So I tried posting this in the CA forum, but didn't get a single response. I was reading that Kaiser EDs in CA have a 1:3 ratio in place and am curious if it's honored. From my understanding, the patient assignment decreases from there if you have ICU pts. I'm trying to understand how they honor that if you're super busy and one of your 3 becomes a unit player. Do they actually remove a pt from your assignment and give it to another nurse?! Do they just have a float cover your other people until you get the ICU pt up to the unit? What's the deal?
There are a bunch of Kaiser facilities across the state of CA, it would be impossible to know what goes on in each facility. I'm sure some departments would and others won't honor a 3:1 ratio. It's impossible to answer that question.
In typical EDs outside of California, this kind of shuffling happens all the time. So yes, it would be possible to have your assignment shifted around to accommodate acuity. It goes with the territory.
I'm specifically curious about Kaiser Zion in San Diego...
I guess it's just hard for me to fathom. I've only worked at one hospital and I don't really see the assignments getting shifted around to accommodate for acuity. I've carried 3 unstable unit players on a 5 pt assignment before. Where I'm at, IF you're lucky enough to have a float nurse to help, it's usually just a brief thing for an IV or meds, but you're still the primary nurse. They don't really reassign. Is that standard? The idea of only having a 3 pt assignment seems like a walk in the park compared to what I'm used to, so much so that I'm having a hard time believing it's real. I guess I'm just hoping that somewhere out there someone is reading this that has experience with Kaiser in San Diego and is kind enough to share their experience.
I work at a Kaiser ED and our ratios are thus:
2:1 ICU (unless you have pressors, then it becomes 1:1)
1:1 titrating q5min (pressors or eclampsia)
I can't remember what the ratio is for 3:1.
Depending on who the charge is, you may continue taking the majority of your patients, or you may be asked to just the ICU patient as you know the patient the best.
Last edit by Kuriin on Oct 29
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