Just curious; Would this pt be one-on-one in your ICU?

  1. Septic, vented, Swann-Ganz, Q1hr peak airway pressures, Q2hr blood sugars, Q6hr CBC/lytes/lactc acid/ABG's plus PRN labs making it more like q2-4hr labs, gastric tonometry with Q1hr PgCO2 readings and Q6 PgPi/Ph readings,Q4hr CVP readings, to OR and back for debridement of necrotic pancreas, on Versed drip, etc, etc..Nurse with < 6 months ICU experience. Also got an admission. Is this alot, or is it just me?Just curious...
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  2. 45 Comments

  3. by   LilgirlRN
    I would think that would be a one on one anywhere. For someone with limited experience...sounds like the nurse would need a hand too.
  4. by   kewlnurse
    no such thing as 1 on 1 in our units.
  5. by   bestblondRN
    That patient would definitely be 1:1 in my unit unless the sky fell in!
  6. by   VickyRN
    Unfortunately, would NOT be 1 on 1 in our unit. We are staffed 2 pts/RN. So, the "other, more stable" pt would be sort of neglected during the shift (just being honest, we do the best we can, but can't be in two rooms at the same time). We have a floating charge nurse who (undoubtedly) would "float" here for much of the shift. Also, great team members who would assist with the "one on one" and neglected pt #2.
  7. by   mattsmom81
    No, it wouldn't qualify for 1:1 in mine unless there was massive hemodynamic instability requiring frequent titrating of vasoactives or pt was close to 'coding'. We can only keep our fresh hearts 1:1 for 4 hours unless we can show they are extremely unstable. Even IABP does not automatically mean 1:1 anymore.....
  8. by   codebluechic
    No, this patient would not be 1:1. The only time we have 1:1 is with a very unstable pt on multiple drips.
  9. by   JMP
    Every patient in our ICU is one to one UNLESS they are a step down material patient waiting for a bed, which can often happen and then, ONLY then would you be doubled.

    NEVER have I seen a vent pt doubled, just does not happen..... I work in a Canadian ICU and a STRONG union is present. Our health care system has problems, but it is great overall.
  10. by   Zee_RN
    Nope. Not one-on-one. No doubt would paired up with a patient with lower acuity but the only two one-on-one's I have ever seen are (1) 84-year-old woman with VERY active, spurting arterial bleed from femoral artery and (2) {my personal favorite} a 36-year-old man with a PRIAPISM.
  11. by   hoolahan
    Wow JMP never leave that place!! In the olden days, yes the pt would have been one to one, but the reality is more like what matsmom said, and even so with the IABP pts now too in the places I've worked in the last few years. It's the reason I stay out of the hospitals to do OT now, I just sign up for more HH OT, where my pt's are always one-to-one, at least while I'm in their home!
  12. by   mother/babyRN
    No one to ones (even the ones that should be) in our units, BUT a more experienced nurse should have had that patient, in my opinion...Were they ALL like that? Was someone helping at all? Seems like a real train wreck especially for a new person. You must be a wonderful nurse..That patient was fortunate to have you....
  13. by   dawngloves
    Even though that's a very busy patient and you are new, if that patient is stable, he will not be 1:1where I come from. Pared with a less acute/busy pt, yes.
  14. by   catlady
    When I first worked in ICU 15 years ago, that patient definitely would have been "specialed." The last time I worked in ICU two years ago, the same patient would have been part of a 1:2 or 1:3 nurse/patient ratio.

    Maybe that's why I gave up ICU nursing.

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