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

*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  FlorenceNtheMachine profile page
    0
    Quote from imaginations
    I believe this is the norm in Australia, in all critical care units for adults, children and neonates.
    I think what I've picked up on, is in other countries, they use fewer restraints and less sedation with vents. I would want a vented pt 1:1 if I didn't have propofol and fentanyl.
  2. Visit  FlorenceNtheMachine profile page
    0
    Actually strike that, I would want EVERY patient of mine to be 1:1! How fantastic would that be?
  3. Visit  LadyFree28 profile page
    0
    Quote from FlorenceNtheMachine
    Actually strike that, I would want EVERY patient of mine to be 1:1! How fantastic would that be?
    Less out of work and burned-flamed out nurses
  4. Visit  edmia profile page
    0
    Quote from FlorenceNtheMachine
    Actually strike that, I would want EVERY patient of mine to be 1:1! How fantastic would that be?
    Yes, it sounds like a dream come true! I would love to be able to have a 1:1.

    Last time I had 3, I felt completely pulled and didn't accomplish good care on any one of them. Thankfully, all were stable ICU pts... If that's ever a possibility.

    Sent from my iPhone using allnurses.com
  5. Visit  IndiCRNA profile page
    3
    i have ran epi @ 999...
    You are saying you have run epi at 1L/hour? What was the concentration? What were titrating every min at that rate?

    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...
    Uh, OK, if you say so.

    FMS is ONLY for loose stool.
    Patient is swimming in sh*t
    FMS are only for loose stools? Thank you for the education. However I thought the description you chose of "swimming" indicated loose stools. I think swimming in solid matter would be difficult.
    qaqueen, mmutk, and tamadrummer like this.
  6. Visit  shakanurse profile page
    0
    Quote from IndiCRNA
    You are saying you have run epi at 1L/hour? What was the concentration? What were titrating every min at that rate?



    Uh, OK, if you say so.





    FMS are only for loose stools? Thank you for the education. However I thought the description you chose of "swimming" indicated loose stools. I think swimming in solid matter would be difficult.
    It was a code while having 3 pts. So, I didn't know the ratio/proportion...The ED doc said to slam it...The L bag was alreay made. SOME CRNA's think they know it all...Last post from me to you...Aloha
    Last edit by shakanurse on Jan 29, '13 : Reason: ERROR
  7. Visit  imaginations profile page
    0
    Quote from FlorenceNtheMachine
    I think what I've picked up on, is in other countries, they use fewer restraints and less sedation with vents. I would want a vented pt 1:1 if I didn't have propofol and fentanyl.
    Too true. We nurse patients as awake as tolerable. We do not leave them out of sight, ever.
  8. Visit  tothc2 profile page
    1
    So in other countries they either have about twice as many RNs as we do in the states or they have half as many ICU beds available. How the hospitals can eat the costs of that many employees or that few patients is beyond me. And epi at 1L/hr?? We use one concentration at my hospital 16mg/250ml with a "preferred" dosage range of 0.1-0.15 mcg/kg/min. You can go pretty high above these parameters, and I have, but I am also generally getting another pressor to hang along with it... And how did you program the pump or know how to titrate if you didn't know the conc? That is a bit scary.
    PMFB-RN likes this.
  9. Visit  sapphire18 profile page
    0
    Yeah also I know the reasoning for wanting patients as least sedated as possible, but it seems kind of cruel. Do you never paralyze patients? Or have patients so sick that they need to be knocked out for patient/vent disynchrony?
  10. Visit  Dodongo profile page
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    I agree with everything IndiCRNA and Tothc2 are saying here. Voices of reason. Talking to some of these other posters is like
  11. Visit  IndiCRNA profile page
    0
    It was a code while having 3 pts. So, I didn't know the ratio/proportion...The ED doc said to slam it...The L bag was alreay made.
    The Epi was in a liter bag!!!!? You didn't know the concentration of the medication you gave in a code? How did you document how much you gave on the code sheet?
  12. Visit  imaginations profile page
    0
    Quote from sapphire18
    Yeah also I know the reasoning for wanting patients as least sedated as possible, but it seems kind of cruel. Do you never paralyze patients? Or have patients so sick that they need to be knocked out for patient/vent disynchrony?
    Absolutely we do.

    All newly tubed/vented patients begin on a fairly standard infusion combination of morph/midaz and we go from there (i.e. increase and add other drugs [usually precedex for sedation, ketamine for pain and vallergen, choral hydrate and diazepaem down NG tubes once feed are started for sedation purposes] or decrease as tolerable (e.g. kids that are older and have been on the vent a while/are tolerating it -- we've had kids sitting up and painting on the vent).

    We paralyse kids where appropriate (newly placed traches are the main ones).
  13. Visit  shakanurse profile page
    0
    Quote from IndiCRNA
    The Epi was in a liter bag!!!!? You didn't know the concentration of the medication you gave in a code? How did you document how much you gave on the code sheet?
    I am thinking 8 mg/1000 mL of D5 (years ago this happened). Pharm made the bag, should I call them and ask the concentration?? The MD was running the code. And, I was not charting on the code sheet...I slammed the epi (as ordered) and was doing compressions and checking for a pulse after all ACLS efforts were done. Pt died. Are you happy now??

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