[Artemis2]

I posted this in the General nursing discussion forum yesterday but I wanted to make sure I tapped the wisdom of this group so I am posting it here too. Thanks for taking a look....

I have been hired to help with transitioning a med-surg unit into an Intermediate Care Unit and I could use the help of the nursing community. This is not a cardiac strpdown (we have one of those) but a stepdown from the general ICU's. Our floor already has a pulmonary focus so I am anticipating a lot of trachs, CPAP/BIPAP and the occasional vent. I'm curious, though,....

How many beds do you have?
What is your nurse-patient ratio? Does it change on the night shift?
Do you use nurses aids or techs? How many per shift?
What does your patient population look like? What kind of diagnoses?
Private or semi private? Bedside monitor or tele?

Thanks for your insight. I need to educate and prepare my staff for what is to come as well as educate and prepare administration about how to do it right...if you know what I mean.

[Cat84]

HI,

We have 18 beds
2:1 ratio with occasional singles or triples it doesn't change at night
1 aide per shift
Lots of COPD, CHF.DKA, surgical, stroke, sepsis, ETOH/Drug withdrawl, lots of vents,lots of drips (everything but ventricular drains, and PA caths)
Semi (2 beds) 4 bed rooms, and privates (iso)
Bedside monitor (NO EXCEPTIONS)

Hope this helps,
CAT

[Artemis2]

Thanks Cat, this is exactly the kind of information I am looking for. Anyone else want to chime in?

[dorie43rn]

We have nice MSU, (intermediate ICU). They are single large rooms with bedside monitors. With all the technology in this world, I sure do wish they would come up with wireless bedside monitors. Anyway.....
We have a 9 bed unit. Sadly, usually there is only one tech between the ICU and MSU. You really need a tech just for your unit. We have a 3-1 nurse patient ratio. Only Rn's, but our hospital is starting to hear our crys, and with the nurse shortage, are starting to use "ALS" aids. They are between a nurse and tech. They are a big help. Our patients are alot of the elderly whose familys can't let them go, like the 99 y/o on a vent because the family wanted her to last to see her 100th birthday, no lie. Also, just like anyone elses, overdoses, pancreatits, sepsis, etc. I work the ICU, and MSU, and there are times when our MSU patients are worse then the ICU patients!

Hope this helps,

Doris

[Christie RN2006]

We have an ICU and a step-down unit in the surgical wing. The ICU is 10 beds and we get a lot of traumas, critical surgical patients, neuro (stroke, hemorrhage, etc), respiratory issues (copd, chf, resp failure, etc on vents), CRRT, and I can't forget the oh so lovely attempted suicides... my favorite are the death row inmates that attempt suicide (NOT!!!). The only patients we can't take are balloon pump patients.

Our step-down unit is 15 beds (all private rooms) and they cannot take suicide precautions, A-lines, ventric drains, titrating drips, or ETT. They can take trach patients that are on vents.

Nurse to patient ratios depend on staffing levels and they attempt to keep those constant between nights and days. In the ICU it is generally 1-2 patients per RN and if staffing is really tight they will give an RN 3 patients with an LPN. On step-down RNs will have anywhere from 2-3 patients alone and up to 6 with an LPN.

They try to place either a PCA or LPN in the unit as a "help all" and one PCA on step-down that is in charge of vitals, blood sugars, baths, etc.

In the ICU all patients are on bedside monitors that are linked into a main computer at the nurses station where we can monitor everything (HR, BP, A-line, ICP, etc) On step-down the patients are on tele and if they are having problems we will leave them hooked up to a portable bp and pulse ox with the alarms turned on.

[Artemis2]

Thanks everyone. I am writing a proposal as we speak advocating a lower nurse-patient ratio than has been previously discussd, more equipment and all private rooms. You all are giving me plenty to go on. I'll be working on this for the next few days so anyone else that wants to add their description of what their unit is like please jump in.