0Oct 26, '08 by **LaurelRNhi everyone,
i was hoping to get some input about staffing ratio's. i work on a cardiac pcu. we have dopamine/dobutrex drips, cardizem, ntg, lidocaine and the like. we have no lpn's - a tele tech, unit secretary, and 2 techs for 24 pts or 3 techs if more than 30 pts. most days as a rn we are assigned 7 pts. i just feel so overwhelmed. i am a new nurse and just can't seem to wrap my head around 7 pts that are going for stress tests, direct admits, post surgical overflow sometimes, er admits, cath patients, and everything that goes into taking care of 7 patients. any ideas???
2Oct 26, '08 by MichifuraWow, and I thought the PCU where I work was bad!
I am in a cardio-thoracic surgical PCU so just like you we have drips, cabg pts with chest tubes and pacer wires, lung pts with chest tubes and pca pumps, s/p pacemakers/aicd placements, cath lab pts, etc.
Our unit has two pods each pod can hold 15 pts; we staff each pod with 1 NA, 1 HUS, and 4 Nurses (day and night). Three nurses get 4 patients and one nurse will be team leader and gets 3 patients and will act as the pod's go to nurse, does assignments as pts are being transferred in and assigns the night nurses, etc.
1Oct 27, '08 by smcabee4 to 1 Rn to patient ratio Max 5-1 on days and 5-1 max 6-1 on nights. NO exceptions unless absolutely necessary, we will hold patients or close beds if necessary. We normally have 2-3 techs and 1-2 us on days and 2 techs, 1 us on nights with a dedicated 3 team cct team.
I work in a 24 bed tele unit we take a little bit of everything except post surgical unless ther is absolutely no other room.Last edit by smcabee on Oct 27, '08
2Oct 27, '08 by SpatializedFirst thought? Run. Run away. 7 patients in that environment is not safe. Plain and simple, not safe.
In our IMCU we run 3:1 primary, no techs with much of the same stuff, plus we pull arterial and venous sheaths on post-intervention/angio folks. Our PCU runs 4:1 with 2 CNAs. One tele tech covers both units.
Our motto has become, "if they've got a heart, they come to us!"
1Oct 28, '08 by carrie13My unit has 25 tele beds and 6 PCU beds. Tele is a 4:1 ratio with 2 aides and 1-2 secretaries. PCU is a 3:1 ratio with 1 aide and no secretary although the tele secretary will help out if she has time. The PCU nurses also watch the monitors. There are 2 PCU nurses on every shift and each has to watch the monitors for their own 3 patients plus the monitors for half of the tele patients.
2Nov 5, '08 by ghostchiliQuote from SpatializedSeriously. 7:1 with multiple drips and what sounds like barely-stable cardiac patients? The most we have here is 4:1, and those are on the medicine & surgery stepdown units. ICU here is 1:1.First thought? Run. Run away. 7 patients in that environment is not safe. Plain and simple, not safe.
I agree with the quoted poster--run far away. :/
1Dec 2, '08 by ivorybunnyI work on a 52 unit bed cardiac monitoring floor. We can have drips as long as they are not titrated. We are 6:1 and only in emergency 7:1. At night we have 4 techs with 13pts a piece to help us. However, we have one monitor tech to watch 52 patients. And that makes me nervous at times.
1Dec 3, '08 by al7139Hi,
I am on a Telemetry/medicine unit (although we are primarily cardiac). On days and evenings we are at a 5-6:1 ratio with 4-6 NA. 2 monitors. We do not titrate drips based on protocols EXCEPT for Heparin drips, although we do have patients on Cardizem, Amio, Milrinone, Lasix, Integrilin, etc. They are stable, and titration based on protocol is not necessary, except for weight based changes.
Our PCU has a ratio of 4:1 and they do titrate and also have electrolyte replacement orders that they do. Our ICU has an ideal ratio of 2:1, with the occasional 3:1, and they also have their own monitor, MD, and do lots more with drip titration, etc, than any other unit.
Having floated to PCU and tasked in our ICU, I could not imagine having 7 patients with high risk drips that you need to titrate. I would be scared for my sanity (and my license!). I have been on my unit since I graduated last year, and still have days when I can't keep up, and we are a less acute unit.
Hopefully you have a good staff to go to for help, and if you don't consider a medsurg floor for a while to get your feet wet with less high risk patients.
1Dec 4, '08 by julzhereHmmm. Not a big fan of Florida anyway (no offense) and have no desire to work there, and seeing the nurse to patient ratio makes me realize another reason why I don't want to work there. Way to high and not safe, especially on a cardiac unit. Good luck to you RNs in Florida, and the patients too.