Patient Scheduling - page 2
Does anyone have a good patient scheduling template they'd be willing to share, or know of a good system to purchase? One of my main problems, and yours too probably, is turnover. My techs work in... Read More
Jun 19, '09our opener comes in 1 hour ahead, to set up her 4 machines, do water checks, make bicarb, bleach water, etc. we come in 45 minutes before and are able to have 16 machines up and ready. How is there no time for breaks for you? Pts are on around lunch time and around breakfast time. All dialysis has a lull about halfway through 1st shift and 2nd shift.
In the morning, the 1st shift starts coming off around 930-ish and by 1130 or so, the 2nd shift is all on. Our put-on and take-off times are all jacked up just like yours, but somehow it always seems to work. It takes a lot of team work, I'll tell you that! We have one pod that has the short-runners, then all the long runs are dispersed into the other pods. This way, we can help the "early pod" person turn around, then they can float around and help everyone else put theirs on. The RN's help with turnaround also.
You need a unit secretary! We don't have time to answer the phones either. All the calls that get patched through to the floor during turnaround just ring and ring until someone actually picks it up.
We used to have one pod that started later, at 7. So most ppl were going on at 530, then a PCT would come in at 615 and set up for their late bay. Those pts preferred coming in later, it was easier for that PCT to help with the main turnaround, and then they would be the closer for that day, since their pts came off later.
I know we all want to have "ownership" of our patients, (She's not mine, I'm not answering that alarm). But when it comes down to turnaround, it really helps when we work as a team. A PCT will get a CVC (his pt) ready for me, while I get my own pt ready with vitals and machine settings. Then we switch. I'll do the CVC while he goes and sticks my pt. We both win!
Good luck and I'll try to think of other stuff that might help.
Jun 19, '09I googled and found this-
Jun 19, '09that's pretty cool. I think Snappy (Davita) or some other IT program has the schedule planner thing in there somewhere, because I've seen the schedule of pts vs. staff ratio, productivity, whatever, pulled up on the nurse's station computer.
Jun 20, '09The staff at our unit do work together, or we would never survive. There is not time for breaks or lunch because we have such a long turnaround. In the moring our first shift starts going on @ 0700 and finishes @ 0800. We do nursing report and the techs then go back to chart on the first shift since there is not enough time to do all of it when the pts first go on, they do packs for the next shift, stock supplies etc. They are very organized and busy. Our first patients start coming off 0945 - 1000, the next shift of patients start going on at 10:30 and put on last until 1230. So between 1000 & 1230 each pod is taking off 4 pts, tearing down, setting up, (alarm testing alone takes 10 minutes), testing conductivity and putting on 4 more patients. In two of the pods the the second shift starts coming off at 1330. We only have three techs & one nurse. Our population of patients are elderly, many are in a nursing home & require alot of assistance to transfer or hoyer lifts. Only 6 pts are "walkie talkies". The RN pitches in where she can with whatever needs done but has her own duties also with meds, pre & post assessments, troubleshooting, trying to answer the phone, monthly med reviews, foot checks (my employer does not feel anyone but an RN is capable of checking feet), physician rounds plus all of the other reports & paperwork that the employer requires. The lull that GeauxNursing describes at their unit does not happen at ours (I wish). The techs are also trying to fit in water checks, bicarb, putting away stock etc. I am still curious how in the sample schedule a pt can come off @ 1000 and one go on @ 1015 in the same pod. The area manager does know that the techs come in & work off the clock in the am, but as long as the total area productivy numbers look good he doesn't care, I guess that would affect his bonus. Thanks for all the suggestions.
Jun 20, '09Wow, cocoa, that sucks! Where do you fit in? Are you the nurse? If you are, I'd demand more help and then you'd just have to totally revamp the pt schedule. I wouldn't work under such stress every day. That's crazy.
Jun 20, '09Cocoa, I just went and made an excel document that has 3 of our pods with the put on and take off times for each pods pts, 1st and 2nd shift. Did it so you could see what a typical schedule is like for me. I used our actual times, so there are 3.5 hour pts, 4 hour patients, 4.25 hour patients. 3rd pod has some CVC pts, so the times might look really close together, but that is because one of our RNs will be putting that pt on while PCT is putting on a stick.
Anyways, if you PM me your email address I'd like to send it to you, show you that there is hope!
You'll notice that morning put-ons take 1 hour, then that leave at least 2.5 hours for PCTs to stock their stations, make packs, draw heparin, nurses give meds and sort out all the morning issues, everyone takes a 30 min BREAK and gets set for turnaround.
Jun 20, '09I come in early and work off of the clock, too. There is no way to be ready when the pts come in if I don't. At least I am working for a non-profit, so some horrible corporation is not getting rich off of my hard labor.
I am on a travel assignment, so I don't have any say on how things are done. At least the staff are all really great and work together- but we are being worked to death.
Jun 22, '09Geaux nursing, that sounds like my clinic.
I try to tell my pts that the time given is an estimated time! This is a goal time. The example I give is that when I go for a Dr appt, normally I have to wait...in the lobby...then wait some more in the room. That is normally because the appts may run longer than expected or the doc may have to go for an emergency. (or if the doc is putting too many pts too close together, but that is another thread):zzzzz. I told the new FA that she needs to put that on the letters when she hands out new chairtimes, "your estimated put on time is _________".
Jun 23, '09Cocoa Girl I just read your post. I can't believe you don't get a break or lunch. We are crazy too, but we must make time to eat. That is so unfair to ask of the staff on a daily basis. Your company should be ashamed, and I am sure it is an illegal work practice. Look into the laws of your state.
Jun 24, '09Quote from krupsIt happens alot. I have always been the only nurse in the unit at 2 of the last dialysis clinics I've worked at. Not only did I not get my entire breaks but didnt get paid for them either. Of which I am now being proactive and trying to get back what is owed. You're expected to leave the floor to go break which in turn leaves no licensed person on the floor. Then you are called out every 5 minutes why bother to eat. There have been times I barely got my britches down in the bathroom before I would hear my name being called. The old adage "no time to take a p***" lol. It seems its a common practice at least at the last Davita and KRU clinic I worked. I'm blessed to be out now and cant tell you how good I feel. I can eat my lunch nowCocoa Girl I just read your post. I can't believe you don't get a break or lunch. We are crazy too, but we must make time to eat. That is so unfair to ask of the staff on a daily basis. Your company should be ashamed, and I am sure it is an illegal work practice. Look into the laws of your state.