staffing

  1. 0
    So i keep reading horror stories about crazy CVICU and CCU ratios. i work in california where the ratio is ALWAYS 1:2 or 1:1. are you really expected to take 3 patients in other states? also how long are your fresh hearts 1:1 for. some hospitals here are 8 hours, others 12-18 hours...

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  2. 18 Comments...

  3. 1
    Only 1:3 when they're not ventilated, walkie-talkie telemetry status patients (we d/c open hearts directly, and sometimes tele floors are full and we have to hold onto a tele patient for a shift). Can be a very busy shift, but it's usually low-risk overall.

    Fresh open hearts are 1:1 for 24 hrs. Sometimes, if they are in just really bad shape, they stay 1:1 for over 24 hrs. IABP are always 1:1. CRRT are always 1:1. And so forth.
    lindarn likes this.
  4. 1
    I'm in CA too & a lot of the time I can't imagine having 3 ICU status patients! I give all of you that do get 3 patients a lot of credit. Our fresh hearts are 1:1 usually for the shift they come out on & that night. After that it depends on how stable/unstable they are... usually 1:2. IABP/CRRT are always 1:1 on my unit.
    lindarn likes this.
  5. 1
    Fresh hearts are 1:1 till at least 3am. Usualy 1:1 until the morning of 1st day post op. IABP, CVVD, are always 1:1. Of course, all our VAD patients are 1:1- we don't do transplant, so a VAD patient is never a bridge to transplant but a salvage patient waiting to transfer to somewhere that does transplant. Our CCU is 1:1 or 1:2 depending on acuity. Our SICU/MICU is the same but can triple if there are floor patients without beds to transfer to. Our progressive units are at most 1:3.
    lindarn likes this.
  6. 1
    My manager feels a IABP can be tripled and they sometimes are.............and she has no idea what the care of an IABP entails and what could go wrong.. She is all about staffing #'s and not acuity!!!
    lindarn likes this.
  7. 1
    Quote from whynursing
    My manager feels a IABP can be tripled and they sometimes are.............and she has no idea what the care of an IABP entails and what could go wrong.. She is all about staffing #'s and not acuity!!!

    IABP tripled?? I can't even imagine! Yes, sometimes they are pretty "stable" but the thought of what can go wrong!
    lindarn likes this.
  8. 0
    I think it depends what setting you work in.

    I work in the STICU and we try to keep the ratio 1:2 as often as possible. Usually the only time we get tripled is if we have to make room for a trauma. The only patients that are mandatory 1:1 are liver tx for the first 24 hours. Our CRRT's are not 1:1.

    However I used to work in a community hospital ICU/CCU and 1:3 was the normal ratio.
  9. 0
    Yep. 3 patients all the time. Doesn't matter if there is IABP, CRRT, or vents. CABG, Valves, etc are "1:1" until extubated per the policy but it never happens.
  10. 1
    ok to the person who said their IABP's are tripled??? ***** how can you possibly assure the integrity of the pump and maintain correct timing with 2 pumps, nevermind 3??? your manager is an idiot and clearly wants people to die. I don't care what Datascope says about their new pumps , the timing i frequently off.
    lindarn likes this.
  11. 1
    I just can't understand how true ICU care can be provided to three patients by one nurse, even without IABP, CRRT, etc. How can you manage a vent, sedation, drips, and frequent assessments, much less charting and family updates/support on three critical patients? My experience is all NICU/PICU, so the population is different. But even the adult med/surg floors I did clinicals on were 3 or 4 to 1 on days.
    lindarn likes this.


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