ICU nurses, Is 3:1 patient to nurse ratio a common occurence or am I just tripping? - page 2

*I posted this in the new grads section but I also want to hear from the experienced nurses* Hi. I'm a relatively new nurse in a general ICU (we get a variety of patients). Considering the shortage of jobs for new nurses, I'm... Read More

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    I work in a general icu and we also have a stepdown unit. about 95% of the time i have 3 patients. Usually 1-2 are vents and 1 is a needy floor type patient. They are considering making the icu 1:3 ratio because they say we are honestly spoiled by having only 2 patients and that we can really handle 3. however, isn't that why its called an intensive care unit? stepdown usually has 1:3 and the telemetry floor 1:4-5. :S

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    I am also a new grad in the MICU. Our hospital gets tripled often enough. I have been off orientation for about 1 month and just last week, I was tripled for the first time. I would say that at least one of our units is tripled 5 out of the 7 days.
    mmutk likes this.
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    What kind of pts are we talking about?
    A walkie-talkie on Amio?
    Or CRRT, septic shock, IABP?
    I have had pts that were singled due to acuity, esp traumatic brain injuries and crrt. I have been tripled with a stable vent, a post cath MI, and a GI Bleed, or similar.
    Vespertinas likes this.
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    I was asked to take a travel position CCU 4:1, I laughed out loud, wasn't expecting that, said noooo to that, would not EVEN think about it.
    CrufflerJJ likes this.
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    We frequently get pre op cabg patients with IABP's... they can move very little so they are the frequent call buzzer offenders. Same thing is true with your swanned heart failures on high dobutamine and what not... buzz. So these are certainly not ready for step down and just documenting everything every hour for three of these guys plus meds assessing and turning.... yikes!

    We do tripple, we never have an open bed, there are always vents waiting in the ER... so if there is a call in... thats what happens
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    What's that our step-down is 10 beds and has the same ratio that the ICU does. 1:2 I want a job on step-down!
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    Don't usually see it, but aw it happen the other day...the nurse they gave the assignment to was agreeable, a very good and very experienced nurse, and the CM had her back...
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    We are supposed to be 1:1 or 1:2 in our ICU but more and more are 1:3 because our staff retention rates are terrible and nurses are leaving right and left... bad management... there was uproar in the unit when it was mentioned we may go to a 1:3 ratio even in non-extraordinary circumstances. In my opinion, it's just not safe.

    One of the other new nurses, fresh off a mere 3-4 months of orientation, got tripled... with 3 "stable patients." One was septic and crashed. The other went into respiratory failure and had to be intubated. And my friend cried because of how stressful it was. Not a great way to keep your staff, to put it mildly. You can never predict what an ICU patient is going to do, even if they're bound for transfer. We're all just waiting for a sentinel event from an overworked, tripled nurse...
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    I work in a community hospital, we are a mixed unit icu/ccu. 16 beds. Only on rare occasions do we have more than 2 patients. Maybe if you have 1 or both patients on transfer and you're only doing vitals q 4hrs. The only other time is to cover so you don't have to call the on-call person in 1 or 2hrs before the shift ends. In that instance we all pull together so pretty much everyone has that "3rd" patient. We don't do fancy stuff like IABP'S, we help insert them, then ship them out. But we do get pretty involved septic shocks, hypothermic protocols etcs.
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    apocatastasis, It is as if you work at my hospital. This is exactly what is happening at my facility and we are paying overtime daily. I pick-up extra shifts during the week and get overtime on a WOW program. I probably make 47 an hour. It is not worth the pay.

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