Average ICU census

[nephrondoc]

In a closed ICU, how many patients are you guys seeing on an average in a day ? Our numbers are anywhere between 10-18 per day.

What number do you think would be unsafe for patients?

---

Members don't see this ad.

 

[jdh71]

In a closed ICU, how many patients are you guys seeing on an average in a day ? Our numbers are anywhere between 10-18 per day.

What number do you think would be unsafe for patients?

I don't know that it us absolute numbers as much as acuity and complexity. But yeah even basic patients if you're seeing more than 20 - 25 a day could easily get out of hand.

Where I work there are two of us in during the weekdays single coverage on the weekends. We usually see about 10 to 14 each on the weekdays. And make due on the weekends as best as we can.

 

[Doctor Bob]

Here, during the day in the MICU there are 2 of us to cover 34 beds. At night there's just one.

The unsafe question is a bit more complex. It depends on the acuity. If there are 34 rocks I can see them all and it's not too bad.
If on the other hand there are 4 sick people crumping at the same time, and they're geographically distributed (at opposite corners of the unit or something), it can be rather worrisome.

 

[sluggs]

A whole lot depends on how well your ICU is organized. I worked at a very high acuity place with great nurses and a great system and could see 13-17 without much difficulty. Now I work in a lower acuity place that is chaotic and 10-12 is a challenge just bc the system is terrible.

 

[tartesos]

I work per diem in a place with 16 beds.
Some days are routine but some can be challenging depending on how sick/crashing and how much you need to do on them( procedures, new pat chart review etc), how much support you have ( pa, np, good nurse etc).
Up to 20 is manageable on most days in my opinion, but It does not take much for it to go ugly.

 

[jdh71]

You know after coming off a pretty grueling weekend and a busy busy couple of weeks in the unit. I think the better way to think of it is daily wRVU.

30-39 is a solid day, I go home at a decent time, see my wife and kids, maybe even hit the gym or jog in the evening
40-49 I'm eating cold dinner and just putting my kids to sleep, maybe get to hang out with my wife for about an hour
50-59 I get home in time to go to sleep and get up and do it again
60+ I leave the hospital at midnight

On those 60+ days sometimes I feel like I'm flying by the seat of my pants a bit.

Though again, it really comes down to patient complexity and acuity at baseline. There is a BIG difference between a basic critical care bill of a straight forward spetic on pressors with an acute hypoxic resp failure and one that is also 80, with a cancer, a coagulopathy, a low EF, a chronic arrhythmmia, with the beans out, and an acute encephalopathy from the illness. One you'll knock out that quick critical care bill and the other you have to sit and be thoughtful about, maybe for awhile.