Nurse: Patient ratios - page 2

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... Read More

  1. by   SICU Queen
    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.
  2. by   Brownms46
    Beaumount, Tx...ICU 3 & 4:1....given to traveler LVN. !!! Staff mostly new Rns..!

    Where's that WalMart apron......gimme..
  3. by   shygirl
    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.
  4. by   Brownms46
    gilda are you saying...that including the CNA ....and the nurses...the ratio is 28:1???
  5. by   shygirl
    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.
  6. by   Brownms46
    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..!!
  7. by   shygirl
    Brownms46, Ok, I will not complain any more. Fifty or 100 residents!!?? OMG!
    I thought my ratio was totally unfair. Thanks, Gilda
  8. by   JimB
    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. 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 . 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
  9. by   burt
    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!!!
  10. by   mattsmom81
    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.<sigh>

    We don't do bilateral vents or CVVHD at my little midcities community hospital so guess I feel lucky there, Burt. It sounds scary.
  11. by   zambezi
    In our CCU, standard is 2:1, for fresh open hearts or unstable pts 1:1, hearts can be doubled if stable and/or after they are extubated, sooner if we are short staffed...frequently we have two second day hearts if stable (though not the ideal pair) IABPS /CRRTs are 1:1...last night we did have some 3:1 due to short staffing but we try hard not to have to do that, the only time we 3:1 pts is if they are overflows from the stepdown unit or we are short...
  12. by   kewlnurse
    Our ICU is cardiac and medical combined, usually 3:1, almost never 1:1, only occasionally on days. Our SICU has way better staffing usually never more than 2:1. Acuity means absolutly nothing in our system
  13. by   Going80INA55
    When I did the unit, it was 2:1 ratio. Fresh hearts where 1:1 until they were extubated or stable. Rarely, we did 3:1 if the patients were very stable.

    However, even given good ratios, good benefits, the best pay in the area, a very supportive MD staff, flex schedules, a choice of 6, 8, 12 hour shifts and managers who try their best to be supportive (most are the type who will get out their and get their hands dirty) the nurses still leave in droves.
    So, what is up with this?

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