jackieRN03

Hi Allele Thanks for the info. You ratios are better than ours. If we had a 3:1 ratio an insulin gtt would be a piece of cake. What part of the country are you in? My biggest problem with this whole situation is that the people who decide what the bedside nurse can "handle" does not work at the bedside and probably hasn't in many years. There is no accounting for acuity of patients or for the type of surgery/disease process. They use these formulas to calculate how many nurses needed per shift that are totally inadequate because of the above factors. Administration throws extra money or high differentials at nurses and thinks this will keep patients safer.

Turquoise, your situation sounds very bad. Check with your state board of nursing. Basically you have 2 RN's taking care of WAAAY too many dangerously sick people. Your nurse manager, DON and administration should be ashamed of themselves for putting all those lives at risk!

We will have to take 2 pts with insulin drips and 2 more. The attitude of management is terrible. They are going into this with a "no stopping it" attitude...I think they realize its too much already. I especially hate the comments like "well you'll just have to do it" etc, because it devalues the staff nurse's opinions and knowledge and tacitly implies we would not do something unless ordered too. I am trying to find statistics from the "top hospitals" using insulin drips on floors and what their staffing is like and how they are coping with it. I am also trying to find research articles relating to insulin drips on floors and its effect on morale. Once we have some hard facts we can go to management as a group and discuss options. Our hospital, like many others, is hoping to get magnet status but they still do not want to include staff nurses in the larger decisions that will affect them the most.

We are constantly running on our floor. Its hard to find time to tinkle sometimes. Suzanne, the source of the article says it all...Critical Care medicine. Surgical telemetry gets all sorts of patients, from the knee replacement getting brady to the lap chole needing IV lopressor. Its a matter of time...we just don't have it to give to one or two patients needing that close monitoring. We may lose some great nurses over this who are already stretched to breaking point!

Our post cardiac surgery floor is soon to get patients still on insulin drips from CVICU. We usually have a 5 or 6:1 ratio with 2 or 3 techs for 30 patients. Although we do titrate some drips, the idea of having a patient on hourly fingersticks with drip titration is daunting. We are told the assigned nurse will have only a 4:1 ratio but must take 2 pt's with insulin drips. We have been told that many top cardiac surgery hospitals are doing this and are coping well. Does anyone have experience with insulin drips on the floor and if so, how does the pt cope with 24 fingersticks everyday? Is the a desire to get pt's out of CVICU quicker? I have seen some studies about insulin drips and the decrease in deep sternal wound infections but the studies did not show where these patient were located.

I'm glad to see you have gone to your manager about this. I'm a little concerned about your posting of such an account on a public web site like this. I have not been participating in allnurses for long but I would be concerned about making this as public as you have. Anytime possible criminal behavior is written down, it is part of a public record that may be used in court. And although we use pseudonyms for our posts, it is possible to figure out who you are and who you work for. Just a word of caution.