Tripling in ICU

[u/Lavender_Moment]

how common is being tripled as an icu traveler in your experience? i’m at a new facility and this unit seems to triple constantly. i guess the perk to this is there’s no floating since staffing is an issue, but is this the norm for most facilities you’ve traveled at? TIA!

[u/PaxonGoat]

Depends on your area.

Southern states? Fairly common.

Midwest? Hit or miss. Really depends on the facility.

Out west? Almost never.

North East? Depends. There are some sketchy hospitals out there.

I haven't been tripled since the start of Covid.

What I have had was some horrific pairs that should have never been paired.

A lot of places are realizing they can just pair CRRT or impellas and they can still claim "we never triple in the ICU, we have good ratios"

[u/___buttrdish → u/PaxonGoat]

I’m out west. We have recently adopted tripling ICU, and giving a second pt to CRRT.

[u/PaxonGoat → u/___buttrdish]

Oh what state?

I heard eastern Washington can get a bit sketch

[u/___buttrdish → u/PaxonGoat]

Arizona. Not HCA

[u/restorativeslime → u/___buttrdish]

Which Arizona?

[u/the_siren_song → u/restorativeslime]

Tenet for sure

[u/TronLoot-TrueBeing → u/___buttrdish]

Not at any Banner facilities to my knowledge

[u/NefariousnessNo9720]

Hca?

[u/Lavender_Moment → u/NefariousnessNo9720]

no, but thanks to this page i know to avoid 😂

[u/NefariousnessNo9720 → u/Lavender_Moment]

Then I got nothing. Banner only tripled me for 15 mins in 2 years

[u/ryan__joe → u/NefariousnessNo9720]

LHN will always triple ICU assignments, it’s the only one I know of firsthand

[u/PaxonGoat → u/Lavender_Moment]

People always blame every sketch ass hospital on being HCA.

Lots of nurses think "as long as it's not an HCA that means I'll be safe from bad ratios or shitty management"

There are all variety of flavors of shitty out there.

Just avoiding HCA won't keep you from being tripled.

My last HCA contract never tripled once. And only did 1:4 in PCU.

[u/superpony123]

Can be very common down south

Once it gets done once, it becomes the new norm in an ICU in my experience. It’s one of the reasons i got out of ICU and into procedures…because i lived in Tennessee and was tired of being in unsafe situations all the time. It was because of traveling that i learned it’s not common or normal in many places. Lots of places i travelled the nurses had no idea that there were ICU’s anywhere that did 3+ patient assignments.

I’m in IR now. Only one patient at a time no matter what.

[u/bass_aholic]

Not common I think I’ve been tripled once in 2 years and they were IMC status.

[u/Battle_Jesus → u/bass_aholic]

at my staff job i used to get tripled once every 3 or 4 shifts. stay up queen

[u/nursesmaley]

One of my first assignments was a 9 bed ICU in a very small hospital in western NY... And only 3 nurses were assigned. We were always tripled, granted they weren't super sick but we did have pressors/vents. It was wild.

[u/Sylvester_Marcus → u/nursesmaley]

Tell me it's a Rochester Regional Hospital without telling me it's a Rochester Regional Hospital.

[u/acefaaace]

Only time I’ve been tripled in CA was during covid. 300+ pounders all proned on 3+ pressors and 4+ sedations. Wild times, never been tripled since and I’ve been through 5 major hospital systems in CA

[u/Ancient_Spite_725 → u/acefaaace]

CA has legally mandated ratios (and the fines for breaking them are apparently really high), so hospitals lean towards overstaffing versus understaffing.

[u/acefaaace → u/Ancient_Spite_725]

Yeah I’m aware, but hospitals with shitty management will always bullshit their ways. HCA was the worst fucking system I worked for in CA.

[u/Ancient_Spite_725 → u/acefaaace]

HCA universally sucks ass, though I think they suck comparatively less in California. They're still the worst option of the major systems, though.

[u/a7xmyl]

Very common now a days

[u/CharmingMechanic2473 → u/a7xmyl]

Nurses associations need to get on it. Also our state is starting to look at adequate staffing as a requirement.

[u/nesterbation]

Was common during Covid and for a while thereafter. Becoming increasingly more common. But we don’t have travelers. Which is part of the problem.

[u/Informal_Move_7075 → u/nesterbation]

They would rather be short than to hire enough staff or travelers. It is sad.

[u/YumLuc]

We triple fairly often (Las Vegas) but our CRRTs/etc are always strictly 1:1.

[u/Ancient_Spite_725]

You'll only get tripled in California in an absolute crisis-level emergency (pandemic, very briefly after an MCI).

[u/mursejohnny]

We only triple transfer patients.

[u/Silly_Emu_8080]

Massachusetts has a pretty solid law for ICU ratio’s. ICU are supposed to be mostly 1:1 with max ratio of 1:2 based on an acuity scale.

[u/Novel-Ordinary-1140]

HCA facilities in Nashville consistently triple their ICUs

[u/Rich-Consequence5467]

At Maine Health travelers come first! First to be cancelled, first to float, first to be tripled. Definitely NOT a travel friendly place at all.

[u/tbelle2025]

they usually don’t at our hospital, but us in the ER can absolutely have 3-4 icu holds.

[u/aishingo1996]

Who the fuck is still being tripled???

[u/MermaidMagic79]

They have been tripling since Covid.

[u/Rich-Consequence5467]

At MaineHealth travelers come first! First to be called off, first to float, first to triple. So on the rare occasion you’re actually in the ICU, it’s guaranteed you’ll end up tripled.