Nurse: Patient ratios

  1. 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.
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  2. 55 Comments

  3. by   BadBird
    Wow 2:1 I remember those days, now it seems 3:1 is common and when pushed due to shortages of nurses 4:1
  4. by   wendyssmile
    I work in combination CCU/CTICU the ratio is 2:1 or 1:1. Post-op hearts are 1:1 initially and sick patients, patients with devices are 1:1. We never have 3:1 rthe charge RN takes an assignment first and then we would call management.
  5. by   Stormy
    I work in a CCU/ICU combined unit. Most vents/unstable patients are 1:1, most cardiacs are 2:1, sometimes 3:1.
  6. by   SICU Queen
    I work in a Surgical ICU, our ratio is 2:1, fresh hearts are 1:1 for 12 hours or until extubated and stable. In the Medical ICU they often have 3:1. I HATE working up there. It's often not safe. I guess their cardiologists don't stand up for them like our surgeons do for us. They also resent us and our better staffing TREMENDOUSLY. We hear about it all the time, and they try to get the supervisor to admit inapporpriate patients to our unit because our staffing is better than theirs.

    It can get very ugly. But for the life of me I can't understand why they think a known MRSA patient from a long term care facility with pneumonia and multiple decubs is appropriate for a 6 bed open unit that has new CABGs and other surgeries? This happened a few weeks ago. I thought the surgeons were going to blow a gasket...
  7. by   RNforLongTime
    I just started working in a 8 bed ICU/CCU and our max patient load is 2 patients per RN. One RN will never have more than one person on a vent. We usually distribute the workload fairly.
  8. by   pghfoxfan
    I work in a CVICU/CCU...Our fresh hearts are 1:1 for 3 hours unless terribly unstable. The only other 1:1 patient is a patient on CVVHD. Mostly we are 2:1 and occasionally CCU patients that are stable are 3:1. Of course when we are crunched with staffing the charge nurse has patiens and the assignments are 3:1.
  9. by   pebbles
    Originally posted by SICU Queen
    I guess their cardiologists don't stand up for them like our surgeons do for us.
    A telling remark if I ever heard one....
    Sad that we need *doctors* to fight for adequate *nursing* care...

  10. by   blueskatkimmy
    I , too, am sick and tired of the nurse patient ratios of 1:3. we nurses are somewhat at fault, because we continue to enable this dysfunctional system. We don't have the "power" or guts to say "NO", SO WE CONTINUE TO "RISE TO THE OCCASSION". Well, the more we "rise to the occassion" the more it becomes the norm and expected. what's next, 4 patients?? Yes!!! I have heard this is a trend. God help us nurses and the patients! and nobody can figure out why there is a nursing shortage, DUH!!! And God forbid, us nurses be supportive of each other. We function like a classic "adult Children of alcoholic" family of enablers. We don't like it if one of our co-workers brings attention to the problem. so, we belittle the skills of the nurse who complained and say SHE IS THE PROBLEM!!! Well, she doesn't know how to prioritize!! Or we act like classic victims with NO power and say, "Well, what can we do about it".
  11. by   susanmary
    ICU 2:1 usually; if very tenuous then 1:1. SDICU 3:1.
    Last edit by susanmary on Jun 10, '02
  12. by   blueskatkimmy
    (cont) we need to start standing up and saying NO!! The hospitals and managers aren't looking out for our nursing licenses. When i accept that pt, i am responsible and i'm putting my license on the line---administration doesn't care. All they do is support the budget. Well, my license supports my budget and puts food on my table, so i have to take care of myself. Incidents reports are good for reporting unsafe conditions--do we do it? No, we'll be labeled as the trouble-makers. I've decided i would rather lose the job than to lose my license, cause i can always get another job! They just don't GET IT-- sometimes the workload is IMPOSSIBLE--IT CAN'T BE DONE!!! Then if you are really lucky, you get that nasty 'ole nurse to follow you who rolls her eyes and starts stomping around and huffing and puffing because you had to leave things undone. It's a no-win situation!!! We need to give each other a BREAK!!!! So, as i drag my bedraggled butt home after 12 hours of pure frustration and rage from trying to do the impossible, i wave good-bye to the CEO, AS HE DRIVES OFF IN HIS JAGUAR. You know the one, the one that keeps telling you that that hospital is broke and may have to close down in 2yrs, so we need to tighten our belts and they need to lay off staff or there will be no raises this year!!!! I'M NOT STUPID!! I can see the incongruencies and lies. What drives me crazy is that many nurses don't. WHY??? I think they are just caught up in the whole system of denial and enabling and helplessness. Do any of you nurses out there also see this??? disillusioned!!
  13. by   live4today
    1:1 open heart until they were transferred to the cardiac unit; and 2:1 SICU regular patients. It wasn't the staffing that bothered me in SICU. It was the "death sound" all around me that ran me out of there. ANY ICU unit is just not for me. Hats off to you wonderful ICU nurses out there! :kiss
  14. by   Zee_RN
    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.

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