ICU nurses, Is 3:1 patient to nurse ratio a common occurence or am I just tripping? - page 4

*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... Read More

  1. Visit  shakanurse profile page
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    I am GLAD you are doing well! Congrats for getting through nursing school, as well as getting a job you want! Don't let exp nurses step on you and make you do their work. They will do it. It happened to me...I was an ER tech b/f and couldn't say no at first...Watch out for the "lazy ones". I "grind" me teeth every day knowing that when I go into work, I will have a crap assignment. You can always say "no" if they give you 3 sick pts b/f you take on the assignment.

    Best of luck to you [COLOR=#003366]LadyFree28!! Aloha
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  3. Visit  Dodongo profile page
    0
    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.
  4. Visit  shakanurse profile page
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    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.
  5. Visit  Dodongo profile page
    2
    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.
  6. Visit  tothc2 profile page
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    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.
  7. Visit  bagola22 profile page
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    at my hospital, a level 1. ours is either 2:1 or 1:1 if on CRRT
  8. Visit  shakanurse profile page
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    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??
  9. Visit  tothc2 profile page
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    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).
  10. Visit  shakanurse profile page
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    Not every facility has the luxury that you have. So, there are true 1:1 ICU pts "on the vent" somewhere...
  11. Visit  IndiCRNA profile page
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    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.
  12. Visit  Dodongo profile page
    0
    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.
  13. Visit  shakanurse profile page
    0
    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.
    Yeah...Every single minute is a bit excessive (my bad), but i have ran epi @ 999...Takes time for gtts to take affect. But, Nipride is a differnt story. This drug is a must after CT surgery. And, it does take a lot of time to get to where you want to be...

    FMS is ONLY for loose stool.
  14. Visit  LadyFree28 profile page
    1
    Quote from shakanurse
    Not every facility has the luxury that you have. So, there are true 1:1 ICU pts "on the vent" somewhere...
    ^True, not every facility has the up-to-date technology or resources. The OP may not have these resources, thus their concern and start for this thread...I'm learning from this post...post on!

    And thanks shakanurse...BTW...my thick skin ways are still in place
    shakanurse likes this.


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