*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.
Point--How are you going to help your "other pt." that is swimming in sh*t when your are titrating gtts every minute for 12 hours??
*** No big deal. Standard even. BTW you shouldn't be titrating gtts every minute. Get a fecal containment system for the other patient, I like Flexi Seal.
*** No big deal. Standard even. BTW you shouldn't be titrating gtts every minute. Get a fecal containment system for the other patient, I like Flexi Seal.
This. All of it. It is standard. Although if you don't flush those flexi seals often enough - explosions can occur.
*** No big deal. Standard even. BTW you shouldn't be titrating gtts every minute. Get a fecal containment system for the other patient, I like Flexi Seal.
Yeah...Every single minute is a bit excessive (my bad), but i have ran epi @ 999...Takes time for gtts to take affect. But, Nipride is a differnt story. This drug is a must after CT surgery. And, it does take a lot of time to get to where you want to be...
Not every facility has the luxury that you have. So there are true 1:1 ICU pts "on the vent" somewhere...[/quote']
^True, not every facility has the up-to-date technology or resources. The OP may not have these resources, thus their concern and start for this thread...I'm learning from this post...post on!
And thanks shakanurse...BTW...my thick skin ways are still in place
I believe this is the norm in Australia, in all critical care units for adults, children and neonates.
I think what I've picked up on, is in other countries, they use fewer restraints and less sedation with vents. I would want a vented pt 1:1 if I didn't have propofol and fentanyl.
Actually strike that I would want EVERY patient of mine to be 1:1! How fantastic would that be?[/quote']
Yes, it sounds like a dream come true! I would love to be able to have a 1:1.
Last time I had 3, I felt completely pulled and didn't accomplish good care on any one of them. Thankfully, all were stable ICU pts... If that's ever a possibility.
You are saying you have run epi at 1L/hour? What was the concentration? What were titrating every min at that rate?
Takes time for gtts to take affect. But, Nipride is a differnt story. This drug is a must after CT surgery. And, it does take a lot of time to get to where you want to be...
Uh, OK, if you say so.
FMS is ONLY for loose stool.
Patient is swimming in sh*t
FMS are only for loose stools? Thank you for the education. However I thought the description you chose of "swimming" indicated loose stools. I think swimming in solid matter would be difficult.
You are saying you have run epi at 1L/hour? What was the concentration? What were titrating every min at that rate?
Uh, OK, if you say so.
FMS are only for loose stools? Thank you for the education. However I thought the description you chose of "swimming" indicated loose stools. I think swimming in solid matter would be difficult.
It was a code while having 3 pts. So, I didn't know the ratio/proportion...The ED doc said to slam it...The L bag was alreay made. SOME CRNA's think they know it all...Last post from me to you...Aloha
I think what I've picked up on, is in other countries, they use fewer restraints and less sedation with vents. I would want a vented pt 1:1 if I didn't have propofol and fentanyl.
Too true. We nurse patients as awake as tolerable. We do not leave them out of sight, ever.
So in other countries they either have about twice as many RNs as we do in the states or they have half as many ICU beds available. How the hospitals can eat the costs of that many employees or that few patients is beyond me. And epi at 1L/hr?? We use one concentration at my hospital 16mg/250ml with a "preferred" dosage range of 0.1-0.15 mcg/kg/min. You can go pretty high above these parameters, and I have, but I am also generally getting another pressor to hang along with it... And how did you program the pump or know how to titrate if you didn't know the conc? That is a bit scary.
IndiCRNA
100 Posts
*** No big deal. Standard even. BTW you shouldn't be titrating gtts every minute. Get a fecal containment system for the other patient, I like Flexi Seal.