2:1 (2 nurses to 1 patient) criteria

[nursewratchet]

Does anyone have a written guideline for 2:1 (2 nurses to 1 patient) critieria? We occasionally have to go 2:1, but there's nothing in writing when a patient becomes 2:1, so constant battle between some supervisors and staff. If you have anything, would you please email it to me or post a link? Thank you!

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[TennRN2004]

We rarely have VADS, but when we do, they are always a 2:1 for the first day or so at least. Reason being our last BiVAD went back to surgery on average probably every other day for a major heart surgery to try and tune him up to be on a transplant list. There is just no safe way one nurse can do everything these pts require, and having helpers is definitely a plus and necessary even with 2:1 ratio, but you're asking for something to get missed from others assuming it's been done, and pt care is comprimised. Also, the few ECHMOs we've had are 2:1. Otherwise, 1:1 pts include IABPs, CRRTs, hopefully fresh hearts if staffing allows, and really sick pts with drips requiring frequent titration. Now, this is not to say we don't come into a 1:1 IABP pt and admit later on into the shift, which in some ways I think is even worse than starting out with 2 pts, one of them being an IABP.

We don't have a set policy per se that I know of, I think it is just understood in our unit a VAD is 2:1.