looking for similar unit--staffing ratios

[compassionate_RNmgr]

I am the manager of a 24 bed unit that preps and recovers patients going for cath lab, diagnostic and interventional neurology cases, peripheral cases, and interventional radiology cases. About 75% of our patients are same day procedures and 25% stay for overnight observation. We are open 24/7 for these observation patients + 4 designated low risk CP beds + our cath lab has a designated weekend team as well.

Our patient care includes pre procedural history, assessment, IV's, shaves, documentation, etc. Post procedure we are responsible for recovery from sedation and line pulls if there are arterial or venous sheaths to be removed on both patients that we started or from inpatient beds that received heparin, angiomax, or integrillin needing a line pull. The inpatients go back to their rooms 1 hr. post line pull. We also discharge the patients who we care for either same day or next day. Occasionaly we have patients that are with us for 2-3+ days if they have multiple procedures on different days, need surgery, or are started on antiarrythmics. We try to move pateints that will be here for more than 2 days if there are beds available.

We currently run with 10 nurses on days --1:3 ratios. The shifts and start times are staggered 5a start, 7 a start, 8:30 a start, and 11 a start with 1 as the daily charge. ALSO--we can't predict add on's or # of inpatients that will come to us. I have 2 secretaries who check patients in, enter orders, and prep next day charts.

At night I run with 3 nurses (after their 9pm or 11pm nurses go home). They take a max of 10 pts total. If there are a higher number of early am pts before 7am they also assist in pre procedure care.

Do you have a similar unit?? How do you staff?? other comments...

Please help me, help my staff, and provide safe & excellent care to our patients :)

[groovy jeff, RN]

man i would love that gig!!! 1:3 would be like heaven!!

[annsgambit]

Hi I am the unit director for a similar sounding unit. We are looking at redesigning our work flows and would love to discuss our units. I see this post was about a year ago....sending this to see if you still check this site. If so respond back and I will send my contact info.

Thanks! Ann

[turnforthenurse, MSN, NP]

wow 10 patients on nights? that's crazy!!! Our ratios used to be 1:4 but we have been short staffed and we are also on a hiring freeze so that doesn't help the situation...lately we have been taking 1:5, dayshift is sometimes taking 1:6 which I think is overkill. We will get patients on drips (amio, cardizem, NTG, dopamine, etc...) so with ratios like that, it can be dangerous.