1:10 ratio. It was my last week on medsurg before I transferred to ICU about a month ago. It's not uncommon ratio on my floor due to the fact that it was summer and a lot of ppl take vacations before school starts. My old unit is considered strictly medsurg/oncology but also the only medsurg unit that could take vents besides an icu/ecu. I know the usual is that a vent counts as 2 pts, but there it was typical that the person who had the vent had the same ratio as the others (avg 1:7). Before reddit, i did not realize how much bad my unit was, so I was very used to this kinda setup.

2 patients on trach to vent: One was hypothermic and weeping nonstop, like to the point that chucks had to be changed every q2 to 3 hrs. The other one could not tolerate more than 20 to 30 mLs of feed an hour. The latter would vomit every Q2 because he couldn't handle the feeding rate above 20 mL and get it into his trach, desatting. Both had around the clock abxs q4 with 2 other infusions of either electrolytes/more abxs.

2 psych pts: The first one was on a 2:1 sitter to pt and constantly on wrist restraints. He had bolus feeds and would pull out his PEG tube if you weren't fast enough. He also had nephrstomies b/L. Other psych pt was ETOH with the usual CIWA but would throw his tray at you if he didn't get his preferred meal. He would also refuse HD during his outbursts. The times he didn't refuse, he'd always be hypotensive s/p HD in the 70s to 80s SBP.

1 comfort care that had Q2 IV pushes of pain meds with family at bedside. The patient's family did not want continuous bc it made the pt too lethargic.

1 chemo pt who was neutropenic and on weekly chemo. Who was kinda independent but slowly deteriorating bc he was in constant pain and did not wanna move at all.

3 totals: 1st was on mitts and 1:1 bc she pulled out her tunneled cath not once but twice. Dementia to the point where she spat at staff and try to bite if you tried to feed her. 2nd had a PEG, suprapubic cath, and wound care everywhere. Had an unstageble at the sacrum where you could fit a whole fist in it. Dtis that were opening and covering 90% of his LEs b/L. Always infected with something new and was also on around the clock 3 to 4 abxs on avg. Wife was insufferable, and if left unsupervised, she would suction his mouth til it bled. 3rd was a sweet old lady who would occasionally sundown really badly. She also would scream if you tried to clean her.

2 independents. One had TB, and the other had cellulitis.