[interleukin]

Someone should get up the courage to tell the Magnet Certification people that your ICU is regularly 3:1 and details about your ID restrictions.

No proper ICU that cares about patient outcomes will staff that way...no matter what the "budget" dictates. Maybe it's time to reassess the "budget."

And you're right, all these awards are, in large part, tailored for a win.

Your infection rate may be due to the fact that the nurses are too overloaded and are not likely to practice good hand washing because they're too busy running from room to room.

Do you actually care for three sick vented patients during your shift?

[lisacammel]

Yes, I agree that someone should notify the magnet council. Nurses think the status is just a joke; it means nothing. I don't usually have 3 vents, unless they are all long term gomers. I could have 2 vents and an overdose, or other benign patient. Or I could have one bad vent/sepsis with pressors, one long term vent, plus whatever ER throws at me as pt number 3. I swear we're not paid enough!
They have yet to find the source of our bug, but I have a hard time believing it is due to the nurses--the infection control nurse is on the unit constantly and running to the unit director if someone so much as hangs a gown on the doorknob while running to get insulin or whatever. It is very strict isolation, unless you are a visitor, lol. People hang out at the desk in their gown and gloves waiting to flag down a nurse, despite being educated 2-3 times!

[bfjworr]

Our standard ratio is 1:2 for our 12 bed unit.... but if there is an in house code or an RRT which involves an ICU transfer we have to flex up..... Our ER has had to hold ICU patients because of lack of nurses in the ICU.... I don't know what the best answer is but I Know that putting more stress on the ICU nurses is not it..... It's definitely a pt safety issue

[scarymary]

I work in the UK on a general ICU. We currently have one to one nursing for level 3 patients. On the HDU where I used to work we had one nurse to two patients, even if they were unstable and needed lots of input.

[Reno1978]

1 RN to 2 patients. I haven't seen it deviate from that in the 6 months I've worked in the unit. I work a mixed MICU/SICU.

[parko]

All "ICU" patients are 1:1. All "HDU" patients will be 1:2 (what constitutes ICU and HDU is another story) ALL ventilated pt's are 1:1. Always.

Staffing here (like any ward) is an issue but we deal with it as best we can. We do overtime (only if we want to) and have an on-call roster to help cover retrievals. If we cant staff the unit, Nursing Admin will get us staff (sometimes very reluctantly!) or some poor bugger from the ward will get flicked up to us. The casuals/ward staff will have HDU patients and core ICU staff will staff your vents/critically ill patients.

That being said, I work in a public hospital in a regional area in Australia, a very different system to that of the US (from my understanding). Our Management do give a damn (they know its on their head if we cant staff). Just last night (while i was doing my arvo/night double!) i had to forward a call onto the Team Leader from an irate anaesthetist who accused her of putting patients lives in danger by not having a bed for a post-op, and subsequently tried to lecture her on the state of the health care service. Do the maths mate, all 12 beds full = no more space for anyone. We ended up having to push a pt that wasn't really wardable up to the wards at 3am to get this post-op (now you tell me that accepting that ICU patient and therefore pushing the "ward" pt out isn't putting their life at risk?)

needless to say, i don't ever see myself entering into management

[jedimasterr]

Like most folks here have said, our ratio is one nurse to two ICU patients. Open hearts are one to one for a certain length of time. On the step down telly unit, the ratio is one nurse to four patients but they do have some help on that floor from the techs for vitals and accuchecks which are Q4H as opposed to our Q1H vitals. When the hospital is full and we can't transfer patients, we are expected to follow the protocols of the unit the patient should be on, and this can be a drag when you have four step down patients and no assistance like you do on the telly floor. Luckily, our unit is very team oriented and you are not left to hang when it comes to cleaning patients. That said, it is still a lot more work than would be expected otherwise.

Overall, I think our unit is safe. However, there are times you get stuck and can't get more help. So far I have seen nothing that indicates to me the unit manager or the hospital are OK with just "stuffing" the ICU nurses. For the most part though, we are expected to float to any unit except the ER and as you would expect just about no one likes that. Someday, we will have eICU and due to my experiences in another field prior to nursing, I have nothing but suspicion toward how eICU will be used. I can certainly see them using it someday to be that perceived "extra" help that allows patient ratios to climb. I have nothing to back this claim up right now so that is admittedly speculation on my part.

[oneillk1]

Originally Posted by Natef26

I know typically ICU nurses get 2 patients standard. I'm curious how it is on your MICU unit?

At my hospital I would conservatively estimate that a good number of the MICU staff have 3 patients 65-70% of the time.Staffing is generally the pits.

We get 1:1 ventilated, sometimes 2:1 unventilated, sometimes 3:2 unventilated or even 1:2 if the patient is really sick (that is patient : nurse)


The only time we ever have more than 1 ventilated patient is when the nurse next door is on a break.

In saying this, we don't have techs, we do everything ourselves

[cardiacRN2006]

Originally Posted by oneillk1

We get 1:1 ventilated, sometimes 2:1 unventilated, sometimes 3:2 unventilated or even 1:2 if the patient is really sick (that is patient : nurse)


The only time we ever have more than 1 ventilated patient is when the nurse next door is on a break.

In saying this, we don't have techs, we do everything ourselves

WOW~! We don't have techs either, but the only reason for a 1:1 is impending code...

Why only 1:1 for ventilated patients? I find them to be the easiest...

[Sister S]

In Australia if a patient is on invasive ventilation then they have 1:1 - like the UK I think.