cardizem drip nurse/patient ratio

Tweety, BSN, RN · Sep 16, 2004

Our cardizen drips are in the progressive cardiac unit where the ratio is 4:1 on days and 6:1 on nights. These patients are asymptomatic, meaning they may have a tachycardia but they aren't symptomatic. Patients who are symptomatic go to the CCU. The nuero unit actually makes their cardizen drips automatic 3:1 ratio, but that's a bit overkill. Our medical-surg telemetry unit does not do cardizem drips.

I agree it's not a good idea to have a cardizem drip on med surg where the ratios are that high. If I was the med-surg nurse I'd pitch a fit.

UM Review RN, ASN, RN · Sep 16, 2004

I agree with Tweety. Mostly because if your nurses on med-surg are not tele-certified, you'll wind up with the extra responsibility of overseeing these patients from over on your unit.

Not a good idea.

Repat · Sep 16, 2004

The med/surg tele unit where I used to work had symptomatic pts w/cardizem, and a 6:1 ratio:(!! We also took heparin and insulin drips.

UM Review RN, ASN, RN · Sep 16, 2004

The med/surg tele unit where I used to work had symptomatic pts w/cardizem, and a 6:1 ratio:(!! We also took heparin and insulin drips.

Wow. That's very scary to me. We only get occasional insulin drips, and we're a progressive care unit. But we do get a lot of cardizem, heparin, and once in awhile, nitro (as long as it's not titrated.) We also get med-surg patients with cardiac problems.

If someone requires a lot of eyeballing, however, we can usually successfully make a case for turfing them up to the Unit.

RNKPCE · Sep 16, 2004

We get Cardizem gtts on my tele unit. Ratio are 5:1 on all shifts but usually days and pm's have about 4 patients.

Insulin gtts require ICU as they require blood sugar check far to often for our floor. We also get renal dose dopamine, no titration of gtts.

mattsmom81 · Sep 17, 2004

I can't tell you how many times I've seen/heard of floor patients on Cardizem drips with bradyarrythmia and hypotension because the nurses were untrained or not monitoring closely enough. Policies should be in place to protect patients AND nurses...Cardizem drips require monitoring and should be in a special care unit with trained staff, monitors and protocols to guide them. Never on unmonitored medsurg, IMO. Recipe for disaster.

Celia M, ASN, RN · Sep 17, 2004

Here in California tele nurse/pt ratio is 1:5 days and nocs. To remain on the floor the patient must be stable and the drip cannot be being titrated to hemodynamic effect

lihuejan · Sep 19, 2004

Thanks to all for your input on the nurse/patient ratio with cardizem drips. I will proudly take this info into battle with me on Monday morning. Jan

critcarenurse16 · Sep 20, 2004

I can't tell you how many times I've seen/heard of floor patients on Cardizem drips with bradyarrythmia and hypotension because the nurses were untrained or not monitoring closely enough. Policies should be in place to protect patients AND nurses...Cardizem drips require monitoring and should be in a special care unit with trained staff, monitors and protocols to guide them. Never on unmonitored medsurg, IMO. Recipe for disaster.

I feel the same way. The potential for the patient to become unstable is too great and requires very frequent monitoring.

Joycean · Oct 23, 2004

Our Telemetry unit has a 4:1 ratio. Patient on Cardizem must be monitored continuously and transported with an ACLS certified RN. We take Insulin drips that require no more that every 2 hour blood sugar checks.

nursebonkers · Oct 24, 2004

Where I work administration wants " All Cardizem drips" to go to GEN TELE floor where the ratios tend to be good on days 5pts to 1RN but at eve/night ratios can go up to 9 pts Per RN depending on avail staff. I work in the ED and I NEVER LET THESE PTS GO UP TO A GEN TELE UNIT!! I simply state are you sure, tele ? to the physician, "they could be dead" with those ratios. Everytime I say it, the pt gets admitted to the PCU where the pt ratio is better. The cardiologists do not know the staffing levels. When I tell them that last night the tele nurses had nine pts each they freak out. It is very interesting.

There is also a policy in place that when a pt on a cardizem drip is admitted to tele and if the drip rate needs to be titrated up or down more than twice the patient needs gets transferred to the PCU anyway.