Icu/open Heart Staffing

  1. I am wondering what are the general staffing ratio's out in the nursing world, in ICU/Open Heart Units. We recently are experiencing a budget problem and the staff in the ICU are finding themselves taking 3 patient assignments as a routine. What is everyone else doing?? Also, our hearts are one to one until extubated and then no matter how ill, they get paired up or tripled up.

    Comments Appreciated
  2. Visit littlecheese profile page

    About littlecheese

    Joined: Aug '06; Posts: 14
    Assistant Nurse Manager in ICU
    Specialty: Critical Care/long term care

    5 Comments

  3. by   LoraLou
    Usually our staffing is one nurse to two patients occasionally 3 depending on staffing and acuity, most of the time its 1:2, now our OHRU is a totally separate unit but with the same nurses so its a little different, just a small 2 bed unit and we don't do many hearts at all, so most of the time its actually 2nurses to one patient, regardless of the acuity, simply because of only being a 2 bed unit and needing of course 2 nurses in the one room. At most it would of course be a 1:1 ratio, if we had two patients done that day.
  4. by   pickledpepperRN
    We have had legally mandated 2 or fewer patients per licensed nurse for thirty years.
    Even when nurses take a patient to the OR or for a test there must be a competent RN to assume responsibility for the other patient.

    Our open hearts are 1:1 until the direct care RN determines that it is safe.
    Usually soon after the patient is extubated if the patient is stable we take over another patient so that patients nurse can accept an admit.
    A patient on CRRT requires an additional licensed nurse, RN or LVN especially if on an IABP too.
  5. by   Dinith88
    Quote from littlecheese
    I am wondering what are the general staffing ratio's out in the nursing world, in ICU/Open Heart Units. We recently are experiencing a budget problem and the staff in the ICU are finding themselves taking 3 patient assignments as a routine. What is everyone else doing?? Also, our hearts are one to one until extubated and then no matter how ill, they get paired up or tripled up.

    Comments Appreciated
    Where i work, the open hearts are 1:1 until 8 hrs after extubation. This all depends on patient acuity, and if unstable the patient will remain 1:1. If stable, 8hrs after extubation, our ratio never goes over 2:1. If all goes well, patients are moved to IMCU/step-down within 24-36 hrs...where the ratio can be as high as 4:1 (never higher)
  6. by   LCRN
    Hello-

    Routinely we have a ratio of 1 RN: 2 patients for most of our assignments.
    Post-op OH are 1:1 the 1st 8 hours and then unless they are considered unstable (requiring 3 or more pressors/dilators) or have open chest with IABP another patient is added to the assignment.

    At the hospital that I work in we have a POD system so each RN has a desk computer, phone and 2 patient rooms directly in their visual field while sitting at their desk. We have a total of 30 beds between the MICU and SICU, all RN's are cross trained to work in both units. This system works well unless both patients in your "pod" are SICK....traumas, crani's with ICP's, AAA repairs, etc.

    We always have a charge RN and a resource RN to assist newer staff members, take the MET Team calls, Codes and place IV's on the floors that are difficult sticks. We (in the unit) also assist with conscious sedation for bronchoscopy's that are on the floor and triage patient's with the ICU Resident. The charge RN and resource RN rotate on a weekly basis and are essential to the daily flow of the unit because they do not have patient assignments and are able to assist with a crisis that always arises.

    Hope this info helps!
  7. by   bethem
    "My" ICU staffs 1:1, intubated or not, all day and all night. Our HDU staffs 1:2. On days, our wards staff 1:4, afternoons are 1:6 and nights are 1:8. I love our ratios.

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