ship. The ship costs MCr 252.07 (including a 10% discount for standard designs) and takes 22 months to build.
Ships are named after mythical lands, or terms of compassion.

 

[McPerth]

The medical support ship requires a crew of eighteen: commander, pilot, navigator, chief engineer, two engineers, two ambulance crew, pharmacist, three medical technicians, four nurses and two surgeons. The ship can accommodate forty patients in double occupancy rooms, and twenty patients carried in low berth. The ambulance crew includes a pilot and a medic, but usually takes on board a medical technician from the medical support ship. The ship costs MCr 252.07 (including a 10% discount for standard designs) and takes 22 months to build.

I'm glad the hospital I work in is directed by more comprehensive people than your Navy's high brass ...

The usual ratio of nurses/patiens in the hospitals I know goes from 1-2 per shift (Intensive Care) to 1-30 (plus about an auxiliar per two nurses) per shift in minimal cares units, with an average per Acute hospital of about 3-4 (including auxiliars)/30 patients per shift.

Aside from that, any surgery requires at least 2 surgeons, one anestesiologist and 2 nurses...

That makes your hospital ship (for 40 patients) would need at least 9 nursery personnel, working on 3 8 hour turns with no spare days for R&R plus at least 2-4 more nursery personnel for surgeries (even counting on robotic assistence I don't believe you could lower much those numbers)

I'd also raise a little the number of doctors, as your two surgeons would need at least an anestesiologist, an internist for non surgical cases and probably an Intensive care specialist for any emergencies.

So, IMHO (and here I know about the matter, unlike most cases) your minimal staff would be 5 (better about 6-8) doctors (including surgeons) and about 12-15 (probably more) nursery personnel (and that includes robotic support).

You must also see that a ship that cared for double patients would double (or nearly so, as surgery nurses would probaly not be increased as much) nursery personnel, but your need for doctors would not raise too much (as most times what you need in at least one from different specialities, regardless how many patients they must care for, within limits well outside that range), making it more efficient.

 

[aramis]

Around my town, Nurses work 12 hour shifts, ICU is 1 per 5 or so... and a surgery can have a nurse-anesthetist and a single surgeon... both "on call".

A good friend is an ICU nurse; another friend was a NICU nurse.

Keep in mind, tho'... military medicine often s short on nurses, and uses medics as orderlies, but hasthem doing both orderly and LPN type tasks. Also, Aensthesia is often done by nurses or dentists...

In my 3 stays (total 2 weeks) in Walson Army Hospital, I never saw a nurse in the wards; we had medics doing the nursing tasks. We saw MD's, DO's, and medics. Oh, and the kid who needed sedation was KO'd by a DDS... Smallpox vaccine reaction.

 

[dean]

Nurses...

Medium Sized Civilian Hospital

ICU 2 patients per nurse
PCU 4 patients per nurse
Medical/surgical wing 6 patients per nurse
Acute Rehabiliation 8 patients per nurse

Surgery usually has 1 Surgeon, 1 Anesthesiologist/Nurse Anesthetist, 1 Assist Nurse, 1 Circulating Nurse. For minor surgeries the Circulator may be replaced by a Surgical Tech.

Most military units forgo a large number of nurses in favor of medics/corpsmen. The Nurses in these roles tend to supervise the corpsmen. One Army Medic turned nurse I know said that in the US Army, the corpsmen do most of the work that only RNs are allowed to do in the private sector (start IVs, do treatments, administer medications).

In addition, I would think a ship like this would be primarily to stabilize the basket cases so they can go into the low berth, and to do quick fixes on the minimally injured to return them to service. No point (with the availability of low berths) having a lot of bed space allocated to a recovery function for anyone with moderate to severe injuries that will take a while to heal, unless the ship happens to have the space or a low number of patients.

 

[Mithras]

I just guessed

Never been in hospital... !

