nurse - patient ratio

Specialties CCU


hi guys..need some help in locating some info. i work in a small 6 bed ccu-icu. we have a new manager, who wants to make improvements. (ok, who doesn't when they first start) one of his ideas is that he wants us to take a 3:1 ratio. wehave informed him that we are more comfortable with 2:1 due to some of our acuities, and that we do not have a lot of experienced nurses..which means the old ones actually have the 'whole" load. (which also means we're burning out!!..and fast.. :o )

does anyone know where i can locate a site that has any type of ratio info?

thanks in advance, and thanks for letting me ramble... :imbar


Specializes in M/S/Tele, Home Health, Gen ICU.

Sorry, I don't know of ant web sites but I thought that ICU staffing had to be 2:1. Here in California we are mandated by Title 22 to keep that ratio, so you may want to check your state regs. I manage a small ICU/CCU of 8 beds. Good luck :)

sharann, BSN, RN

1,758 Posts

I don't want to bash someone I don't know, but it sounds like your managers idea of "improvements" is more budgetary than nursing care improvements. He may get a raise out of it but you may find your care suffers. This calls for an immediate department staff meeting(and you all must tactfully explain why you must keep ratios the same) Pull studies off the web if needed. United front without being confrontational works wonders. Good luck


32 Posts

if it helps:

i've seen plain old mi, bad belly, and metabolic disaster, etc icu with 2:1 as the norm. that said, we also went 2:1 with balloons pumps and cvvhd. crashed cath lab balloons used to be 1:1, but staffing dictated worse and worse ratios.

it's up to us to say no.


335 Posts

So true, so true - it is up to us to say NO!!!

I would present the facts, keep it focused on pt care and outcomes. Don't make it personal. I agree that it is prob budgetary driven from the NM side. ( what isn't these days?)


1,245 Posts

I believe the new calif. regs are posted on this site.


9 Posts

Staffing is always a sore issue. We have a small 8 bed ICU/CCU. Ventilated patients, CVVH,ballon pump and any haemodynamically unstable patients are always 1:1.

Always stand up for patient care and safety which also equates to staff and hospital safey as well.

Good luck :rotfl:


7 Posts

thanks for all the input guys...

for the last 8 weeks my life has been hell with this guy. he threatened my job, talked about my religion (wiccan), talked about how poor my attitude and patient care was,(funny thought how the md's always wanted me to care for their patients) and decided to try and be sly and touch me boobs....

but if i did anything it would be in retaliation!-does the phrase BS mean anything!!!!

well to say my job, not to mention my sanity..i went to EAP, and guess what was funny. the rep kept telling me ..he can't do that-he can't say that.etcetc.

and ya know 2 days later...this guy was asked to leave. think the impending potential job/sexual harrassment suit had anything to do with it!!??

thanks for letting me you guys!!!!


754 Posts

Go to your local library and look up the state hospital regs. ICU staffing is definitely in there. BUT, don't be surprised to find that your ratios may have changed to 1:3 like I found out in NJ, however, there is the wording that acuity changes must be taken in to account and done if 1:1 or 1:2 is needed. Most GOOD hospitals will not go beyond the AACN reccomendations. Someone changed them approx 10 years ago. NOW, of couse, AACN advocates for 1:2 with the possiblity of changing them 1:1 if acuity warrents.

Does your manager have his CCRN? IF not, why was he even hired??????

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