RN to Pt ratio-- Stepdown

[RNMomma22]

What is your nurse to patient ratio on your stepdown unit?

[NurseyPoo7]

3-4:1

[Nurse SMS, MSN, RN]

What I was told when hired? 3:1 with occasional 4

What happens in reality? ALWAYS 4:1 with occasional 5

NOT safe.

[Do-over, ASN, RN]

4-5 on days (I usually got 5), 4-6 on nights (I almost never stayed at 4 all night).

We did not have vents or many drips, but I still felt 5 was too much for dayshift.

[VANurse2010]

I don't consider 4:1 on stepdown unsafe per se, but all step-downs are not created equally! Some are ICU-like - others are basically just telemetry units.

[DoeRN]

Worked at one hospital where is was 6:1 with titrating drips. Didn't stay too long at that hospital. I was in management there and felt terrible about the staffing ratios.

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[Nurse Kyles, BSN, RN]

There is a maximum of 3:1. My unit does not take any vented patients.

[Do-over, ASN, RN]

There is a maximum of 3:1. My unit does not take any vented patients.

That sounds almost too good to be true. Is there a catch?

[MunoRN, RN]

"step down" has various meanings depending on the facility. A true "step down" level of care is between ICU level care, and progressive care/telemetry level of care, although many facilities have nothing in between ICU (1:1 or 1:2) ratios and progressive care which might have a 4:1 to 6:1 or even 7:1 ratio depending on their patient population.

If by "step down", you're referring to drips, but not pressors, post open heart patients usually POD 1 or 2, active infarctions, 'heavy' floor patients, no vents, then that is more of progressive care, which is usually 4:1 with heavier patients, or 5:1 or 6:1 if at least a couple of them are "walkie-talkies". Of course Nurse to patient ratios mean very different things depending on the level of CNA and other support.

[Nurse Kyles, BSN, RN]

If by "step down", you're referring to drips, but not pressors, post open heart patients usually POD 1 or 2, active infarctions, 'heavy' floor patients, no vents, then that is more of progressive care, which is usually 4:1 with heavier patients, or 5:1 or 6:1 if at least a couple of them are "walkie-talkies". Of course Nurse to patient ratios mean very different things depending on the level of CNA and other support.

This is the type of patients that my unit gets. We do get open-heart patients as soon as POD 1. We pull a lot of sheaths. We run gtts but no pressors. My unit is called a Progressive care unit. We always have a 3:1 ratio on days, PMs and NOCs. Days and PMs each aid has 9-10 patients. On NOCs each aid has 15 patients. If a nurse has even one PCU patient, they cannot have more than two "floor overflow" patients. My unit is split PCU/tele & the max ratio for a regular tele nurse is 6:1 NOCs and 5:1 days/PMs.

[VANurse2010]

This is the type of patients that my unit gets. We do get open-heart patients as soon as POD 1. We pull a lot of sheaths. We run gtts but no pressors. My unit is called a Progressive care unit. We always have a 3:1 ratio on days, PMs and NOCs. Days and PMs each aid has 9-10 patients. On NOCs each aid has 15 patients. If a nurse has even one PCU patient, they cannot have more than two "floor overflow" patients. My unit is split PCU/tele & the max ratio for a regular tele nurse is 6:1 NOCs and 5:1 days/PMs.

I wish I worked on a unit like this. It sounds like appropriate PCU level care and staffing. My unit is basically just medical telemetry. We are usually 5:1 but can and often do go to 6:1. Ratios are the same 0700-1900 and 1900-0700

[applewhitern, BSN, RN]

Ours is 4:1. I worked it for 5 years, with no nursing assistant. It was horrible. I never sat down, ate, or anything else. I am back in ICU now, and believe it or not, the patients are much easier to take care of in ICU.