Nurse Patient Ratio on Telemetry with Drips

[KaroSnowQueen]

Our N/P ratio has been 1:6 forever. We are a telemetry med-surg unit.

Now they are wanting us to take drips and are sending all the nurses to a class to learn about the drips (Amiodorone, Cardizem, Dobutamine, etc). But our ratio has been increased to 1:7!!! We all are feeling very nervous about this and often feel overwhelmed with regular patients, let alone taking on some potentially unstable pts on Cardiac drips.

What are the ratios in this situation on your units?

PS "They" are saying our ratio was ALWAYS supposed to be 1:7, but in reality this has come about by them turning several private rooms on our unit into semi privates and just not increasing the number of nurses accordingly - we did gain one nurse but we really need two. And didn't increase the CNAs at all.

[geekgolightly, BSN, RN]

ratio is 1:4 days and 1:5 or 6 nights.

[LeahJet, ASN, RN]

I've worked in a few tele units over the years and it was 1:4 with titrates at one hosp. in Indianapolis... and in other ones, in other states, it was 1:6 with NO titrates.

[brianaerrn]

The cardiac telemetry floor I worked on had a ratio of 1:3 on days and 1:4 at night. Only one aide for the entire floor though.

[AtlantaRN, RN]

I am on a stepdown unit, and we are 1:4 ratio with dobutamine, nitroglycerine, dopamine, cardizem, natrecor drips...

regular floor med/surg is 1:6 ratio with NO drips...(although I did work at a facility that you could hang natrecor as long as it wasn't being titrated)

linda

[toadie]

i work in the unit so i don't have first hand experience but i work with many nurses who just transferred from step down into the unit. they say that they had 6-7 pt on telemetry. a pt who is on vasoactive gtt can only go to step down if they are semi stable, meaning the previous nurse has not had to titrate much. the thing that concerns me would be the vitals. at our facility a pt with vasoactive gtts, regardless of where they are or how often they are being titrated must have vitals charted every twenty minutes for the duration of the drip. that makes for quite a bit more work if normal vitals are Q1H or Q4H.

[Nella]

I worked a telemetry floor with a ratio of 1:6 on nights, maybe 8 years ago. Almost every patient had heparin, dobutamine, dopamine drips going. Renal doses. We had limits on what we could give on the floor. Cross that line and the Pt had to go to ICU/CCU.

[DutchgirlRN, ASN, RN]

Get together with the other nurses and present a united front. You know in your gut that an increase in the patient acuity and pt number is unsafe. Request that this new plan be presented to the nurses in full , for everyone to disscus. If the nurses stand together , they may re think this plan.

Very good idea! We have Telemetry on our floor and our ratio is 6:1 tops, usually 5:1. We do have dopamine drips but not the others, they have to be in the unit. I would not take that many patients. I think 6 are too many considering those drips. It's not worth your license.

[MQ Edna]

I work on a cardiac telemetry floor and we take gtts like Cardizem, Amiodorone, Integrilin, Heparin, Lidocaine, etc....most our patients aren't on anything other than Cardizem or Heparin but we do take post stents right after the sheath is pulled, we take post heart caths, we prep CABG pt's and take them 1 day post op w/ chest tubes and temporary PM's.

Our ratio is 1:4-5 on both days and nights, with 2 tech's. Every one of our patients is on telemetry monitors, and the pt's on drips are on telemons at the bedside.

Occasionally nights will only have 1 tech. If we have 2 techs the techs draw all the blood. One tech, nurse's draw blood.

I would NOT take over 5 patients on the tele floor, EVEN if none of them were on drips! That is rediculous! When I float to med/surg, oncology, etc occasionally I'll take more than 5 but not by choice.

I WOULD GET OUT!!!! 7 patients, forget it! you might as well hang that license out on the line!!!

[HappyNurse2005, RN]

I'm on a cardiac surgery pcu, which is obviously telemetry. we get other pt's who need telemetry, too. So we have 1 day post op cabg pts, valve replacements, thoracic surgery pt's, cath's, stents, etc etc.

We get Amio, Cardizem, Heparin, Insulin, Dobutamine, Dopamine, Integrilin drips, etc. Can't do nitro drips on PCU, though. No titrating, really, except for the Heparin/insulin

[HappyNurse2005, RN]

oh, duh. ratios. We hve 1:4on days, not uncommon to have 1:3, occasionally 1:5 on days. Never 1:6.

Nights can do 1:6.