pt/nurse ratio?

  1. What are the pt/nurse ratios at you facilities? I am a recent grad in MICU/SICU and feel like I have been "thrown to the wolves." I have been having three critical patients a night, actual "ICU" pts, vents...multiple gtts, ventrics ect. Is this the norm nation wide, or are we just being hung out to dry?
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  2. 17 Comments

  3. by   sway
    Thrown to the wolves, as far as I can tell.
  4. by   PJMommy
    Quote from sway
    Thrown to the wolves, as far as I can tell.
    Yep.
  5. by   are-in
    2 patients only, 1 if they are critically-critically ill.
    Quote from emsboss
    What are the pt/nurse ratios at you facilities? I am a recent grad in MICU/SICU and feel like I have been "thrown to the wolves." I have been having three critical patients a night, actual "ICU" pts, vents...multiple gtts, ventrics ect. Is this the norm nation wide, or are we just being hung out to dry?
  6. by   Melody1968
    Quote from emsboss
    What are the pt/nurse ratios at you facilities? I am a recent grad in MICU/SICU and feel like I have been "thrown to the wolves." I have been having three critical patients a night, actual "ICU" pts, vents...multiple gtts, ventrics ect. Is this the norm nation wide, or are we just being hung out to dry?
    Thrown to hungry wolves!!!
  7. by   HillaryC
    Quote from are-in
    2 patients only, 1 if they are critically-critically ill.
    Same in my SICU. I recently transferred from Surgical IMC, where they tried to have us just have two patients on days because they were so heavy -- but we always got short-staffed. Three was a nightmare. I really feel for you. Can you change hospitals?
  8. by   pricklypear
    Quote from emsboss
    What are the pt/nurse ratios at you facilities? I am a recent grad in MICU/SICU and feel like I have been "thrown to the wolves." I have been having three critical patients a night, actual "ICU" pts, vents...multiple gtts, ventrics ect. Is this the norm nation wide, or are we just being hung out to dry?
    It varies a lot in our unit. Having 3 vents on gtts and unstable has not happened to me where I am. Even having 2 highly unstable patients is rare - and usually happens because the one that was stable became unstable suddenly.

    I work in a smallish community hospital, so we frequently have patients in ICU who don't need to be there. But we also do open hearts, and any other thing that may come along except neuro. That makes it easier to spread the fun around a bit. Some of the larger hospital ICUs have ONLY critical patients. So everybody gets shafted.

    I feel for you You are going to burn out quickly.
  9. by   sway
    The worst part of it all is that as a licenced provider, you are the one legally responsible for providing a specific standard of care. If something ever came to litigation, you would be responsible for your actions (or lack thereof), even if we all know it would have been impossible for you to have been in 3 places at once. Does that make sense? The hospital may also bear some liability, but you will not be able to get out from under the liability by saying 'the assignment was unreasonable'...if you accept it you're responsible!! Basically, you're being set up to possibly fail so the hospital can save some money. Do you have a union? If not, remember that when bad things happen, the hospital has millions of dollars to spend on fancy legal teams to protect itself. Will they stand behind you??

    Do all you coworkers see this situation as no big deal? I know there are many different nursing models, so if you have people (techs) doing all your baths, blood glucoses, turns, etc. I could maybe see taking 3 critical patients. Personally, I've never worked anywhere that assigned more than 2pts/nurse, unless they have transfer orders or are post stent.

    Protect your license and livelyhood...be careful!!!
  10. by   pricklypear
    Quote from sway
    Protect your license and livelyhood...be careful!!!
    Hospitals have so many "outs" these days it's pitiful. There have been 2 lawsuits in my area suing the hospital for short-staffing which led to inattentive nursing errors. The nurses involved were not named except as witnesses. Hopefully, people will become more aware that the hospital is the root of the problem (usually) when something happens. In the meantime, I won't accept assignments I feel are unsafe. I've only had to refuse a couple of times.
  11. by   LCRN
    Quote from pricklypear
    Hospitals have so many "outs" these days it's pitiful. There have been 2 lawsuits in my area suing the hospital for short-staffing which led to inattentive nursing errors. The nurses involved were not named except as witnesses. Hopefully, people will become more aware that the hospital is the root of the problem (usually) when something happens. In the meantime, I won't accept assignments I feel are unsafe. I've only had to refuse a couple of times.
    I work at a moderately large teaching hospital. We have both a MICU and SICU, all the RN's have to be cross trained and able to take any patient that enters including fresh traumas, CABG's, Neuro cases...etc...Although we just expanded and went from 18---->30 beds between the combined units we are always trying to push patients out to get new ones in. Our ratio is 1:2 now since we expanded but prior to we had to take 3 patients. Our step-down floors take some pressors, cardizem, dobutamine and are able to take transvenous pacers as well, so some might even consider the step-down patients "critical".

    We did graphs on ventilator assisted pneumonia/decubitus ulcers/cvc infections and found that there was a direct correlation with increasing patient ratios, which in turn costs the hospital more money to care for and increased lengh of stay for patients causing disatisfaction. Ultimately we don't "triple" our assignments anymore.

    If the patient's are really "critically" ill, you need to advocate for them by going to management and expressing how unacceptable it is. Also as mentioned before your license in on the line when you assume responsibility and care of these patient assignments.

    Good Luck
  12. by   sway
    Quote from LCRN

    We did graphs on ventilator assisted pneumonia/decubitus ulcers/cvc infections and found that there was a direct correlation with increasing patient ratios, which in turn costs the hospital more money to care for and increased lengh of stay for patients causing disatisfaction. Ultimately we don't "triple" our assignments anymore.



    Good Luck
    Can you copy and paste your research results here? That's very interesting. Does anyone know of any other nursing research that shows a correlation between staffing and outcome? Some people at work are of the opinion that taking 3 patients is no big deal, and I'd like to prove otherwise.
  13. by   LCRN
    Quote from sway
    Can you copy and paste your research results here? That's very interesting. Does anyone know of any other nursing research that shows a correlation between staffing and outcome? Some people at work are of the opinion that taking 3 patients is no big deal, and I'd like to prove otherwise.
    Sway-It will take a bit of time because I have to request the analysis from administration and as you know dealing with management always tends to take a while. Once I get the info I'll post it for you!
  14. by   emsboss
    Thanx for the responses...SORRY it took so long to answer... Administration is "aware" of the problem...we have had 3 nurses resign in the last week...we are probably going to have to shut down one of our units (8 beds). This will help the nurse/patient ratio...For a while . I can only hope things get better.

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