Ratio?

[NebraskaRN]

Nurse to patient ratios can be difficult and a very complex and hard problem to figure out with the nursing shortage and bad economy.

[ittybabyRN, RN]

I work in DC in a 54 bed level 3c unit. We have 46 private rooms and 2 4bed pods. We have level 2/3 mixed (no stepdown or intermediate area). We often have 1:1's, the usual is 2:1 and rarely we have 3:1. A 3:1 assignment would be feeder/growers only or feeders mixed with NPO's but no vents/frequent labs etc, and we only have 3:1's when we are short or have quite a few critical pts. Ratios are based on how acute the pt is or how "needy" a pt is. ECMO/HFOV/Cooling/PPHN kids are generally 1:1. Other than that it depends on what the kid is doing to warrant a 1:1 assignment. We very rarely have 2 vents paired. Admits are usually paired unless the kid coming is really sick and then the admitting nurse would have to give up her babies.

[NebraskaRN]

thanks for the information

[BittyBabyGrower, MSN, RN]

Our ratio is usually 3:1 for gainers and growers, 2:1 for a vent and a feeder or two vents. But that isn 't written is stone. You may get 4 kids if we are busy, you may have 2 vents and a feeder. Admits are 1:1 usually for at least 4 hours. You will find that all units are different. I know that there are others theads on here about this.

I think that private room units usually warrant more staff, but I know that isn't always the way, esp with hospital budgets the way they are.

[SteveNNP, MSN, NP]

I work in a IIIc unit in NYC.

Most assignments are 2-3 babies...since we don't have many vents. You can have as many as 4 on our stepdown unit. Our admission/stabilization unit on L&D handles all the admission/line, etc stuff before sending the baby down to the unit, so admissions aren't 1:1s here. ECMO/HFOV/JET/cooling/postop cardiacs are all 1:1s until they become stable.

[NebraskaRN]

thanks again i have seen other threads about this but i wanted more up to date information

[littleneoRN]

I work in what would be considered busy IIIc that transfers kids out when they become stable feeder/growers. So, we have some Level II type kids but not that many. Most of our vents tend to be 1:1, but sometimes you'll have a more stable vent paired with a stable feeder grower or other low need baby. It would be extremely rare with bad staffing to have high frequency ventilation paired. ECMO, PD, and body cooling are 1:1. Admits are 1:1 usually for at least the 1st shift and then as needed after that. You don't have to keep your previous assignment if you are admitting, even if the admit is super stable. Intubation and line placement is done at the delivery, but that's about it. You still have labs, x-rays, adjustment of tubes and lines, fluids, meds, frequent vitals, etc. to do. This gives us the chance to focus on the baby, family, and all the admission documentation. We "never" have 3 pts, but I've seen it a few times when we're really in a staffing crunch. SiPap, CPAP, nasal cannula, room air kids are all generally paired. Our step down units are 2 or 3:1, depending on acuity.

Oh, and we have private rooms.

[NebraskaRN]

thanks what state are you in? just curious if you don't mind.

[ittybabyRN, RN]

I work in what would be considered busy IIIc that transfers kids out when they become stable feeder/growers. So, we have some Level II type kids but not that many. Most of our vents tend to be 1:1, but sometimes you'll have a more stable vent paired with a stable feeder grower or other low need baby. It would be extremely rare with bad staffing to have high frequency ventilation paired. ECMO, PD, and body cooling are 1:1. Admits are 1:1 usually for at least the 1st shift and then as needed after that. You don't have to keep your previous assignment if you are admitting, even if the admit is super stable. Intubation and line placement is done at the delivery, but that's about it. You still have labs, x-rays, adjustment of tubes and lines, fluids, meds, frequent vitals, etc. to do. This gives us the chance to focus on the baby, family, and all the admission documentation. We "never" have 3 pts, but I've seen it a few times when we're really in a staffing crunch. SiPap, CPAP, nasal cannula, room air kids are all generally paired. Our step down units are 2 or 3:1, depending on acuity.

Oh, and we have private rooms.

I would also like to know. I am a new grad...well I guess I was a year ago anyways while I love my unit I get pretty bored with the feeder/growers and am looking into travelling/working elsewhere eventually. Would love to work in a level 3 that is mostly just that and sends kids out when they reach a certain stability

[NebraskaRN]

Update I have had many good assignments since that day. The unit is trying hard to make assignments better. I am very happy with this hospital and my choice to work here.