ICU nurse to pt ratio "norm" on your unit?

Specialties MICU

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Specializes in ICU.

I know typically ICU nurses get 2 patients standard. I'm curious how it is on your MICU unit?

At my hospital I would conservatively estimate that a good number of the MICU staff have 3 patients 65-70% of the time.Staffing is generally the pits.

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Our staffing is beyond horrible. I'm talking about 90% of the time everybody has a 3 patient assignment regardless of patient acuity, swans, vents, pressors, etc.

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My unit's standard is 1RN:2pts, except if we have OOU's, then we may triple these, but not routinely. If we have high acuity--unstable, pressors, road trips, procedures, then we would not triple the OOU, but pair one of these with the higher acuity pt to reach the 1:2 ratio.

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No more than 1:2, ever. If the patient is very unstable or for the first 8 hours post open heart surgery, then it's 1:1.

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Specializes in Dialysis.

Staffing by acuity seems to be an alien concept to management. If you are assigned 3 critical care patients you are rationing care because there is no way you are meeting all the needs these patients have. Or is your unit keeping patients that shouldn't be in ICU?

As much as I hate lawyers I think some clever one should bring a fraud lawsuit against the hospitals that staff 3:1. Charging for a service that they are not providing is fraud.

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Specializes in Advanced Practice, surgery.

In the UK ICU'sn are generally staffed on a 1:1 basis with HDU patients (non ventilated) on a 2:1

Can't imagine caring for more than 1 ICU patient, you would need eyes in the back of your head

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Specializes in Cardiac.

Our ratios are stict, 1:2 for ICU pts, 1:1 for pts who are very critical. Never, ever 3 ICU pts per nurse.

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Specializes in Neuro ICU and Med Surg.

Usually 1:1 or 1:2. We have only tripled very rarely. I have never personally been tripled. If they are tripled they must be stepdown vs q2 neuros q4h.

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I know typically ICU nurses get 2 patients standard. I'm curious how it is on your MICU unit?

At my hospital I would conservatively estimate that a good number of the MICU staff have 3 patients 65-70% of the time.Staffing is generally the pits.

2:1 99% of the time. 1:1 on occasion. Sometimes I see an order for 1:1. Would your doctors be willing to write for a 2:1 or 1:1 ratio?

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To those of you who report strict 1:2 RN/pt ratios, how does your unit handle the situation where there are no step down/general beds available, so ICU pt's are "stuck" in ICU, although being billed at the appropriate (i.e. stepdown) rate? This has happened with some degree of regularity recently, so the OOU pt's that are written out with or without tele/pulse ox are "stuck" in ICU until beds open up elsewhere. We have actually discharged patients directly from the ICU home (although rarely) because of this. I am curious to know how other units handle this, perhaps there may be something to pass on!

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Specializes in Cardiac, Med-Surg, ICU.
To those of you who report strict 1:2 RN/pt ratios, how does your unit handle the situation where there are no step down/general beds available, so ICU pt's are "stuck" in ICU, although being billed at the appropriate (i.e. stepdown) rate? This has happened with some degree of regularity recently, so the OOU pt's that are written out with or without tele/pulse ox are "stuck" in ICU until beds open up elsewhere. We have actually discharged patients directly from the ICU home (although rarely) because of this. I am curious to know how other units handle this, perhaps there may be something to pass on!

Very good question, my unit deals with the same problem on a regular basis and in fact, the whole hospital has had such a high census lately we've been taking "only bed available patients" because there was no place else to put them. This included stable tele and isolation patients who definitely didn't meet ICU criteria. So yeah, that 2:1 ratio has been out the window lately. I can't wait until the census goes down a bit, because quite frankly, these patients are a drain on nursing resources.

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Specializes in Cardiac.

Our strict ratios are based on ICU patients. If we have tele pts, then they go to 1:4. It's all in the 'status' that the Dr writes. But for Tele pts, we only do Q4 assessements and VS, so they are pretty easy compared to my Q1 VS I/O and Q2 assessments.

But, we dont' have room for that many tele patients. So usually I will get 3 stable, easy tele pts if we have them...

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