ICU nurses, Is 3:1 patient to nurse ratio a common occurence or am I just tripping?

Specialties MICU

Published

  • Specializes in ICU, Surgical Services.

You are reading page 3 of ICU nurses, Is 3:1 patient to nurse ratio a common occurence or am I just tripping?

Charmedone923

51 Posts

Lately, it's being done more and more in our unit because they pull out staff to staff the other Icu. Just the other night, they took 2 of our RNs which caused our unit to work short. 3 Rns were tripled and our charge nurse had to take patients. We were told by management that We will have our RNs floated to help the other Icu out even if it means we have to work tripled? I think every person in our unit wishes there was someone/somewhere we can voice our concerns to. It's just not safe to have 3 especially if they are still on pressors or still intubated.

But, we need our jobs, sooo....

gaonsi

58 Posts

I work in an icu where the acuity is ridiculously high. I was doubled with one unstable patients and received a third critical patient. I have around a year of experience and was completely swamped and overwhelmed.1:3 is now the norm on my floor when really some of our pts require one to one care. Not being able to effectively manage the patient increases length of stay. Needless to say, I left in tears. You're definitely not alone.

Cardiolyte

48 Posts

Specializes in Interventional Cardiology, MICU.

Saturday, myself and a traveler were assigned 3 pts in the MICU. Our unit can not refuse to accept new admit's for ANY reason.

The unit is bleeding experienced nurses. Management goal of 80% new hires/20% experienced nurses in every unit every floor. So many errors I can't get my head around them, and management looks the other way.

-pt on a paralytic, pain medication gtt, sedation gtt new RN titrating down pain and sedation gtt's using FLACC score

-same nurse gave 10 ML not units IV push

list just goes on and on............

I need to get out too..

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

It' not because experienced nurses aren't out there....they aren't hiring. I know of an experienced ICU nurse who's been looking for 18 months.....she's >55....darn shame....

sapphire18

1,082 Posts

Specializes in ICU.
It' not because experienced nurses aren't out there....they aren't hiring. I know of an experienced ICU nurse who's been looking for 18 months.....she's >55....darn shame....

We NEED them...:/

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
We NEED them...:/
Hospitals don't want to pay them. They are at the high end of the pay scale and we have limited use.....were older......good Lord only knows when we will drop dead....:sarcastic:. They want about 10 years experience they are relatively low on the lower side of the pay scale and enough expereince tobe useful. Not many of them around.
In my unit vents are 1:1. If census is low then HDU patients (stable, non-vented) are 1:1, if we're busy, one nurse will take two HDU patients, no more. Most other ICUs in the area are similar.
This is very inefficient and costly. There is no reason a vented patient should be 1:1, purely for the fact s/he is on a ventilator. Paying for double the amount of RNs? My unit is 2:1 at the most and we are 1:1 in certain situations such as CRRT. Our step down units are 3 or 4:1 but the ICU is 2:1 tops. I think it all depends on acuity. I've seen a few ICUs that were more like step downs.

turri05

1 Post

I also work in a general icu we rarely have 3 patients unless we are understaffed.....when we do care 3 that person usually has the 3 least sick pts

Nursing ratios differ state to state. It's 2:1 or 1:1 for us. I've had 3 ICU patients once in the decade I've done ICU but that night was worse than my worst med-surg experiences!

imaginations

125 Posts

This is very inefficient and costly. There is no reason a vented patient should be 1:1, purely for the fact s/he is on a ventilator. Paying for double the amount of RNs? My unit is 2:1 at the most and we are 1:1 in certain situations such as CRRT. Our step down units are 3 or 4:1 but the ICU is 2:1 tops. I think it all depends on acuity. I've seen a few ICUs that were more like step downs.

I believe this is the norm in Australia, in all critical care units for adults, children and neonates.

BrandonB779

25 Posts

Specializes in TNCC, PALS, NRP, ACLS, BLS-Instructor.

MICU RN for 1 1/2 years now, we generally have 2:1 ration, with specfiics on 1:1 criteria for care (multiple pressor titration, IABP, Protective Hypothermia, or really really crashing) but we have done 3:1 usually with our step-down patients or those that are good to be transferred. When push comes to shove, it just happens.

shakanurse

11 Posts

*I posted this in the new grads section but I also want to hear from the experienced nurses*

Hi. I'm a relatively new nurse in a general ICU (we get a variety of patients). Considering the shortage of jobs for new nurses, I'm very grateful I found a job in an area of nursing that I find interesting albeit challenging. When I interviewed for the job, I was told that the Patient:Nurse ration was 2:1, and very rarely would a nurse have 3 patients. Well as it turned out, 3:1 is the norm on the unit (we're chronically understaffed) as I've seen more nurses tripled than doubled on any given day. Is that the norm in ICUs? Or is it just because we're a general ICU? I personally think it's dangerous because there is no way a nurse can be in 3 rooms at a time, and inevitably, one or more patients receive less than optimum care, especially if one of the three patients is more critical than the others. I worry about liability should something go wrong on the nurses' watch (more like the absence of it). Should I be concerned about this or is this the way things are in most ICUs?

PS: It's insane that nursing units across the country are so understaffed (putting more stress and workload on the nurses especially the more experienced ones) while thousands of nurses, new and old, remain without work.

Good thing that I was off last night-otherwise my response would be a novel. 3:1, I think, is the "new norm", sad to say!! Work in a 30+ bed unit and do ♥'s, CRRT, IABP-you name it. 6 years in the ICU, and I still feel that I do not completely know the rationale behind it all b/c most of the time it's charting and meds for 3 and sometimes 4 true ICU pts...I feel that I have lost my knowledge on why my pts are on this or that. 90% charting/10% pt care. God forbid that I didn't chart foley care and get a ding email...

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