by 2banurse

I was just curious at how busy your NICU is? What level? How is your staffing? Do you have a large turnover? Do you have a shortage in your NICU?

I realize that these are a lot of questions, but hey, that's what the board is for, right?

Kris

Let's see....we are a 50 bed unit, but have had more than that! We usually staff with a minimum of 14-16. We have also had staffing numbers as high as 18. Depends on census and acuity. We are a Level III, the only things we don't do are hearts and ECHMO, they get shipped out for that. We have our own transport team with a NICU nurse, fellow, RT and a flight nurse if going by air. We have a few open positions, but we are mostly short on aides that do the linen, garbage and stocking. We also can't keep a secretary on second shift for some reason.

We had a huge turn over 2 summers ago, a change in management brought that on. We have about 25-30% of our staff with greater than 10 years experience.

OK, my turn. We are a 16 bed unit. 7 Level 2 beds, 9 'level 1--- feed & growers, antibiotics, etc." We are combined with our well baby nursery, which averages anywhere from 10 - 20 babies.
Staffing on nights is generally 4 RN's & 1 LPN, or 5 RNs. 1 Cna who works Monday - Friday 7 - 3.
As far as turnover, we have some RN's who have been here 10+ years. We are in a military town, so most of our turnover has to do with military wives. Our census is also dependent on the military --- 9 months after a float comes back we have a baby boom!!! Now our town is turning into a ghost town with all the deployments, and our census will probably drop some unfortunately. Right now I think we only have about 3 open positions, but we are (secretly) hoping they don't fill them due to the expected decrease in census. We don't have that much turnover in staffing though. The last big turnover was about 2 years ago ( when I was hired).
By the way, I LOVE my job and 98% of the time I LOVE the unit. Right now we are getting ready for JCAHO so that accounts for the other 2% of the time!!!

Thank you Nicugal and Mofe'ny, I appreciate your responses.

NicuGal, is that 14 to 16 RNs per shift or total? What is the ratio of patients to RNs?

Thanks,
Kris

That is per shift. We have about 100 nurses on staff including part-timers and PRNS.

Ratios depend on acuity and staffing. We can have 4 kids...mostly they are feeders, sometimes there is a CPAP or NIMV thrown in there. Our vents are usually paired together, or with one or two feeders, never more than 2 vents. Trachs, since they are usually really bad kids, usually only with one other kid. Our bigger chronic kids we try to only give one other with too. But this all depends on staffing and acuity. We do have the occasional one-on-one, usually a kid that is on HFOV or really unstable.

I have to say, I work with a good group...we will do what needs to be done and if someone has an admit we all pitch in to help..that may mean taking 5 kids, but if it is doable, we do it.

We try to keep the charge nurse without an assignment so that she can help out and pick up kids if there is an admit. Our transport nurse has to have an assignment that has kids that are easily absorbed into another assignment.

We have a 32 bed Level III unit and are more full than not. We are more understaffed than not. Our turnover is like a revolving door the past year.

The unit I worked on before I retired last July is a 40 bed unit, half ICU/half continuing care. We were budgeted for a daily census of ~ 28, I think. We had 15 staff scheduled, including perdiems.

ICU pts get 1:2 staffing, 1:1 if very unstable, to/from surgery, on a post-op heart, I've seen 2 nurses to one pt. Continuing care pts get 1:3 staffing.

Most of the day shift has 20-30+ years of experience! I had 34 years as a nurse, ~22 in NICU. Night shift was many staff with 10-20 years, lots of new grads, also. More turnover on nights because there's hardly ANY on days!! therefore, not a lot of hope of getting to a day position. There are people that have been there over 15 years who still rotate--not much, but they are technically in a day/night slot.

Our NICU is smaller, a level 3 - 24 bed unit. We have about 70 nurses on staff, all RN....and we are hirering now!

We are a 32 bed Level III NICU. Usually, we try to staff at about 21-23 RN's at any given time (we only have 2 LVN's on staff). Our more critical pt. are 1:1, while some of the more chronic kids are 1:2. We have about 120 nurses on staff right now and I think we have about 14 openings right now. We do ECMO, etc. Since we are a children's hospital the majority of our pt. are brought in by our transport team.