Rapid Respiratory Weaning Unit (RRWU) converted to COVID-19 ICU

County General, Brooklyn, New York

Rapid Respiratory Weaning Unit (RRWU) converted to COVID-19 ICU

Nurse to Patient ratio is expressed in two ways: the number of patients working per shift divided by t Prhe number of beds occupied by the patient. The nurse to patient ratio in an ICU setting is one to one or one to two. The nurse to patient ratio on (RRWU) is one to four. During the COVID-19 the Rapid Weaning Unit, bed capacity 24 with a total of five  regular med-surgical registered nurse, two patient care associate, one receptionist with two ICU float nurses had the task of caring for fifteen vent weaning patients and ten intensive care patients who had varies degree of acuity. Report on the entire unit was endorsed to the two critical care ICU nurses since their job was management and documentation of ventilators, titrated of vasopressors, management of central venous catheters, initiation and maintenance of continuous venovenous therapy(CVVH) and being a resource nurse to the med surgical nurses. Report endorsed and noted in the form of SBAR. May 5th, 2020

 Situation: COVID-19 ICU had a census total census 25 patients. 8 patients on vent support requiring complete care, 6 patients on rapid weaning pathway, 4 patients on CPAP alternating with high flow nasal cannula, and 6 on vasopressor requiring high level ICU care. One patient on renal replacement therapy CVVH.

Background: One ICU nurse with 20 years of experience and the other with one year. The five med surgical nurses with 1-5 years of experience. (RRWU) staffing grid: 1RN to 4 patients.

 Assessment: High unit acuity, one patient on CVVH, six patients on vasoactive drugs, ICU nurses are the resource nurse/ clinical nurse. Staffing ratio is above the staffing grid that outlined in the policy. staffing needs: six med surgical nurses, four ICU nurses needed. 

 Response: Administrator Chantel Francois was noted, and union present Frances Thomas was informed of the unsafe staffing situation on COVID-19 unit.Protest of assignment was filled out about the unsafe practice on the unit.

Introduction

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