1-1 ratio for nurses

[Roozeyk]

Are there units that still have one to one nurse/patient ratios, or have they long gone to the wayside?

[ChristaRN]

My PICU is usually a 1:2 ratio unless a child is extremely unstable or just won't sedate well and is a risk of self extubating. Once we had a child who actually required two nurses initially with an open belly, numerous chest tubes, vented, maxed out on 3 pressors. Coded over 5 times, stroked, and that girl is alive (neurologically intact and rehabing beautifully) today! :0)

[K+MgSO4, BSN]

Renal transplants are nursed 1:1 on the renal ward in the hospital I work at. ICU is 1:1 high dependency is 2:1. I have reallocated staff on my ward to do 1:1 if no HDU or ICU bed available. But I work in a public acute hospital in Victoria where we have ratios of 1:4 so it is easier!

[RNforLongTime]

I've been in ICU for over 9 yrs now. Rarely are pt's 1:1. I had a pt with an IABP AND running CVVHD and STILL had another pt to care for!

[umcRN, BSN, RN]

I work in a Level 3 NICU, typically its 1:2 but for the very unstable its 1:1. I can distinctly remember a patient I took care of while I was on my orientation though, poor guy, was on ECMO - had an ecmo rn running that, was on CVVH and had another RN running that, then had me and my preceptor as "bedside" nurses and this was at the end of my orientation and both of us were RUNNING all day to keep up with him.

I also work in a unit with private pt rooms which I think makes the 1:1 care more necessary sometimes.

[imaginations]

In my state in Australia our union has just negotiated 1:4 ratios (standard for a day shift in general wards, there are some exceptions for different areas/shifts).

ICU (i.e. vented patients) are 1:1, HDU (critical but non-vented) 1:2.

[RN1488]

A lot of places L & D is 1:1 once they are in active labor.

[TakeTwoAspirin, MSN, RN, APRN]

That's one of the things I love about the OR. I can only do one case at a time, regardless of how many are backing up in the aisles.

[DavidFR, BSN, MSN, RN]

I think this varies from country to country. In France even ICU is rarely 1:1 but when I worked in the UK the standard in ICU was 1:1 pretty much without exception. I don't know if that's changed - I've been gone from the UK 10 years. A lot depends on whether you have a co-ordinator in charge with no patients, a runner, care assistants, respiratory therapists etc. etc. I can't quote sources but I do have a memory of reading studies where patient outcomes are supposed to be much improved in settings where the ratio is 1:1.

ICU is the one area where I find the otherwise excellent French health care system is lacking compared to what I was used to in the UK. Here I've seen 1:2, 1:3 and even 1:4 which I personally think is totally unacceptable for ICU. Of course ICU criteria vary greatly too. Many French ICU patients are not necessarily intubated and ventilated. In my book an intubated patient needs 1:1.

[BacktoBasics]

I work in a non-trauma, non-transplant, non-open heart ICU. Our mandated 1:1's include, CRRT, IABP and artic sun. Some patients are made "1:1" for a few hours because they're off the floor for a long period of time and the nurse has to accompy them. If a patient isn't doing well our ICU is pretty good with helping out their assignment.