ICU Patient Ratios

irishicugal · Mar 8, 2016

Jesus that's terrifying!! I'm in ireland, here we are ideally 1:1, or 1:2 at a push if they aren't vented or are stable, or there's some kind of in-hospital emergency. Mech vents are ALWAYS 1:1...

Misnim · Mar 8, 2016

You are lucky! We used to be mainly 1:2, now we're primarily 1:3, sometimes ALL mechanically ventilated. On top of that many of our experienced nurses have run for other hospitals, and the rest of us with experience are exploring our options.

VANurse2010 · Mar 9, 2016

I could see that *maybe* on some kind of vent-weaning ward in a transitional or long term acute care type setting. In an actual ICU with actual ICU patients? No. just no.

Misnim · Mar 9, 2016

I agree, with the right population in a LTAC type facility it could maybe, possibly be done safely.

Where I am it's multi drips, multi interventions critically I'll patients. I just don't see it as anywhere near reasonable or safe.

MissChloe · Mar 20, 2016

CVICU nurse here. All vents are 1:2 or 1:1 if critical. We do have 1:3 assignments on our floor but not the really critical and/or vented patients.

Pheebz777, BSN, RN · Mar 25, 2016

Normally our ratio is 1:2 down here in McAllen Texas. 2 vents at max per nurse. Although we go 1:3 sometimes depending on acuity of the patients, however we do have those days when we have multiple call-ins and massive influx of admissions where 3 vents/nurse is not avoidable. Our facility though has a dumb protocol of having only 1 nurse per balloon pump which I find is ridiculous, (Unless I'm the nurse taking care of the patient! lol!) while another nurse has to handle 3 patients. I usually make myself available for a 2nd patient if my balloon pump is stable enough.

irishicugal · Mar 25, 2016

We don't have RT's either or CNA's here, maybe if we did then we could stretch to 1:2... But I wouldn't like it - maybe it's a control thing cos I like to do everything myself!!

EllaBella1, BSN · Mar 28, 2016

We're supposed to be 1:2 but occasionally get tripled when the census is high. The only time we have 1:1s are for post-code hypothermia, CRRT, anyone who is prone for ARDS, or occasionally for really really unstable full-code patients. We also always have several RTs who manage most of our vent related tasks aside from the Q2 oral care. And we have a CNA/tech maybe 50% of the time. A constant 1:3 ratio sounds rough.

CrazyGoonRN · Mar 28, 2016

I have heard of that ratio at long term acute care facilities but never in an icu

MYSTICOOKIEBEAR · Mar 28, 2016

If it was an LTAC with patients who have been on the vents and have been stable on them for months, maybe. But in an ICU setting? Absolutely not.

Unless it is some new progressive place that is trying to pilot a new program where there is one nurse who watches all of the vents in an area like a hawk but doesn't actually take a patient load. Kind of like how the CVVH RNs at night watch and restart all the CVVHs and do their rounds and checks throughout the shift but do not actually take any patients.

As your statement stands, I think they are missing some information to their story.

Lennonninja, MSN, APRN, NP · Mar 29, 2016

If it was an LTAC with patients who have been on the vents and have been stable on them for months, maybe. But in an ICU setting? Absolutely not.
Unless it is some new progressive place that is trying to pilot a new program where there is one nurse who watches all of the vents in an area like a hawk but doesn't actually take a patient load. Kind of like how the CVVH RNs at night watch and restart all the CVVHs and do their rounds and checks throughout the shift but do not actually take any patients.
As your statement stands, I think they are missing some information to their story.

How does an RN have a cvvh assignment and not a patient assignment in your unit? If my patient is on cvvh I'm 1:1 with them, and doing all of their care, assessments, and running the machine as well. Dialysis RNs never touch anything r/t cvvh in my hospital.