PCU/Step-down

[esrun2015, MSN, RN]

Didn't know where to post this since there isn't a section for PCU nurses. My question is what are your nurse-to-patient ratios for PCU/Step-down? In my hospital, there are five PCU units. I would like to see how we compare to others in the nurse-to-patient ratios. We are 4 to 1 sometimes, but mostly 5 to 1, which is the same for the Med/Surg units.

[LovelyRN10, BSN, RN]

I was just hired as a new nurse and at my hospital the ratio is 3:1. However, the other  hospital in my town has a ratio of 4/5:1.  

[JzK CCRN, BSN, EMT-I]

In my hospital, up until last week, PCU has been 12 beds with 3 RNs. Sometimes, there's a shortage so PCU will have 2 RNs. Depending on what's happening in the hospital and ICU it's self, ICU RN might float to PCU to balance out these numbers. 

Currently, the PCU is being renovated so they might add more beds, don't know.

Like many renos, we don't know until its over ?

[Parvulus_puella, BSN, RN]

Our PCU/IMCU is 1:4.  Sometimes day shift has an extra nurse and they can do 1:3.  We have also recently started utilizing LPNs, so the RN may have a total assignment of 1:4 but the LPN may take 1 of them. 

[Determined33]

I started as a new grad RN in PCU and our ratio is 3:1 in California, which is great! Other states are definitely different. In my county hospital our unit was considered critical care/ICU step down, with drip titration etc.  I would like to mention that when I also worked at a smaller local, community hospital in the Med/Surg- Tele unit, we would get 4 Tele patients, or 5 MedSurg patients. We had LVN's working on our unit and they essentially performed the same job as an RN except for pushing IV medications and starting IV's. This is great for LVN's gaining experience similar to an RN. The problem in my opinion is that the LVN is under an RN who has her own 4-5 patients and now the RN has to review and sign off on all of the charting for the LVN's 5 patients and it is now under her license. I think this is not a good practice overall as it is very challenging for the RN, on the dangerous side if the RN doesn't have adequate time/ or any time to get to know the LVN's patients too, yet it is essentially under the RN's license if anything goes wrong with the LVN's charting and you signed off on it (mandatory to do before your shift is over and you have an LVN assigned to you). This is my understanding and how it had been explained to me by the long term RN's in this hospital. Fortunately, the couple of LVN's I knew were wonderful and I never had an LVN assigned to me. (PS no extra pay for the RN to do this extra duty either.)

[Corey Narry, MSN, RN, NP]

I work in California and as a provider, the patients admitted in step down are either "acute care" meaning 4:1 staffing vs "transitional care" which is 3:1 staffing.