Nurse Patient Ratio on Telemetry with Drips

  1. 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.
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  2. 21 Comments

  3. by   steelcityrn
    To me that does not sound safe. To even have 7 patients on a monitor is bad enough. People can crash fast on drips. Opens the door for alot more errors. How the heck are you going to watch that many people? How many times are you going to have to run in and answer iv alarms? How about the need for asst with bed pans while they are on drips. I can think about alot more, and am sure you have also. This is your hospitals answer to making more money, and not caring about the risks involved to the patient or staff. You need to form a group and go to the adm. together. Good luck, if this happens I hope you can handle it all.


    P.S. about the ratios....when I used to work med surg and it was a monitored unit, we never had more than 3 monitors....days had 5-6 patients total, eve 7-8 and nights was up to 11 patients! and one aide between 3 r.n.'s . Its not wonder nurses are leaving in droves out of the hospital!
    Last edit by steelcityrn on Mar 12, '05
  4. by   medicrnohio
    That sounds very unsafe. I work on a cardiac telemetry floor and our ratio is 1:4. We take drips but they have to fall within our guidelines or they go to ICU. Talk to your manager or someone.
  5. by   mdfog10
    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.
  6. by   lee1
    You need to go to the library and look up the state hospital guidelines. In NJ if the floor is telemtry the highest ratio allowed is 1:6. Other states might have similar guidelines.
    Also complain to any and all of your administrators. Are you a magnet hospital?? When they see people leaving or transferring it should give them a clue, but many times that of course is not the answer especially to those who live nearby.
  7. by   blue chips
    Quote from lee1
    You need to go to the library and look up the state hospital guidelines. In NJ if the floor is telemtry the highest ratio allowed is 1:6. Other states might have similar guidelines.
    Also complain to any and all of your administrators. Are you a magnet hospital?? When they see people leaving or transferring it should give them a clue, but many times that of course is not the answer especially to those who live nearby.
    FIND ANOTHER JOB. :angryfire :angryfire
  8. by   nrsjo
    Our staff takes 4-6 on days and pms and 8 patients on nights. Not all patients are on drips, but can be. They are all monitored. No drips, other than heparin, are titrated up. It makes for very hectic shifts if you happen to have patients with unstable rhythms, because unless they are hemodynamically unstable, they do not go to ICU. We have a lot of patients with AICD's, PPM's, fresh caths, etc.
  9. by   mogiee
    I work on a telemetry unit, not all are patients are on drips, but a majority of them are. Ratio on days 1:5 Nights 1:7
    Days 4 nurses 4 aides one clinical supervisor
    Nights 3-4 nurses, no aides.
  10. by   Sonny276
    Quote from 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.
    These people are asking you to take a great risk. We have two units that are similar but the ratio is 1:4 and they are limited to having a NTG drip only and only under special circumstances. Circumstances such as not enough patiens for a full 1:4 load or an additional nurse is called in for a one on one with the drip patient. I suggest you all stand togeather and ask the higher ups which one of them is going to take the heat when the patient dies because of their greed.
  11. by   UM Review RN
    Well, that's our usual ratio on nights, with an aide. Thing is, we don't titrate. So suppose a patient is on a Cardizem drip, running at 5 mg/hr. If his HR goes to <60 and sustains or his BP drops, we stop the drip and call the doc. If the patient then needs to be titrated, the patient is sent to the Unit.

    We even occasionally do insulin drips, but even one patient on that q1h accucheck protocol has us begging to send the patient to the Unit because the patient is simply too labor-intensive to really keep an eye on along with our other patients. So we don't find that one very often.

    But the other poster who noted that not all patients will be on a drip is correct. I had someone on a Cardizem drip and another on a 3% saline gtt the other night--guess which one scared me the most?

    The hypertonic saline, of course.
    Last edit by UM Review RN on Mar 13, '05 : Reason: fixed a typo
  12. by   lee1
    AGAIN, know what your state regs are and don't let them take advantage of you !!! THEY can be reported to the state labor boards
  13. by   rstewart
    Quote from Angie O'Plasty, RN
    .............which one scared me the most?

    The hypoertonic saline, of course.


    Yup yup....those hypoertonic solutions are tricky. You just never know what they are gonna do.
  14. by   geekgolightly
    ratio is 1:4 days and 1:5 or 6 nights.

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