Survey on how many patients you get in a shift

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Specializes in NICU, Nursery.

I know some states have regulations for ICU units, NICU is an ICU soooo we SHOULD be getting only a maximum of 2 patients per shift. Am I one of the unfortunate ones who got stuck working in a hospital who shoves you 3-4 patients??!!? Sometimes even 5. Yes. Hourlies and all that. Should I leave and go elsewhere? Or is elsewhere the same too? Ughhh!!!

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I work in an adult ICU and being tripled is just common practice now :\

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Our nicu is a level 4 and we usually r 2:1 but if they r feeder/growers and about to be discharged then sometimes a 3:1 but depends on the census and the amount of nurses. If the baby is on a vent it's never a 3:1

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Specializes in NICU, Nursery.

Omg! Just had a bad day, thought everything was going well until the end, I always say 3 is too much, 4 is just dangerous no matter how long u have been working as a nurse It's just waay too much if u ask me. We have no one to help us out either no techs, lpns etc. only nurses and we have to do EVERYTHING! Ugggghhhh!

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Specializes in NICU.

1:1 if a vent (rarely will we take an additional patient with a very stable vent, but that has happened as well), 2:1 if a very sick vent, 1:2 for CPAPs (occasionally Cpaps will be tripled), 3:1 feeder growers, and 5:2 for RN/LPN team for feeder/growers/NAS

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I must work at the same hospital. We are so short staffed right now! It wasn't like this when I first started here. It's not uncommon to have up to 5 feeders, but we usually do have an aide, sometimes 2 if we are very busy. But recently we've had ridiculous ratios on the vent babies as well. The other night I had 4 in the ICU, 2 on vents, 1 on high flow O2 and one on NEC watch! I did have an aide with me that night. Last night I had 2 who are both on isolation, one on an oscillator and the other on a vent. Tonight, by some miracle, there are 6 nurses on and I have the oscillator baby 1:1, which is the way it's supposed to be! We have been filling out protest of assignment papers almost on every shift, but nothing changes. It's scary.

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Specializes in NICU.

Nurse Connie, that does sound scary! Do you have the aide assigned just to you and your team of patients, or does the aide float the floor?

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Specializes in NICU, PICU, PACU.

It depends on our staffing. We try to only put one kid with vents, NAS kids, or chronics. When we are busy you can have up to 4 step down kids and up to three with the above kids. Cooling and PPHN kids on nitric are 1:1. Back in the day we would have 6 step down kids and 2 vents with a trach kid...it's a wonder any of us stuck around!

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Specializes in CDI Supervisor; Formerly NICU.

Typically, in my old unit, we would have:

critical/jet/nitric/oscillator kids 1:1.

stable vents + 1-2 feeders.

feeders/cannula/cpap/etc 2 or 3:1

worst assignment I ever had (called safe harbor): 2 jets with drips, a cpap kid, first admit, and c-section nurse. Plus resource nurse. We didn't have a charge or secretary. Another nurse had 2 jets and a cpap. All other nurses in the unit that night had less than a year nursing experience, or were floating from picu/pedi. How we didn't lose any babies that night is beyond me.

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Three or four in intermediate, which can range from feeder/growers to stable vents. When staffing is good, a CPAP or vent would be in a 2-3 baby assignment, but if we're short, all bets are off. We do have CNAs in intermediate so ideally if we have a four baby assignment, we'll have an extra set of hands, but not always.

On the intensive side, we usually have two babies, unless one is critical. Automatic 1:1s (if at all possible) are cooling blankets, multiple presser drips, insulin drip, obviously a baby who has coded recently, and an unstable jet/oscillator. Right now we're crazy swamped and there was a very unstable oscillator (recent code, recent pulmonary hemorrhage, multiple blood products, multiple critical labs, total hot mess) that was part of a THREE baby assignment for 24 hours before it got changed. Totally not cool, but they had to make it work. That is not an assignment I would have accepted...its just dangerous. It's fortunate that the kids who were close by weren't also requiring a ton of attention, or else it could have gotten ugly fast.

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Specializes in NICU.

1-4, depending on acuity.

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NICU:

1:1 unstable kids, kids on nitric

Typically 2:1 vented, CPAP, vapos. I never say stable, because even the most "stable" kid can turn on you very quickly.

Step down:

Usually 3:1 ...all hell breaks loose with our staff when the special care nurses get 4:1. However, after spending a shift down, there I can confirm that 4:1 is nuts with feeder/growers and q3 hour full assessments. Those nurses just keep going and going. I MUCH prefer my sick as snot 1:1 or 2:1 than having 4 crying/feeding neos... But that's just me! That's why there is room for us all.

The special care nurses are now being informed that we will mix our acuity instead of having two units and there is a lot of resistance.

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