Patient ratios progressive care units - page 2
by kaylasmommy | 15,350 Views | 22 Comments
I work on a progressive care unit which had a pt:RN ratio of 3:1 when I started 3 years ago and now we are moving to 4:1 ratios now. The facility/mgmt has stated that 4:1 is the national standard for progressive care units now. ... Read More
- 0Mar 19, '13 by kalanel5Wow I am a cardiac nurse by no means an I work on a neurosciences med-surg floor. We get post heart cath patients on bed rest, titration drips such as heparin, insulin and cardizem. We are usually running with 5-6 patients at night with 2-3 techs for 32 patients. We too can't keep nurses. I am appalled that we take care of similar patients that you guys do but you all are in ICU's and stepdown units. We also get patients post pacemaker placement.
- 0Mar 23, '13 by kylee_adnsI work on a split cardiology/PCU unit with 15 beds of each. Our PCU has open heart patients as soon as 1st day post op. Drips like cardizem, amio, nitro, dopamine, integrilin, angiomax. We run Lots of heparin gtts and a moderate amount of insulin gtts, but those gtts can be ran on the cardiology floor too. We have heart cath patients & pull (way too many) sheaths. We have a criteria policy we follow for PCU. Certain gtts are not allowed & invasive ventilation isn't either. Acuity varies from day to day.
We have a strict 3:1 ratio in PCU on all shifts. If an RN even has 1 PCU patient they can not have more than 2 other floor patients. The cardiology ratios are 4-5:1 on days & PMs & up to 6:1 on NOC shift.
After reading all the PCU ratios you guys are saying, I am feeling much more grateful! 3:1 is good! Sometimes we like to whine since the competing hospital in my city has a max of 2:1 in intermediate care. Oh & they don't have to pull sheaths in their IC either.
- 0Mar 26, '13 by JRDeeRNwe are 3:1 dealing with vascular, heart, lung and endocrine (thyroidectomy) patients. as well as overflow ER patients... i honestly dont see how I could manage a 4:1 ratio with the work list i have with my patients. i was running around all day it seemed like today. barely enough time to eat lunch much less making sure every patient felt like they received the care they needed. luckily my unit is a very team oriented unit so that helps.
- 0Apr 2, '13 by tiffanyleigh0212i work on a step down unit. our floor has 42 pts with a ratio of 1:4 or 1:5. we are the only floor besides the ICUs that can take a vent pt. if we have a vent pt it's an automatic 1:4 ratio. we also take pts on aquadex, it is also a 1:4 ratio. then you have all your standard cardiac stuff. heart caths, ablations, cabgs, stemis, nstemis, chf, drips, bipaps, trachs, chest tubes, etc. our charge nurse takes 2 pts, so theyre not always able to help either. we have 1 CNA for the entire floor and monitor our own teles. we're extremely understaffed and are required 3 12's one week and then 4 12's the next week, then back to 3. in the past month we have had a total of 8 nurses leave between day shift and night shift. i'm just about at my point of looking for a new job as well.
i'm curious to know how the pay is set in other hospitals. do all of your RNs make relatively the same base pay, or does it differ depending on acuity of pts? ours is standard, so while were coding pts, other nurses are on other floors literally watching movies and making the same amount of money.
- 0Apr 17, '13 by Proverbs 16:3I work in a PCU in one teaching hospital and the ratio is 5-6, mostly 6. A lot of times, dayshift come in to 1:6 ratio. They've been trying to make it 5 at all times but it's not been working. It's so stressful, can't even take a break to eat or pee, just busy, busy, busy. The turnover is atrocious and I sucked it up for years. I started floating to the PCU at a large academic medical center and their ratio is 1:3max, phlebotomy comes around q2-3hrs to draw labs, much less stress and it's just wonderful. Obviously, I'm working less at my old job and I wonder why i'm still there each week I go there. Yes, my other job pays about $3 more than the regular staffers at my new place make but I've come to a point where I'd take less money if that eliminates the stress. The good part is I actually get time and half plus at the newer place since i'm float.
As others have said, all PCUs are not created equal. I say find a place where you can learn without the stress of task-focused care.
- 0Apr 23, '13 by ShillaBSNAfter reading this I feel like I was really robbed. The last time I worked on a Step down we had a day ratio of 1:6 and nights of 1:8. If one of the night nurses called out we had a ratio of 1:12, with one or two techs. We ran most of the drips I see above, heparin, lasix, cardizem and insulin. We also took the occasional vent. But almost always had at least a few trachs, bipaps etc on the floor.
- 0May 2, '13 by dandk1997RNI work intermediate cardiac care (a level below prog and above med surg) and we only get 4-5 on days, 5-6 on evenings, and 5-7 on nights. 4 on prog seems like too much to me, but I honestly don't know how many our prog nurses are taking. Now I feel like I should go ask them.
The techs are great when the pts' needs are things like toileting and food and tissues etc, but they are useless (no offense, it's just outside their scope of practice) when it comes to the drips/vents/etc you are describing- ours aren't even allowed to silence an IV alarm even if I am in the room and aware. TurnforthenurseRN's post describes my floor pretty well, but we don't do insulin gtts -ever- or titrated pressors. They can only go to ICU or CCU (but we do get other titratable drips.) We get bipap pts (no vents,) but they usually have a 1:1 sit. We don't get post-CABG pts, but we do get tons of post-cath and EP pts.
It sounds like there is a lot of crossover in the different descriptions of what we get on our units, and the staffing ratios are all over the place. But it does sound like the few differences between what I get and what you get are enough to make an extra patient seem like a bad idea. Best of luck to you!