Nurse to patient ratios - page 2
I am interested in knowing how units like mine staff the assignments. I am in a 26 bed cardiac interventional unit. Our main patient population consists of post PTCA/Stent patients, with and... Read More
Oct 13, '02Our unit is similiar, we are a 33 bed unit that is postinterventional. However, we also see MIs, CHF, and tele. We check the ACTs, and pull the sheaths on the floor. We also get post-op day 1 open hearts on occassion. Our policy is to have 7 nurses on the floor, and one charge nurse. However, that can change because 5 of those beds need to be kept open at all times for emergency PTCI(except when full with PTCI). I t equals out to about 4-5 and sometimes 6 pt apiece. We run integrilin, tridil, heparin, dopamine and dobutamine(titrating both), reopro, lidocaine, cardizem, and procanimide on a daily basis for most.
Nov 24, '02We have 6 pts per RN on our tele floor, most days I literally never sit down and often skip lunch. Any more than that would be insane. I am considering transferring to another unit because I think its unsafe. But I like tele ... not sure what to do.
Jan 7, '03Stella,
it sounds like your unit is a CCU, with the exception of not having the advanced technology close at hand, nor having the privledge of having 1-2 pts per nurse.
Your unit sounds complicated and would make me very nervous working it with 4-6 pts!
Apr 17, '03our tele unit outside of my CCU takes between 5-7 each. One or two RN's the rest LPN's. I really feel for them because it is at time unsafe. I try to keep an open line of communicaiton with them & walk out to check on the patients if they are going bad, make room for those crashing, even where we are so busy. I applaude the telemetry nurses!
Apr 25, '03Our telemetry floor has 36 beds and we get patients back after sheaths are pulled with sytec dsgs in place. We hang drips and we also have chemical rapid detox patients on telemetry (usual stay 48 hours). Our ratios with CNA is usually 8:1 - no CNA 5-6:1. The detox patients are usually 4:1. I hate direct admits from the Dr's office, they haven't been assessed, nothing initiated - you start from scratch, which can eat up all your time.
Apr 25, '03I don't work on tele but have a very close friend who does. Nights has 10-12 patients each, usually 1 moniter tech and 1 aide. No pressor drips are allowed outside the icu in our hospital.
Keep in mind we are the largest cardiac hospital in the area, yet the in no cath lab after noon saturday till mondya morning. We have the highest death rate in the country for post cardiac surgeries, we are about 5-10 years behind the rest of the country. Gee I wonder why soo many patients die. Nowhere in the hospital does accuity mean anything, not on the floor, not in the ICU's, nowhere. They just look at bodies.
Apr 25, '03Having worked on several tele/stepdown floors, I'll chip in my $.02 worth. One hospital where I was staff for about 6 years, our tele floors were 34 beds. The one floor which took the post-interventional patients with lines (about 8-10 beds designated for this purpose) the nurses usually only had 2-3 patients (maybe 4 on nites but not 100% sure of this). The rest of the floor, which got all variety of cardiac patients (CP R/O MI, post MI, post pacer, post EP, post cath, etc, drug washouts, cardioversions) the ratios were 1-4 or 5 on days, 1-5 on evenings, and 1-6 or 7 on nites
As an agency nurse, I worked at one suburban hospital's Interventional unit on nites and had 4 patients (but days had 5! Go figure!). However, the one nite was sheer hell b/c I had one patient acutely stroking out (who should have been moved on evening shift :angryfire). Thank goodness for the staff there, they really pitched in and helped me out!
I applaud you, Stella, for sticking up for your staff. When are administrators going to understand that you have to staff by acuity and not just straight numbers?!?! Kewlnurse, I am frightened for your friend's license--10-12 patients at nite! (Totally unsafe in my opinion).
I hope this info helps all of you that are looking at your ratios. I love cardiac nursing but am looking forward to moving into advanced practice (which of course will have its own headaches) so I don't have to sweat nearly as much about my license being at risk
Apr 25, '03LLD sounds like yor floor was staffed like our ICU, man I gotta get out of here. Poor staffing is the norm not the exception.