Re: patient ratio
I started off in Florida with the 7:1 same nightmare. I ran...fast and far away. Got a per diem at a magnet hospital in Florida and that was 4-5:1.
Currently, I am in California with state mandated ratios based on acuity... and have never had more than 4:1 on tele/pcu.
Where I work now we have
52 beds with multi gtts that titrate to parameters.
We do LVADS, and 12 hour post op hearts with chest tubes and wires and keep them until discharge...
and of course we get all of the little old ladies that have any history of afib or HTN... : ) until we go on diversion...then granny gets transferred. We get post angios but the intervention caths go to the CVIU. We don't pull lines on my unit.
We have a 'war room' with dedicated monitor techs.
No LVNs, but our NAs have 13 patients on days and 15 on nights.
We have 1-2 secretaries depending on the time of day (paper charting/orders...ugh). A charge nurse at all times... with no patients. An IV team, a Lift team and from 1330-2200 we have a resource nurse for breaks and admissions.
The best part... we have dedicated open heart education nurses that work directly for our surgeons that are awesome! They go with the surgeon for informed consent, and stay to talk with the families. They update the families during the procedure. They round on the patients daily after... and best of all they do 100% of the discharge teaching. It's a beautiful thing!
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