ICU nurses, Is 3:1 patient to nurse ratio a common occurence or am I just tripping? - Page 5

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  1. Jan 27 by
    Quote from shakanurse
    You must be a nurse manager...There are vented pts (sick as hell) that are maxed out on pressors. Think about why they are on the vent b/f you speak...Dodongo...Aloha
    First of all, no, I'm not a manager. Second of all, the poster said that a pt on a vent, regardless of anything else going on with the pt, was 1:1. I have never heard of this. If this were the case then almost every pt in my ICU would be 1:1. Like I said, acuity of pts is a huge factor. Last night I had 2 vented pts. One was maxed on dopamine and close with dobutamine. Receiving blood products constantly. The other was rewarming from hypothermia on amio, lido and neo, and would probably be placed on CRRT today. Then he would be 1:1. Again, simply being on a vent should not make a pt 1:1. That would make some step down patients at my hospital 1:1.
  2. Jan 27 by
    Septic shock+Titrating ALL pressors+VENT+Swan=1:1. Again, think about why they are on the vent...Not just because they are on the vent.
  3. Jan 27 by
    Quote from shakanurse
    Septic shock+Titrating ALL pressors+VENT+Swan=1:1. Again, think about why they are on the vent...Not just because they are on the vent.
    This sounds like a normal ICU patient... What's your point? I've had plenty of patients in a shock state, pressors, swans and on the vent. They were not 1:1. Still 2:1.
    Good Morning, Gil likes this.
  4. Jan 27 by
    Quote from Dodongo
    This sounds like a normal ICU patient... What's your point? I've had plenty of patients in a shock state, pressors, swans and on the vent. They were not 1:1. Still 2:1.
    I completely agree. I work in a mixed MICU/CCU (just like you according to your profile) and shock, pressors, IABPs, vents are totally common and are not considered criteria for 1:1. (Swans make things easier btw, i love them) Stable vents, stable pressors etc aren't even necessarily criteria for ICU, just step down. This is ICU nursing at a large academic hospital. My hospital has over 1600 beds. People from states away are transferred there. If other hospitals cant fix them - they come to us. If we can't fix them - they go to heaven.
  5. Jan 27 by
    at my hospital, a level 1. ours is either 2:1 or 1:1 if on CRRT
  6. Jan 27 by
    Point--How are you going to help your "other pt." that is swimming in sh*t when your are titrating gtts every minute for 12 hours??
  7. Jan 27 by
    Quote from shakanurse
    Point--How are you going to help your "other pt." that is swimming in sh*t when your are titrating gtts every minute for 12 hours??
    Hundreds and hundreds of critical care RNs manage it everyday they go to work - myself included. You're busy every second of your shift. We have computers on the wall in all of our patients rooms so I usually do my charting in one of my patients rooms. The monitors show you what's happening in your other patients room so if you gotta go do something you go do it. We have clinicians and 2 charges covering so if you need help then you ask (or call the RIC nurse).
  8. Jan 27 by
    Not every facility has the luxury that you have. So, there are true 1:1 ICU pts "on the vent" somewhere...
  9. Jan 28 by
    Quote from shakanurse
    Point--How are you going to help your "other pt." that is swimming in sh*t when your are titrating gtts every minute for 12 hours??
    *** No big deal. Standard even. BTW you shouldn't be titrating gtts every minute. Get a fecal containment system for the other patient, I like Flexi Seal.
  10. Jan 28 by
    Quote from IndiCRNA
    *** No big deal. Standard even. BTW you shouldn't be titrating gtts every minute. Get a fecal containment system for the other patient, I like Flexi Seal.
    This. All of it. It is standard. Although if you don't flush those flexi seals often enough - explosions can occur.