[New CCU RN]

We staff for 1:2 and for the most part that is how it works....we have a 14 bed CCU (seperate CSICU so generally no surgical pts). We have 7 RN's on every shift. Charge takes an assignment, another RN carries the code beeper. If pt is very unstable..... active GIBer that is getting scoped or fresh IABP we will do 1:1 and try and call in more staff but sometimes someone has to triple in order to let the other nurse go 1:1 with the unstable patient.

[New CCU RN]

PS we get tons of overflow all the time so we can get a micu, surgical-trauma, neuro, whatever...u name it we get it..... makes things interesting....

[AmiK25]

I work in a 20 bed Medical/Surgical ICU at a large teaching hospital with a level one trauma center. Barring an extreme emergency, we always have four patients who are 1:1 and 16 patients who are 1:2. It works out really well unless we have more than four patients on CVVH (only happended once that I know of). I don't remember anyone ever having to take three patients.

[nurse-lou]

I work in a 30 bed cardiovascular/trauma/surgical/cardiac ICU, we get a little bit of everything pretty much, TONS of MICU overflow! One has been here for TWO months today!

We've lost over 15 staff members since I started here 6 months ago. 3 pt assignments are becoming commonplace. We have 4 travellers here right now. One has 2 weeks left, one has 4 weeks left. NM has decided NOT to renew any of their contracts and a few of them had wanted to stay an extra month. Hospital management came up with a temporary fix that is STILL not helping! Things are going from bad to worse.

Our usual ratio is 2 pts to one RN. Unless the pt is an unstable IABP pt or on CRRT(CVVH) then those pts are a 1:1. Fresh post op open hearts are also 1:1 for the first 4-6 hours post op.

[BadBird]

I work agency in many ICU's, the standard is 1:2 but I quit working in one small community ICU that wanted us to take 4 pts! I will never forget that night, I had 2 on the ventilator, one that crashed and just was put on the vent then the admin. called and wanted me to take a fresh GI bleed, I said NO! Called my agency, told them I refuse the 4th and to cancel the remaining shifts I scheduled at that facility as I will never return there, funny thing is I work at the sister hospital and never have more than 2 pts. I think the smaller community hosps. get dumped on more.

[New CCU RN]

I think you may be right there Badbird....although I am only speaking from what i have seen..... so .. I could be wrong, but my hosp which is a larger teaching hosp generally unless it is absolutely impossible has a 2 pts to 1 RN. Sometimes when we have to go 1:1 someone has to triple, but it is rare...and the triple will usually be pts that are going out to stepdown...just waiting transport type deal.

However, some of the nurses i work with also do agency in addition to their job at the hosp I am at...and they have also said that at the smaller hosp generally they do have a a normal 3 pt to 1 RN ratio..... nuts. These are 3 unstable or potentially unstable pts.

[CougRN]

I work in a large teaching hospital in a 34 bed sicu/micu. We never take 1:3, mostly we have 1:2 and 1:1 depending on the patients acuity and staffing levels. I think the nurses here would run out screaming if they were ever asked to take 3 pts.

[HazelLPN]

I work in a 15 bed unit and most patients are on 1:2 care. It is fairly rare for us to have patients on 1:3 care as they can be taken care of on the floor. Open hearts are usually 2:1 for the first 4hrs and then 1:1 the remainder of the shift. New admissions are usually 1:1 for the first few hours of initial assessment, depending on acuity. The charge nurse takes no assignment. We usually do it with 7-8 RNs plus either an LPN or NT/NAII. The NTs and NAII do not take full assignments and are paired with an RN. They usually take 3 1:2 patients or a 1:1 with a 1:2. The LPN (I'm the only one) takes a full assignment covered by the charge nurse or can take a 2:1 with another staff RN. We also have one NAI per shift who takes no assignment but works under the direction of the charge nurse. There is usually one unit clerk or unit cleak specialist for all shfts.