[Magilacutty]

Does your unit staff each shift with "support" RNs that do not have pt assignments?
If so, do they have specific responsibilities for: staff development, admit nurse, delivery nurse, transport nurse, pod/nursery room break coverage, etc.?
What has your experience been in units that utilize RNs without pt assignments?
How mqny beds is your unit licensed for?
My unit is looking for suggestions to better utilize this type of a role each shift.
Thanks for your feedback!

[danissa]

in our unit, we have one person per shift who is the shift Co-ordinator. They are responsible for the smooth running of the shift and generally do not take a baby, unless we are really busy, then they may take 1 or 2 high dependency babes who are 2-3 hourly feeds for example. This allows them to check all drugs, fluid changes and cover other staff for breaks.Also decide baby allocation and do paperwork and are responsible for making sure thaat the leaky roof is fixed on that shift etc! It works really well in our place, it's good to know who you will be doing drugs/fluids with, instead of having to search for someone who is free for a short while. Also to know that one person will be dealing with any unit problems arising, means that it gets done, rather than "oh, I thought so&so was doing it!" We encourage both junior(with support!), and senior staff to do this, so everyone gets used to it.

[TiffyRN]

Our unit uses a charge nurse and a delivery nurse who do not take an assignment. There has been talk of adding a 2nd charge nurse for the lower acuity end of the unit, so far we don't have the staff for it. Of course in an emergency the charge or delivery can take an assignment but it really doesn't happen often. Also the delivery nurse will often "obs" a baby for a few hours; if it's over a couple of hours, the baby will be assigned to of the floor staff.

The charge and delivery obviously do what their titles would suggest and also serve as resources for IV's, art sticks, whatever procedures or questions, or simply "come get this screaming methadone baby now please!!".

We generally have about 45-55 infants with about 18-22 RN staff per shift.

[SteveRN21]

We used to use a "resource" RN who didn't take an assignment and went on all deliveries, transports, placed lines, etc. It was ok, until the staff started to forget delivery room resuscitation/stabilization stuff because they never went on deliveries. The resource people also got to go to the majority of educational stuff available. We got rid of it after a few months due to staff dissatisfaction. However, now that we have hired a lot of new people, many of them have expressed their desire to not have to go to deliveries or do charge, etc. As a result, our charge RN will now not have an assignment, but will go to all non-emergent deliveries (unless it is an expected admit, in which case the admitting RN will go) in addition to charge. We'll see how this pans out. We are a 35 bed Level III, with frequent transports from outlying nurseries.

[PremieOne]

My unit is a Level II/III in which we do some sugeries. We have an ANN on evening & night shifts who is in charge of the unit. She usually does not take an assignment but is there to help out if we get multiples back to back. She also helps out with dinner relief. PremieOne

[augigi]

My adult ICU (generally ran at 10-12 beds) had a charge nurse (admin), associate charge nurse (bed assignment, in charge of shift), and "resource nurse" or Clinical Resource Person (CRP). We called the CRP the "crapper" for short, since they basically did break relief, helped out with log rolls/head holds, whatever you needed really.

[Gompers]

I work in a large level III unit and we don't use support RNs. Our charge nurse never has an assignment - if we get more than 3 admissions a shift, she might pick up one or two "easy" babies to help out but this is rare. So she serves as our resource nurse for advice, IV sticks, etc. We also have a high risk delivery nurse assigned each shift - this is random and usually the nurse has a lighter assignment so she is able to run to deliveries and others keep an eye on her patients while she's gone. We all get our fair share of being the delivery nurse so we keep our skills current. Our nurses that are assingned to admit/transport each shift are also random, so we keep our skills up in those areas, too. The admit nurse always has an assignment made up of 2-3 "easy" babies so that when she gets her admission, other nurses absorb her kiddos into their assignments so she only has the new admit for the rest of her shift to worry about.

So yeah, unless there is some medical reason to avoid running to deliveries or on transport (like bad knees, vertigo, pregnancy, etc.), we all take turns at that stuff. The charge nurses do serve as resources, and probably 20% of our staff is trained to do charge so they switch around a bit as well.

[RainDreamer]

We have a charge nurse and a high risk nurse each shift .... both of which do not have assignments.

I think if we're really low staffed then the high risk nurse will have a light assignment, but I RARELY see this. The high risk nurse goes to ALL high risk deliveries and all OB traumas. Usually the high risk nurse is running their butt off ALL NIGHT LONG. We have lots of high risk deliveries in our L&D, so they keep us busy. When high risk isn't on deliveries, they can help out with IV starts or anything else that the staff needs help with. The high risk nurse also helps out with admissions after they bring the baby over and usually helps out a great deal with it, unless called to another delivery.

[2curlygirls]

We a "Team Leader" who goes to high risk deliveries, helps transport babes to off unit procedures, helps admit. I like to see it as helping the unit run smoothly. This is my favorite thing to do. I did it until I was 37 1/2 weeks pg with my 2nd DD. I think L&D got a kick out of me waddling to deliveries.

[NicuNightRN]

We have a charge nurse and a clinician, but no other kind of "support RN." We try to avoid them having assignments, but it is sometimes unavoidable if we're understaffed. We're the neonatal referral center for our area, so we do a lot of transports from the rural hospitals into the city. The clinician goes on all transports and deliveries within the hospital, but other nurses go on deliveries also if we get multiples or if the clinician is out on transport. Both of these nurses are our resources for advice, IV starts, assistance when all of your kiddos want to eat at the same time, etc. Our system works pretty well, and everyone in the bay always helps out whenever we get an admission, or one nurse is overwhelmed with her assignment.