 

[Mithras]

Dean, I like that. I saw the Type M as a neat hospital ship, but looking at it through the eyes of posters on this thread, it looks like its too small to make a decent 'hospital ship'. So maybe I should tweak it to function purely as a casualty receiving ship.

In addition, I would think a ship like this would be primarily to stabilize the basket cases so they can go into the low berth, and to do quick fixes on the minimally injured to return them to service. No point (with the availability of low berths) having a lot of bed space allocated to a recovery function for anyone with moderate to severe injuries that will take a while to heal, unless the ship happens to have the space or a low number of patients.

EDIT: That huge cargo bay has lots of potential as additional cold sleep storage for the severely wounded...

 

[McPerth]

Around my town, Nurses work 12 hour shifts, ICU is 1 per 5 or so... and a surgery can have a nurse-anesthetist and a single surgeon... both "on call".

A good friend is an ICU nurse; another friend was a NICU nurse.

I am an ER nurse, and so is my wife too.

While some hospitals also have 12 hour shifts here (I worked them when I ended university), you end the shift too tired to have quick reflexes should any emergency occur (mostly in the night shift, as I've always worked). Most hospitals work on 8 hour shifts or 7-7-10 hours shift (the 10 hour shift is night one and uses to be every other day, morning and afternoon shifts use to be 5 days a week).

Personally I find a ratio 1 per 5 in ICU quite risky.

Keep in mind, tho'... military medicine often s short on nurses, and uses medics as orderlies, but hasthem doing both orderly and LPN type tasks. Also, Aensthesia is often done by nurses or dentists...

Even General Anesthesia? I see this quite risky too.

In my 3 stays (total 2 weeks) in Walson Army Hospital, I never saw a nurse in the wards; we had medics doing the nursing tasks. We saw MD's, DO's, and medics. Oh, and the kid who needed sedation was KO'd by a DDS... Smallpox vaccine reaction.

Most military units forgo a large number of nurses in favor of medics/corpsmen. The Nurses in these roles tend to supervise the corpsmen. One Army Medic turned nurse I know said that in the US Army, the corpsmen do most of the work that only RNs are allowed to do in the private sector (start IVs, do treatments, administer medications).

In any case the ship would require more personnel to make the nursery work, be they nurses, doctors, corpsmen or whatever is deemed apropiate. When I said nurses here I meant the work post, I know in armed forces is usual for people to be at works they are either not qualified or overqualified (by civilian standards)

Surgery usually has 1 Surgeon, 1 Anesthesiologist/Nurse Anesthetist, 1 Assist Nurse, 1 Circulating Nurse. For minor surgeries the Circulator may be replaced by a Surgical Tech.

Spanish legislation says another staff surgeon (usually a resident, or the adjount if the resident is acting as main surgeon) is also needed in the operation room. Also the anesthesist must be a doctor (an anesthesist nurse may be assiting him is it's deemed necessary). Of course, thats civilian legistlation...

Medium Sized Civilian Hospital

ICU 2 patients per nurse
PCU 4 patients per nurse
Medical/surgical wing 6 patients per nurse
Acute Rehabiliation 8 patients per nurse

Those ratios are more similar to what I'm used to see.

In addition, I would think a ship like this would be primarily to stabilize the basket cases so they can go into the low berth, and to do quick fixes on the minimally injured to return them to service. No point (with the availability of low berths) having a lot of bed space allocated to a recovery function for anyone with moderate to severe injuries that will take a while to heal, unless the ship happens to have the space or a low number of patients.

Dean, I like that. I saw the Type M as a neat hospital ship, but looking at it through the eyes of posters on this thread, it looks like its too small to make a decent 'hospital ship'. So maybe I should tweak it to function purely as a casualty receiving ship.

As this is a small ship universe, I see it as a full hospital ship (albeit a small one), where the personnel recovers from light (and medium) wounds and illness (never forget the non combat related casualties). In most cases recovery time may be of just 2-3 weeks, so being able to rejoin its crewmates in about one jump time (as long as the TF remains together), instead of needing to be transfered to rearguard, spending there that time and then retourning (if possible, as God knows where the ship would be by then), so effectively losing this one crewmember for the ship crew, needing a replacement, and eroding ship crew cohesion once even light casualties begin to mount, even if crew cohesion is not featured in the game.

