Sometimes our staffing is not as good as it should be, but usually we are okay. In our Level III, it varies from 2 RN's:1 baby (very high acuity- haven't seen this yet in the time I've been there) to 1RN:1baby (HFOVents, usually, or nitrous; very critical, unstable babies) to 1:2 (can be 2 vents, sometimes one is unstable, other is better) to even 1:3 (3 relatively stable Level III babies; this is unusual, but only happens when we are super-short on staffing). I've never seen a LIII assm't with more than 3 babies- at 3 we're already calling the staffing office and screaming. Even 3 "stable" LIII's, you're running your butt off most of the time, because they have qh assessments and vitals, q2h resp tx's, meds for sedation, abx, treatments, interventions, etc. If I get a 1:1 assignment I cringe sometimes because I KNOW it's going to be tough- the babies aren't assigned only one nurse for no reason! Critical care ratios typically ARE better, but you have to remember that the babies are sicker, and more care is involved. Just depends on the babies, really, but it's rarely a cakewalk. After working critical care for 18 months, though, I do have a little more control over the quality of care I give, and would now NEVER work on a floor unit like Med/Surg. Not happening in this state- 8-11 patients per nurse is just stupid and unsafe IMO. In our Level II nursery, we can have up to 6 babies before we are considered "over"full, but 6 babies with meds out the wazoo who are refluxing all over the place and refuse to eat is A LOT to handle. One night we had 12 babies and it was just me and another nurse who'd been pulled from Inpatient Peds, and had no NICU experience at all. It was a NIGHTMARE and I came home and my husband looked at me and I just fell on the bed and cried! LOL Staffing had said, well, too bad, we don't have anyone for you, and you're right on grid. Well, great, but the grid doesn't account for babies like this, or the fact that my assistance is in the form of a completely new nurse (and I'd only been out of school for 6 months!) who doesn't even know how to apply a blood pressure cuff to a baby, much less how to draw up and give meds she's not familiar with, or work the syringe pump, which they don't use up there, or feed a baby with a feeding problem, or start a new IV on those four babies who have all suddenly infiltrated. When we are at our limit, if it's mid-shift, we're screwed. Period. Staffing won't send anyone (they're all assigned) and we don't have anyone on call ever. We just have to work together and prioritize- maybe that baby doesn't get a bath, maybe the feeds go on pumps all over the unit, we just worry about the ABC's, feeding them, giving meds. It can get really hectic, but thankfully it's not all the time, unlike regular floors. I hear horror stories all the time and think, what are they THINKING, staffing a unit like that? (The staffing personnel, I mean) Hope that's what you wanted to hear. ;>) Neonatal nursing has it's benefits, and that can definitely be one of them. I wouldn't work anywhere else in the world unless I HAD to by circumstance, and it's for more than one reason. Good luck with your search!