Staffing by Tonnage

  1. We decided this weekend that staffing should be done according to average tonnage on the unit. The first three rooms in ICU: Bed 1: 252 pounds, new Guillian-Barre pt. Bed 2: 284 pounds, intubated, big overdose attempt. Bed 3: 348 pounds, intubated septic and no fecal bag will attach! That's 884 pounds right there. Surely that's worth at least 6 nurses.

    What do you think? 1 nurse per every 150-175 pounds of patient? (Mind you, we haven't be able to sell this concept to management yet )
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    About Zee_RN

    Joined: Oct '00; Posts: 1,664; Likes: 176
    RN, Inpatient Hospice; from US
    Specialty: 17 year(s) of experience in Hospice, Critical Care


  3. by   Stargazer
    I started laughing when I read this thread title, because I knew exactly what you were going to say! One of the reasons I left ICU after 7 years was that I was tired of injuring my back lifting patients.

    Problem is, even average-sized folks who are in ICU long-term end up getting septic or going into failure and 3rd-spacing like crazy, so they take on another 40 lbs of water weight. And even an average-size person seems heavier when they're so sedated or comatose that they're "dead" weight; i.e., can't assist you in moving them at all.

    How about establishing a maximum total unit weight (like an elevator)? Anything over and above that requires one extra staff person for each additional 360 pounds or something.

    I think you're onto something there!
  4. by   Scavenger'sWife
    BWAAAHAAAHAA!!! :roll

    I have often said the same thing........or that I would get more money if I were paid by the mile!!!
  5. by   passing thru
    So true of ICU. Most people outside of ICU , nurses and administration AND doctors don't have a clue as to how much lifting takes place in ICU. Everyone is on tube feeds and is incontinent of stools, in one end--out the other. I remember one nite there was 7 female nurses and one male nurse working. About halfway through the shift, the male nurse reminded us he was getting exhausted as each female came to get him to help with lifting their patients, "cause he was a man" we were wearing the poor guy down.
    I would try to get administration to listen. In our hospital, on the big ones, and as you say, a 170 # dead weight is heavy, anyhow, we get the R.T.'s and lab guys to assist. And with the big ones, we do not begin until there are 3 lifters on one side and 3 on the other. I, personally, am not going to injure my back to clean poop cause the bosses don't want to set a policy for lifting dead-weight pts. in ICU. We've ask docs to help before,what a laugh..when they realize what we want..they refuse. I think you need to keep asking or transfer out. Post partum is lifting. I've never forgotten one of our nursing school instructors said "if you ever injure your back, it will be injured for life", and she also preached, "take care of yourself first ."
  6. by   Jolie
    That might work for adult ICU, but it would be a bad plan for the NICU. We could have 3 total care patients who do not add up to 2lbs!
  7. by   prmenrs
    Yeah, the babies are tiny, but the equipment weighs a ton, and we were forever moving monitors and incubators around, pushing or pulling transporters, etc.

    Also, if it's a REALLY sick kiddo--i.e.--cardiac, ECMO, etc, you have to be so careful when lifting--things get dislodged. You know, little things: chest tubes, lines, ETTubes....
  8. by   frannybee
    It sucks being the biggest nurse on the matter what state I'm in or how knackered I am, if there are 3 people to lift someone, I always end up by myself facing 2 others (we often work with only 3 staff). Then there's the auxilliary nurse who says she can't lift with the bed at hip/waist height because 'it hurts my back' then drops the bed to her knees. I'm not surprised it hurts, honey - you've done your back in with lifting patients with the bed at your knees! Will not listen to the man. handling advisors or me, seems like I can't win. I just avoid working with her now if I can, especially given the amount of enormous pts on the ward right now.
  9. by   ERNurse752
    "Post partum is lifting"

    No lifting in the ER? Boy, I must be getting screwed...I wanna work in that one!
  10. by   passing thru
    What kind of pts are you lifting in the ER?
  11. by   psychonurse
    Your drug overdoses need to be lifted. When the ambulance rolls in with someone on a gurney, you always have to transfer them from thier bed to yours. I left hospital nursing cause of too much lifting. Corrections doesn't have a lot but we will start gettting more and more when the age of our inmates get older and older. I did have a patient last week that we had to help with transfers from his bed to the wheelchair and back again. My back thanks me every day that I have l don't have to lift during my shift.
  12. by   momoftriplets
    Well, In my Er, there is a lot of lifting. Those lol always are sliding off their carts, we get quite a lot of bariatric patients nowadays as well. And we are constantly pushing carts to and from Ct, ultrasound, surgery, to the floor. Er is extremely physical. oh, I almost forgot. we also are getting people out of the car that are dead weight that should've called 911.....
  13. by   essarge
    No lifting in the ER? Wow...I really want to work in that one! Besides the ambulance, "wanderers", and various others we always have holds that need to be cleaned up, turned when we take them to the floor we have to transfer them into their bed!!
  14. by   baseline
    ER is VERY physical! Lots of moving and lifting and pushing and pulling and ducking !!!