closed staffing

  1. Help!! Can any one talk to me about Closed Staffing Units and how you maintain this? I work in an 8 bed CVICU. We have 30 nurses and have attempted closed staffing for the first time over the last year. This week we OPENED We need to revamp our current On-Call system and hope for better commitment. Any help would be greatly appreciated.
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  2. 8 Comments

  3. by   ProfRN4
    Do you mean no one floats in, and no one floats out?
  4. by   begalli
    Quote from kat9114
    Help!! Can any one talk to me about Closed Staffing Units and how you maintain this?
    A good Nurse Manager. Someone that makes people want to show up to work knowing that their work is important and appreciated and someone who goes to bat for nurses in all types of situations.

    Of course though, a good nurse manager is only as good as the people that the manager works for. If staffing stinks, the unit is a danger to both patients and nurses, and nurses are underpaid, overworked, under-appreciated, and they don't feel any satisfaction in their job...then it doesn't matter who's in charge.

    I guess my unit could be considered "closed." We are a 25 bed CTICU. We only float (and very rarely) to the 32 bed Med/Surg/Trauma ICU and they float to us (again, very rarely). Between the two units there are more than 200 RNs.

    I guess in addition to a great NM, the individual units need to have the budget to hire adequate staff and a policy that keeps them on that unit only.
  5. by   kat9114
    Quote from bonemarrowrn
    Do you mean no one floats in, and no one floats out?
    Yes, the only time we float is to an ICU for managing CRRT,IABP when they have no qualified staff. Can you help??
  6. by   USA987
    I work in maternity. We are a closed unit. Our full-time is 72 hrs. every two weeks. We are required to sign up for 8 hrs. of call time every pay period. Part-time staff are also required to sign up for 8 hrs. Also, some of our per diem staff sign up for call holes if they didn't have enough shifts for the month.

    It seems to work for us. On your call time, if they call you in, you have up to 1 hr. to get there. We just get straight pay if we are called in...if you don't get called in you get a whopping $3.50/hr.

    Good luck
  7. by   ProfRN4
    Quote from USA987
    I work in maternity. We are a closed unit. Our full-time is 72 hrs. every two weeks. We are required to sign up for 8 hrs. of call time every pay period. Part-time staff are also required to sign up for 8 hrs. Also, some of our per diem staff sign up for call holes if they didn't have enough shifts for the month.

    It seems to work for us. On your call time, if they call you in, you have up to 1 hr. to get there. We just get straight pay if we are called in...if you don't get called in you get a whopping $3.50/hr.

    Good luck
    I assume this is a condition you agree to when you are hired? And when it was initiated, did everyone on the unit have to agree to it? Is anyone exempt?

    To the OP- I think teamwork is the key (something my units lacks a little). If it's voluntary (to come in when you are needed), the same people will likely be doing all the extra work. I think that's the reason the idea was shot down on my unit. Our unit is small (4 beds) with a small staff. And there is one per-diem (me!!!), with a handful of nurses from other units who will work extra on our unit (not much, though). You need a bigger pool of nurses for it to work. When I was staff there, I needed to cut my hours (and was not approved, so I went per-diem). If you grant someone a decrease in hours, chances are they will be more likely to help out when there is a crunch (I know this is not always the case). So, while I thought I wanted our unit to be closed (to avoid the floating in and out, and to maintain a higher quality of care), It would have been difficult to commit to more than I was already doing. And how much more can you get out of a full timer? Don't get me wrong, I am committed to my job, if I had to do it, I would. But, as with everything, some would find a way to get out of doing there share (I don't like nurses who don't play fair :angryfire

    It seemed as though, for a period of time, we were a closed unit, because we were the only ones covering our sick calls (we would NEVER get a float). SO either we would work short, or one of our co-workers would feel bed and come in and do extra.

    I know I'm ranting a bit, but this was a sore subject for quite some time where I work.
  8. by   USA987
    [QUOTE=bonemarrowrn]I assume this is a condition you agree to when you are hired? And when it was initiated, did everyone on the unit have to agree to it? Is anyone exempt?


    Yes, it was covered during my interviewing process. I was told that when it was implemented it was by a majority vote by the staff.

    90% of the time it works for us, but sometimes it stinks. Days when we are so busy and it feels like we are drowning...and no more reinforcements to call in...as we have called everyone and no one answers their phones!!!!!
  9. by   shodobe
    At my hospital we have "float circles" where different units only float to areas that are in their float circle. I work in the OR and ours is L&D. They have never floated to us, and to tell you the truth we would rather do without than have people in our area that haven't a clue. The reason for their inclusion was for us to bail them out time after time for things like a ruptured uterus or something as simple as an appendectomy! They are L&D nurses and nothing more. This criteria was set-up so we couldn't refuse to go there for any reason. I think the ER is in the ICCU float area and I wonder how an ER nurse could function in an ICCU setting. Our hospital ER rates no more than a glorified "clinic", so no real criticals come here. I think this floating idea is OK to a point but also it can be very dangerous because all nurses can't switch on and off to othere areas. Also I read a few threads on this subject where the floating nurse is given no help what so ever from the unit personnel and just left on their own to struggle. There have been many positive ones though where all the help is given, so not everyone is appreciative of the extra help.
  10. by   GAgirl
    Our unit is closed, and has been since I've worked there. It seems to work well. When staffing has been particularly bad, we were required to sign up for 1-2 shifts extra per schedule. We have self scheduling, which helps tremendously. We never get pulled. When staff start leaving it to the handful of nurses willing to work extra to keep shifts staffed, the threat reappears that we will open our unit and lose our self scheduling. That seems to motivate everyone to cover our own shifts.

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