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

1. 
   Jan 28, '10

   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.
2. 
   Jan 29, '10

   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
3. 
   Jan 29, '10

   What's sad.......is 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!
4. 
   Jan 30, '10

   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...
5. 
   Jan 30, '10

   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...
6. 
   Feb 2, '10

   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.
7. 
   Jan 2, '13

   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.
8. 
   Jan 3, '13

   In my unit vents are 1:1. If census is low then HDU patients (stable, non-vented) are 1:1, if we're busy, one nurse will take two HDU patients, no more. Most other ICUs in the area are similar.
9. 
   Jan 3, '13

   Quote from imaginations

   In my unit vents are 1:1. If census is low then HDU patients (stable, non-vented) are 1:1, if we're busy, one nurse will take two HDU patients, no more. Most other ICUs in the area are similar.

   What is HDU?
10. 
    Jan 3, '13

    Quote from apocatastasis

    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...

    *** I don't understand why you and the nurses in your unit accept report on that 3rd patient? SHort of a huge emergency like a devistating snow storm or another 9/11 I won't take 3, even when I am sure I can handel it I don't want to set a precedence.
    That said now that I have escaped the Magnet hospital treadmill and got a job in a nice non Magnet union hospital it isn't an issue.
11. 
    Jan 3, '13

    Quote from sapphire18

    What is HDU?

    High dependency. Essentially a non-ventilated, stable patient that requires ICU monitoring/has the potential to go down hill
12. 
    Jan 3, '13

    Lately, it's being done more and more in our unit because they pull out staff to staff the other Icu. Just the other night, they took 2 of our RNs which caused our unit to work short. 3 Rns were tripled and our charge nurse had to take patients. We were told by management that We will have our RNs floated to help the other Icu out even if it means we have to work tripled😁 I think every person in our unit wishes there was someone/somewhere we can voice our concerns to. It's just not safe to have 3 especially if they are still on pressors or still intubated.
    But, we need our jobs, sooo....
13. 
    Jan 9, '13

    I work in an icu where the acuity is ridiculously high. I was doubled with one unstable patients and received a third critical patient. I have around a year of experience and was completely swamped and overwhelmed.1:3 is now the norm on my floor when really some of our pts require one to one care. Not being able to effectively manage the patient increases length of stay. Needless to say, I left in tears. You're definitely not alone.

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