Cvvhd - page 7

Our manager is trying to convince us that a patient on CVVHD is not a 1:1 patient. This therapy requiers constant monitoring and calculation changes. Usually they are not very stable, or they could... Read More

  1. by   LadyNASDAQ
    Quote from dv8rn
    Our manager is trying to convince us that a patient on CVVHD is not a 1:1 patient. This therapy requiers constant monitoring and calculation changes. Usually they are not very stable, or they could have regular dialysis. Are any of you doing this in your ICU's? Are they 1:1?
    When the mistakes are made due to a 2:1 ratio, how will the NM be able to defend herself in court? This is a very dangerous role and you will have to keep a log on paper every time this ratio is instituted. In your nurse meetings, make it clear that you will include this log in any patient mistakes that you or your co-workers face from then on. You must get a petition going to be sure that no Nurse is found liable for any mistakes due to unreasonable working conditions. I would also send this to the BON because it will affect your license if you are held accountable because you could not physically do your job safely and accurately.
  2. by   99redballoons
    Wow. I worked in the ICUs of a large teaching facility where the staff always has 2 patients (balloon pumps, Prisma, even an ECMO pt!) ICU RN responsible for setting up Prisma, troubleshooting, etc.) Consider yourselves lucky!!
  3. by   nurse_ane
    and in my wonderful ICU, I had a cvvhd pt who had to be started on insulin drip, tube feeds, and blood transfusions (nevermind the lab draws, EKGs, and regular pt care). Yep, all on my shift. Did I say I had another patient, who was postop day 2 (thankfully stable), but on isolation for TB, and had to be tranferred out?! I don't know how I made it out of the unit after 12 hours!!!
  4. by   noelia23RN
    That's crazy especially if this is the norm!
  5. by   TigerGalLE
    I had a CRRT patient last week and I had 2 other patients. The patient was stable but on CRRT for an aspirin overdose. We ending up discontinuing his CRRT treatment around noon, thank God. I have never worked so hard in my life.

    That day I started out with 2 patients (1 on CRRT, 1 septic GVHD with multi-system organ failure on xigris). Then at 0800 I got a rapid response from the floor that needed 2 units PRBCs, 2 units of Platelets, and a levo drip.
  6. by   nurse_ane
    sometimes you wish you had 10 hands and 10 eyes all working at the same time. I don't mind being busy, but hate the paper work at the end of it all!!!
  7. by   tsicuRN1
    On our floor we NEVER have 1:1 patients and we run crrt a lot. The only exception would be if our patient was on cvvhd waiting for a transplant, the day they get the transplant we go to OR with them to run the machine. But other than that, its always 1:2 and on top of that we never get a free floating charge either! They have at least one, sometimes 2 patients as well. Its a madhouse sometimes!
  8. by   mmutk
    We do our's 1:1, it's all about safety and competence. I have worked at other hospitals though with a big disconect between managers and the patient's acuity.

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