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

jedimasterr · Mar 27, 2008

Like most folks here have said, our ratio is one nurse to two ICU patients. Open hearts are one to one for a certain length of time. On the step down telly unit, the ratio is one nurse to four patients but they do have some help on that floor from the techs for vitals and accuchecks which are Q4H as opposed to our Q1H vitals. When the hospital is full and we can't transfer patients, we are expected to follow the protocols of the unit the patient should be on, and this can be a drag when you have four step down patients and no assistance like you do on the telly floor. Luckily, our unit is very team oriented and you are not left to hang when it comes to cleaning patients. That said, it is still a lot more work than would be expected otherwise.

Overall, I think our unit is safe. However, there are times you get stuck and can't get more help. So far I have seen nothing that indicates to me the unit manager or the hospital are OK with just "stuffing" the ICU nurses. For the most part though, we are expected to float to any unit except the ER and as you would expect just about no one likes that. Someday, we will have eICU and due to my experiences in another field prior to nursing, I have nothing but suspicion toward how eICU will be used. I can certainly see them using it someday to be that perceived "extra" help that allows patient ratios to climb. I have nothing to back this claim up right now so that is admittedly speculation on my part.

oneillk1 · Apr 1, 2008

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.

We get 1:1 ventilated, sometimes 2:1 unventilated, sometimes 3:2 unventilated or even 1:2 if the patient is really sick (that is patient : nurse)

The only time we ever have more than 1 ventilated patient is when the nurse next door is on a break.

In saying this, we don't have techs, we do everything ourselves

:up:

cardiacRN2006, ADN, RN · Apr 1, 2008

We get 1:1 ventilated, sometimes 2:1 unventilated, sometimes 3:2 unventilated or even 1:2 if the patient is really sick (that is patient : nurse)
The only time we ever have more than 1 ventilated patient is when the nurse next door is on a break.
In saying this, we don't have techs, we do everything ourselves

WOW~! We don't have techs either, but the only reason for a 1:1 is impending code...

Why only 1:1 for ventilated patients? I find them to be the easiest...

sister s · Apr 7, 2008

In Australia if a patient is on invasive ventilation then they have 1:1 - like the UK I think.

Vikingnurse · Apr 9, 2008

I need some more information in your nurse to pt ratio. We are ALWAYS 1:1 day, evening and night. But then again we deal with everything medicin, personal care, ventilator "things" (suction, ABG's etc.) Both day and evening shift we have what we call serviceassistents. They do the cleaning, help with mobilisation and some other helpful things. In the daytime we have 2 ekstra nurses that also help with whatever.

If I understand it correctly you have respiratiory therapist and perhaps other similar proffessions around the patient.

What I would like to hear is how many healthcare proffessionals are around the patient.

sister s · Apr 9, 2008

Yep - so if the patient is ventilated they have 1:1 nurse. It's a 5 bed ICU ward (we don't separate surgical/medical etc, and there's a nursing float for the ward to fetch and help with stuff and answer met calls. Other than the Intensivist, physios visit once a day and the dietician visits once a day, but that's it. It seems to work. Other ICU patients can be 2:1 if they're not invasively ventilated. :nurse:

ICU_nurse · Apr 9, 2008

Why only 1:1 for ventilated patients? I find them to be the easiest...

It's a safety issue, not a matter of them being "easy" (which sometimes they most certainly are!!)

Ward policy states that our Ventilated patient's are never to be left unattended. We don't have assistants or anything (apart from the PSA, who we grab if we need a turn or to run bloods to pathology), you as that pt's nurse do all care for the whole day, there is noone (besides the nurse next door to you) who can step in if you are called away/need to grab supplies etc etc. If that happens (including covering for breaks) then you need to let them know and they step out of the room in a spot where they can see both patients and all monitoring systems. This is why when going for breaks, all your IMEDs need to be up to date, nothing should beep or alarm (you know, unless they're sick or something :lol2: ). The covering nurse should be able to sit at their desk and observe.

When the hospital is full and we can't transfer patients, we are expected to follow the protocols of the unit the patient should be on
For the most part though, we are expected to float to any unit except the ER and as you would expect just about no one likes that.

Yep, if the patient is wardable they go to 4th hourly obs.

You don't get flicked to ED? That's the first place we seem to end up!

Parko :-)