ICU Staffing Levels

TWO

I'm Stefan from Germany. we nurse two patients with respirator. Without respirator max. three. In the nightshift we work at three patients (with respirator). I know that in switzerland one nurse one patient to tendet. I hop that my english is understandably !

I work in Mississippi. In my unit it is not unusual to have three vent pts. I worked CVR two nights ago and had to take two fresh CABG's. Both on neo one on dobutrex. I ran like a maniac all night long!!!!!

2 is the norm in pittsburgh, but I left a hospital that was pushing for 4 ICU pt's including vents, too risky!!!

Here in Arkansas we have a max at mos tof the hospitals of two. Starts becoming too risky with additional patients. At the hospital where I work even teh stepdown has a limit of three patients per nurse.

Demoking

We are have 1:1 ratio most of the time for ventilated patients.

Fresh CABG's are 1:1 for the first four hours, at least...longer if unstable. Our normal load is two patients, wether ventilated or not; so you may have two vented patients, or two unvented patients. Rarely do we have a three patient load, but it does happen when staffing is inadequate.

There are other situations for 1:1...IABP and CRRT, for example.

dndixie...I would be putting in my resignation if something like that was pushed upon me. I just don't think it is in the best interest of the patient.

The most patients we can have is 3.... and depending on the patient load, it's very possible to be assigned 3 vent patients.

Our fresh hearts are 'supposed' to be 1:1 for the first 6 hours, but that's not always the case, especially if the heart comes close to shift change. Balloon pumps, prisma, etc.... patients are supposed to also be 1:1.... again, not always the case. It really just depends on what's going on with those patients on whether or not they'll get doubled up, or even tripled.

Level I traumas ideally should be 1:1 as well....especially if they're really unstable.

I think our charge RNs do a really good job of distributing our patients in the safest manner possible, and they even take on a patient if they need to.... and that may not sound like a sacrifice, and I can't speak for days but at night ...... they thoroughly check all the charts and make lists for the nurses on what they think the patients need ordered/dc'd ..... very nice on those nights when you're so busy, the most you get time to do is take a quick peek at the H&P and recent orders/labs..... we're also always on trauma call....and they help out around the unit, doing whatever anyone needs them to help with.....

My favorite nights are 2-3 stable ventilator patients that are all on Norcuron/Morphine/Versed drips.

I also rather enjoy one very unstable patient on lots and lots of drips..... blood products, etc....

My hospital is slightly unique in that although we are a pediatric facility, our unit (he burn unit) takes adults, pretty much the only one in house, however the extra percautions and extra careful policies in place because of the pediatric atmoshpere carries over to us. In the burn unit a vent pt is considered a 1:1 nursing special, that nurse has no other pts, and must stay within visual contact of the pt unless relieved. If theya re trached they chage to a 1:2 and visual contact does not have to remain in place. In our PICU if a pt is on a vent and is a chronic and stable kid they may also be a 1:2, my mother worked in a large well known hospital in this area and the load was 3, though she ended up with 4 on ocassion, she left there!