Wondering how other hospitals are.

[collinsRN]

I was just wondering how other hospitals are around the country as far as nursing goes. I work on CTVU at my hospital. We take care of post CABG patients (usually greater than 24 hourse post-op), Thoracotomy patients, Vascular surgeries, Chest Pain, NSTEMI, STEMI, CHF, Valve surgeries, and pretty much any other cardiac problems.

I will take 6 patients Its a 40 bed unit with usually 2 or 3 aides depending on how many patients we have on the floor. I may have 2-3 CABG patients and sometimes I feel very overwhelmed by the load I have. It seems to me that this should be considered a step-down unit and we should only have 4 patients if we are taking care of Open heart patients.

Please tell me how your hospital is? I would like to know if every place is like this or if I should just do something else. Because sometimes the stress gives me chest pain and I should be a patients too!

[laurenicoleRN]

I worked on a floor just like yours... We even pulled femoral artery sheaths after caths. It was very stressful. I left after a year and half, because of the stress. I loved patient care and feeling like I was really making a difference, but the job was really getting to me mentally. I felt the same way you do.. my floor wasn't officially called a step-down unit, but like I said we pulled sheaths, did cardiac drips and pretty much everyone had a chest tube at some point. We were a step down but if we were called that then our patient to nurse ratio would have to be 3:1. We were supposed to be 4:1 but that rarely ever happened!

[Reno1978, BSN, RN]

We have a Cardiac Unit that sounds like you describe and the ratio is 4:1.

[MicsterRN]

I work IMC - Intermediate Care, and the ratio is 4:1.

[MInurse.st]

My current clinical is on a med-surg floor and it's only 4:1.

It's also very difficult to get a job there, because no one ever leaves!

[NurseStephRN]

I work on a floor exactly as you have described, except we are smaller, just 20 beds.

My ratio is 4:1 with 2 aides from 1900-2300 and 1 aide from 2300-0700. On a really bad night we'll have 5 pts.

My assignment will sometimes include 3 open hearts (CABG, valve, whatever) and maybe a 23 hr obs chest painer. Depending on how many days post-op my post-ops are it could get really overwhelming. POD 1-2 is the worst because they will still be on an insulin drip with hourly accucheck, plus chest tubes, foley, etc. I can't imagine taking care of a couple post-op hearts with a 6 patient assignment! 4 patients should really be the norm when taking care of this population.

[AprilRNurse]

I love my job, and am reminded when I read posts like this.

I work med/surg and CCU in a rural hospital. Med surg it's usually 3:1 on days and evenings (sometimes 4:1 if the 4th admission is after the other three are tucked into bed for the night)... or 5-6:2 with an RN/LPN team. (our LPN's do not take their own assignments) we do not have CNA"s.

In CCU it's either 1:1 or 2:1. We do not have interventionalists there- so no cardiac procedures. Our insulin drips and vents are 1:1's, as are many of our overdoses and ETOH withdrawal patients. We do drops, pressors, BIPAP, vents during the week (transfer on friday if unable to wean)

We have the best staffing ratios I've heard of. I never plan on leaving.

[collinsRN]

Those ratios sound wonderful. I guess the whole world isn't like my hospital. I love taking care of the type of patients I take care of. But I don't feel that I can do it safely when I have such a large load. I am considering going to another hospital. But it seems like in this area. (I live in Kentucky) Everywhere is the same.

I was thinking about moving to a larger city in Kentucky or a surrounding state thinking maybe bigger better hospitals would be different.