micurn2

Does anyone have a policy for CVVHD or IABP???

I work in a 12 bed MICU (noc shift) short staffed so more often than not we have 3:1 ratio. we get CVVHD alot and the occasional IABP, alot of intubated,sedated pts with their various requirements of standards of care that they need. IABP and CVVHD pts were always 1:1 pts but as they say "not anymore"....our IABP class was one eight hr day and each year we receive updated inservices which "qualifies" assignment to the pt. My first experience with CVVHD was "on the job" training by the dialysis nurse who thought it was funny that we hadn't been told that we had to take care of the machine and the pt etc etc...now CVVHD comes with "bigger" bags that don't have to be changed as often so our nurse manager feels they don't have to be 1:1 so we now get second pt. We don't get as many IABP pts because the more critical ones actually get transported to another hospital ( can't wait for my first inexperience on transporting) so each time we keep on a little longer I go get my books and "refresh" myself. I can call the MICU resident if I have problems; who may or may not know that much about IABP or I can call the cardiologist on-call. We tried standing our ground but we lost to management because unfortunately we don't have a policy covering either the CVVHD or IABP. IS there anyone out there who could help me help keep my pt(s) safe and provide the BEST care possible???