Nurse: Patient ratios

Specialties MICU

Published

Hi,

I was wondering what kind of nurse: patient ratios you have in the ICU. Here in NM we try to stick to 2:1 (1:1 for the very ill), but I have also worked in TX where we routinely had 3:1 and in Baltimore where is was even worse! I would love to hear about the staffing in your state and units, especially with such shortages of ICU nurses. Thanks.

Specializes in Hospice, Critical Care.

2:1 in our community hospital ICU, for the most part. On bad days, it may be 3:1 but that will be carefully moderated--maybe an ICU patient and 2 that should be transferred out (whether it's actually ordered or not is another thing).

There's a community hospital in our area trying to change their ICU ratio to 4:1. That's time to walk-out, IMHO.

Specializes in SICU.

OMG! 4:1?? That's absolutely disgusting. How do these a$$holes think we can properly care for critically ill patients 4 at a time?

I'm going back to school to get a degree in Computer Science or something non-medical. Nursing SUCKS.

Specializes in Everything except surgery.

Beaumount, Tx...ICU 3 & 4:1....given to traveler LVN. :eek:!!! Staff mostly new Rns..:eek:!

Where's that WalMart apron......gimme..:p

You guys are not going to believe this...I work in a nursing home. The ratio here is...are you ready....28:1! Can you believe this? I know that ICU is more challenging but many days many of them need much more than a med pass.

Specializes in Everything except surgery.

gilda are you saying...that including the CNA ....and the nurses...the ratio is 28:1???

Brownms46,

That is exactly what I'm saying. There are 6 nurses and each of us has this ratio (28:1). There are 3 CNA's also on each hall.

Specializes in Everything except surgery.

gilda

Now for LTC...that is a great ratio, compared to having 50 or more residents to each nurse. Or nurses on this board who had said they over 100 residents..:eek:!!

Brownms46, Ok, I will not complain any more. Fifty or 100 residents!!?? OMG!

I thought :chair: my ratio was totally unfair. Thanks, Gilda

Here in Vegas, we have 2:1 max. Usually 1:1 on first day post op, at least until extubated, unless that is delayed. One of the hospitals combined its ICU and IMC. So you might have one critical care patient and two IMC patients. Or four IMC patients. AS for myself I don't trust any administrative hirarchy to not abuse that one, so I don't work there. :eek: As for other units, I realize how lucky I am so far, when I was an LPN agency nurse I worked at one Catholic nursing home in Maryland where there I passed meds to 150 patients on two floors. I would get report when I got in, set up to pass meds, started passing meds for the first med period. This would be one hour before the scheduled time, finish an hour after the scheduled time, and then have to set up right away for the next scheduled med time. You finished just in time to go home:o . I took assignment with them exactly twice, and never went back for another assignment. If agencies were more dependable here, I would be working in another one.

Jimb

At my hosp in Dallas, we routinely have 2 patients each with a floating charge nurse. This is a surgical, trauma, neuro, OB ICU. Lately, things have been extremely busy with acuity sky high. We have had several patients who should have automatically been 1:1 because of CVVHD, multi gtts (8-10) double lumen ETT with bilateral vents, etc. Management would place an "easy" patient next to one of these very sick patients. Needless to say, the easy patient got very little critical care-we were lucky nothing bad happened. Most of the time we do a great job with the staffing situation we are given and mgt. counts on it. It takes a nurse with guts to stand up and say no, I will not accept such an unsafe assignment. Of course, that nurse always gets labeled and we hear such statements as "all the other nurses were able to handle the assignment, why can't you" I am so sick of seeing fellow nurses made to feel bad, inadequate, etc. I will always stand up and say no to any unsafe assignment given to me and support such a stand in others. We should not let ourselves be forced to put patients or our nursing licenses at risk!!!

At my hosp in Dallas, we routinely have 2 patients each with a floating charge nurse. This is a surgical, trauma, neuro, OB ICU. Lately, things have been extremely busy with acuity sky high. We have had several patients who should have automatically been 1:1 because of CVVHD, multi gtts (8-10) double lumen ETT with bilateral vents, etc. Management would place an "easy" patient next to one of these very sick patients. Needless to say, the easy patient got very little critical care-we were lucky nothing bad happened. Most of the time we do a great job with the staffing situation we are given and mgt. counts on it. It takes a nurse with guts to stand up and say no, I will not accept such an unsafe assignment. Of course, that nurse always gets labeled and we hear such statements as "all the other nurses were able to handle the assignment, why can't you" I am so sick of seeing fellow nurses made to feel bad, inadequate, etc. I will always stand up and say no to any unsafe assignment given to me and support such a stand in others. We should not let ourselves be forced to put patients or our nursing licenses at risk!!!

Used to be wiggle worm patients on balloon pumps were 1:1, fresh hearts, and anyone unstable or the promise of it. Not anymore. As was mentioned, managers pair up the time consuming patient with a less ill patient who will get precious little attention.

We don't do bilateral vents or CVVHD at my little midcities community hospital so guess I feel lucky there, Burt. It sounds scary. :(

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