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Low census anyone?


We are sooooo slow right now. It's ridiculous. I am getting cancelled at least once a week. We will pick up a little then we are right back down. It's driving me nuts. Where are all the babies? Our delivery service is unchanged and busy as ever (4,000/year). I just don't get it. I'm not asking for tons of babies, but at least 15 would be nice. Those darn tocolytics and steroids. Also the length of stay is just not what it used to be.

I am in the DFW area. Anyone else slow in the DFW area or in other parts of the country?

helicoptergal, BSN, RN

Specializes in NICU, ER.

Yep we are slow to. We attribute it to the economy. We service a large agriculture, migrant farm laborer population. And have unfortunately been in a drought for a couple of years. Sadly our migrant families have left to find work and have taken their families with them.

I am in Fort Worth and we slowed down for a couple of months earlier this year but are now very busy. We are working our on-calls and extra shifts. Where in DFW are you?


Specializes in NICU.

My unit was horribly slow last summer/fall/winter. Back in March, our census exploded - tons of

Not really. A nice constant flow. We go over about once a month for a few days, then it's back to normal. Thank goodness because we are short staffed.

Imafloat, BSN, RN

Has 13 years experience.

We have been low for at least 6 months. Our census will go up for a week at a time, then go right back down. I have been floating a lot. I have only been canceled once. Our acuity is down and our length of stay is down.

NicuGal, MSN, RN

Specializes in NICU, PICU, PACU. Has 30 years experience.

I'll send you some...we got hit by the department of health during their visit for being over census.

NeoNurseTX, RN

Specializes in NICU Level III.

I think my unit has been way high since summer 2008.


Specializes in Neonatal ICU (Cardiothoracic). Has 9 years experience.

We have had a comfortable census of 57-64 for the past few weeks after riding near 75-76 for awhile. We hold 58....

Unfortunately for the nurses who enjoy and built their lifestyle around our constant availability of overtime, we are now approaching a 1:2 nurse ratio of staffing levels, and have NO overtime now....

Our per-diems are floating a lot, and people are starting to squabble over the occasional night-shift call-in OT.

I was offered OT to simply triage and check VS in the peds ER.... thanks to swine flu scares, we've had 50-150 kids in our ED at any given moment for the past few weeks. I'm probably going to cross-train to this Peds ER in case I want some OT.


Specializes in NICU.

We are an 85 bed Level IV NICU, and usually are at full or over capacity. I think the maximum number of babies we had was 88. Two months ago, our census dropped dramaticaly to 55. Staff were freaking out, because that meant that RNs were being pulled to other units, and all overtime was cancelled. We have guidelines for pulls...Critical areas are pulled to other Critical areas only. So, we go to PICU, CVICU, or the Burn Unit. Guidelines are that we be given the most stable patient when we are pulled, but I remember being pulled to PICU a long time ago, and being asked if I thought I could admit a patient. I said no.

Imagine being used to our lovely tiny preemies, and then being assigned an 18 year old who weighed more than me. :o it wasn't fun.

Edited by twinkletoes53
grammar check


Specializes in NICU. Has 6 years experience.

I want to understand more about your facilities that you say run overfull. When our Level III is full, we find some kids who could be ok moving to Level II, either ours or transport out to a community Level II closer to home. Or we send kids to the peds floors who might be appropriate there. Or the PICU. Or we defer admissions. Now we are lucky enough to have another ECMO and surgical referral center nearby. I know not all of you do. But what do you do with extra babies? Where do you put them? How do you monitor them? What do you say to parents whose babies are housed in places that don't seem to look like actual bedspaces? Do you ever have issues with JCAHO or other regulating agencies about this? It seems like it would be illegal to run over the licensed number of beds, but I guess I don't actually know. What are the reasons for not doing any of the above mentioned to make legitimate space? I'm not trying to be critical. This just feels really foreign to me, and I want to understand more about how this works!

malenurse122879, MSN, RN

Specializes in NICU, Pediatric Urgent Care. Has 9 years experience.

Shreveport, LA area - 43 bed nicu... we've been between a census of 13-24 kids since DECEMBER!!! Well, that's when I started at this hospital anyway... I have been called off twice consistently every single paycheck... so yeah you do the math on how much I've lost there... It SUCKS. I'm at the point now of finding a new hospital - There's one that gave me an offer in NW Arkansas and they are overflowing with kids.. so census shouldnt be an issue.

RainDreamer, BSN, RN

Specializes in NICU. Has 13 years experience.

We're not too bad. We have some slow spurts, but that just means we don't have as much OT available as before. Our census isn't packed like usual, but we have lots of sick kiddos that are 1:1, so that keeps us still using about 35 nurses/shift.

I want to understand more about your facilities that you say run overfull. This just feels really foreign to me, and I want to understand more about how this works!

We go way over several times a year. I know it's a big no-no and the hospital may get fined for it, but we are the only unit in our hospital that can take care of babies.

We tell the OB floor that we are full and hopefully the attendings divert their pts to another hospital, (fat chance). We send some to the regular nursery, term ones that are stable and just doing 48 hrs of abx or maybe just need a little phototherapy

.We try and transfer out, but often everyone else is full too. So if they are born in our facility and are sick, they are ours to keep.So, we scrounge up monitors, isolettes and vents (rent or borrow). Everyone sucks in their gut and squeezes a bed in where there are o2 and sx outlets.


Specializes in NICU.

We've been slow too for a couple months. Typically we have 50-60 babies, but we've been consistently in the 30s for a while now. We are getting called off about every other week. It's just awful! And to think my hospital has the most births in Ohio every year....I wonder if we will lose that status this year.

babyNP., APRN

Specializes in NICU. Has 13 years experience.

I'm on my second night of OT this week. It's not necessarily that we have that many babies but that we moved to a huge new unit with all private patient rooms, so vented patients are trying to be kept 1:1. Sure, I'll sit for 12 hours only working maybe 4 of them, lol. I don't think this will last long.

Los Angeles area, Level III NICU, 03/20/10: We've been slow since 11/09, have been getting slower since then. Registries offer little help (rarely get calls for NICU RNs). It's really scary right now. Better luck to the rest of you!


Specializes in ICN. Has 24 years experience.

In Northern California, we were horribly slow for several months--one time getting down to 19 patients, and our high is 38. The last two weeks, the census has risen quickly and we're holding about 28-30, although a large number of those were RSV babies for awhile. We did get a bunch of syndromes and asphyxias suddenly, too.

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