How is your ICU staffing done?

Specialties MICU

Published

With recent budget cuts we are going to an acuity based staffing matrix. Rather than having the straight 2 patients to 1 nurse ratio we are being asked to take 3-4 ICU patients. I work at a small ICU at a community hospital, and I will admit some of the patients we have are floor patients with overly cautious physicians. How do you all staff the ICU? Common 2:1 ratio? Acuity? For those that do acuity based staffing, how are patients assigned?

Specializes in MICU - CCRN, IR, Vascular Surgery.

I work in a 30 bed ICU and staffing has been terrible lately. I can't remember the last shift where there wasn't at least 1 triple if not 2 on the floor, and these aren't triples with pts who are getting ready to move out either. I already know that we're 4-5 nurses short tonight, and I've already worked my 3, so tonight is an extra shift. Can't wait...

We're supposed to only have 2, but if they're really bad, we will go 1:1.

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Specializes in SICU, trauma, neuro.
Not only do we have normal ICU stuff to do (I.e. Neuro checks Q1H, full assessments Q2H, turning and all that jazz) but as a night shifter we are also responsible for giving everyone baths.

Not cool. :no: As to the bath and night shifter issue: on the night shift we do baths on sedated pt's only. (Unless someone is hugely incontinent of stool, or wakes up on their own at 0500 and we have the time.) But if they are awake, we've gotten away from doing unnecessary cares overnight to let them get as much sleep as possible in an ICU and decrease the risk of delirium. We also got the times for routine a.m. X-rays and venipunctures/ABGs changed from 0200 to 0500-0600, also to decrease middle-of-night disturbances.

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Specializes in Critical care.

Our CABG patients are 1:1 for the first 12-24 hours. Everyone else is 2:1, but we end up with three patients a piece all the time on night shift due to staffing issues.

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Specializes in Quality, Cardiac Stepdown, MICU.

If you find you have a lot of PCU acuity pts in the ICU, have a PCU nurse floated up to your unit to take care of them.

I worked in a hospital as a PCU nurse where any pt with a chest tube had to go to the ICU (long story), so there were a lot of non-ICU pts in the ICU. Nearly every shift a PCU nurse would go up there, take a least 3, and "babysit" the PCU pts. They were never given drips or vents, just pts either waiting for transfer or of lower acuity who had to stay in the unit for other reasons. This freed up the unit nurses to give actual ICU care to the sick pts.

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