As such, I'll even suggest to make a stateroom as OR and one as Post Suergery Recovery Unit . In real world they will both need more space that a room, but they don't need as much 'out room space', as the patient has another bed assigned even when there, and he/she will not move anyway when on them.

Another thing I'd feature to any hospital ship (even if it doesn't influence in any way the design, just some more colour) is a more graduable grav system than other ships. Anyone that has had to move immovilized trauma patients will sure agree grav controls would make life quite easier, both for us and for the patients.

EDIT: That huge cargo bay has lots of potential as additional cold sleep storage for the severely wounded...

I'd convert most cargo space to more staterooms, both for inmates and personnel, even if you must add some staff, the ratio staff-inmate decreases as the hospital grows (as explained on the previous post)

I just guessed

Never been in hospital... !

Lucky you. Don't feel hurried to try :rofl:.

 

[aramis]

I am an ER nurse, and so is my wife too.

While some hospitals also have 12 hour shifts here (I worked them when I ended university), you end the shift too tired to have quick reflexes should any emergency occur (mostly in the night shift, as I've always worked). Most hospitals work on 8 hour shifts or 7-7-10 hours shift (the 10 hour shift is night one and uses to be every other day, morning and afternoon shifts use to be 5 days a week).

Personally I find a ratio 1 per 5 in ICU quite risky.

So do the nurses around here. They really don't like 12 hour shifts.

ANd the ICU at both hospitals makes use of technician-orderlies. You don't get your vitals by a nurse - a medical technician does them. The staff ratio in the ICU (I've spent WAY too much time there) is 1-2 RNs, 1-2 LPNs, and 3-5 orderlies for a 15 bed ICU.

Even General Anesthesia? I see this quite risky too.

Yes, even general. Nurse Anesthetists are "supervised" by MD anesthesiologists in the civilian world, but really, nurse anesthetists have just as much specialty training as the average Anesthesiologist... a full year of coursework, and a year of interning.

Only in the military are Dentists doing surgical anesthesia, but since field hospital units need them for evaluating dental trauma, and providing routine dentistry... they're there, they have more training than many MD's.

Then again, Alaska just approved as well Dental Technician Practitioners... Trained as hygienists, then taking an extra one year course, they can do fillings, floride treatments, simple extractions, and examinations.

The Medical Board has (several times in the last decade) considered granting prescription writing to DC's (Chiropractors). It's not passed, but by only a single vote, several times.

In frontier areas, or in military field hospitals, lots of supposed "safety issues" turn out not to be so much safety as role preservation.

 

[dean]

McPerth;
There is a general trend here in the US civilian sector that is gradually transferring the routine care of patients to Nurse Practitioners and Physician's Assistants. In the US, CRNAs (Certified Registered Nurse Anesthetists) are now required by the national certifying agency to have a doctoral degree in anesthesia; in many respects CRNAs becoming certified over the next few years will have more education - and almost certainly more applied experience - than a newly graduated anesthesiologist.

The ER in my hospital has the "core" staff on 12-hour shifts (7 to 7) and staffs additional staff on 8- and 10-hour shifts to cover the busier times (mid-morning to 0200 or so). Most of the rest of the hospital has the 12-hour shifts for all nursing staff. In addition to the RN, they try to staff one nurse aide for every 8 to 10 patients.

I will observe that in the US, much of the time spent by a nurse is doing paperwork to satisfy legal, policy, and administrative requirements. Much of the charting that is done is to provide evidence that the "minimum standard of care" was provided at the least, in case something goes wrong and there is a law suit. I strongly suspect these requirements are much less stringently required in the military setting, so higher ratios could be safely achieved. in addition, lie in all military roles, you are simply required to work as much as needed, or at least until exhaustion befalls you...