patient assignment

  1. 0 How does your hospital divide patient assignments at the beginning of the shift?
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  3. Visit  nurselyman profile page

    About nurselyman

    Joined Jan '11; Posts: 1.

    12 Comments so far...

  4. Visit  RN0820 profile page
    1
    Strictly by number...unfortunately. also depends if we have an LPN. Also, the nurses that work 12s like to stay where they are and the nurses who have worked the day before keep their sections for continuity of care. Hope this helps.
    nurselyman likes this.
  5. Visit  loriangel14 profile page
    0
    Usually it's done by number, they try to keep you in consecutive rooms and if you worked the previous day, try to keep you with the same people. Where I work PNs and RNs get the same assignments, there is very little I can't do, like PICC lines flushes and starting blood, so I get an RN to help if I need any of that done.Also where I work if there is a patient that is very trying to deal with and you have had them for a couple of days you can always ask to not have them on your assignment. We usually try to have these patients rotated so no one has to deal with them ALL the time.
  6. Visit  nursynurseRN profile page
    2
    by acuity... They divide up the hardest patients on the floor, like those with dressing changes, A Lot to of meds, ACCUchecks, and attiude problems . They also keep in minds the patients who have who have sitters. Then they see who will be discharged and divide them up to soi that not just nurse gets all the discharges. It sa littel complicated but depending who is in charge they do a better job at it.
    ChristineN and Orange Tree like this.
  7. Visit  Horseshoe profile page
    1
    Quote from nursynurseRN
    by acuity... They divide up the hardest patients on the floor, like those with dressing changes, A Lot to of meds, ACCUchecks, and attiude problems . They also keep in minds the patients who have who have sitters. Then they see who will be discharged and divide them up to soi that not just nurse gets all the discharges. It sa littel complicated but depending who is in charge they do a better job at it.
    That's the way it's done where I work, though I think it is not necessarily hospital policy, but the culture in my own unit. Outgoing charge nurse reports to incoming charge nurse, and the incoming charge nurse makes assignments based on that report. On our unit, the assignments are always open to negotiation if a nurse has a legitimate concern about it.
    Orange Tree likes this.
  8. Visit  JSTARZ profile page
    0
    on my unit we do a modified team nursing...1 RN 1 LPN and a CNA who is shared with another RN and LPN. So we usually take on ten patients per team me as the RN will take the most acute or the patients who "NEED" a RN (Numerous IVP drugs, blood, and the most critical). So I usually take on the 4 or 5 busies and give my LPN the other less critical 5 or 6. It works great (when I have a good/competent LPN) and I float as needed to those patients assigned to the LPN!!
  9. Visit  evolvingrn profile page
    0
    Strictly by number..... The weakest nurse gets the lower number regardless of acuity if it doesn't divide evenly......a little frustrating because it's always the same nurse that gets the easier load.
  10. Visit  HonestRN profile page
    1
    strictly by number and room location which inevitably leaves one nurse with a crummy assignment while another usually has a cush one. I think patient assignments really should be done by acuity for better care.
    Orange Tree likes this.
  11. Visit  Orange Tree profile page
    0
    Ours is also divided by section, although some effort is made to even out the admissions and discharges. It's nice when a good nurse gets an easy assignment, because that nurse helps everyone else out. But unfortunately, the bad nurses often end up with the "best" patients and play on the internet while the rest of us suffer.
  12. Visit  HRSBSNRNC profile page
    0
    How does your unit figure out the acuity? Is there a tool they use? This sounds similiar to my unit, however, the acuity tool is not always accurate, or the nurse who is determining the acuity is under estimating or over estimating the acuity. I would love to see the acuity tool you use.

    Thanks,
    Heather
  13. Visit  3dayRN profile page
    0
    off going charge nurse makes assignment. Some charge nurses pay attention to acuity, others don't consider it at all. We never take more than 5 patients. So, I would rather start with 5 so that means no admission for me If we were there the day before the charge tries to assign the same patients but can't always get all the same patients back d/t room changes etc.
  14. Visit  amarilla profile page
    0
    We divide by number; usually we all start with 6 or 7, unless you're one of the unfortunate folks to come on in-between at 3-11 and get whoever is left as well as 2-3 admissions. Our unit is shaped like a L, so they try to keep people on the same hall to minimize being split. If you work consecutive shifts, you'll most likely get your people back if they're still on the floor.
  15. Visit  nfdfiremedic profile page
    0
    I work in an ER, so my answer is a bit different than the others. We take great pains to make sure nurses are NOT assigned in the same rooms two days in a row. In fact, they get very upset if they are. We try to give everybody a chance to rotate through everything that they're qualified to do (I say "qualified to do" because not all of our staff are certified for the trauma bay or have the required year of experience to be out in triage.) Our assignments are made in 24 hour increments by the department coordinators.

    Typically, we assign the nurses either 3 or 4 rooms (all in a row so they don't have to run around all over the department.) If there are patients with higher acuity (i.e. an ICU patient that hasn't been stabilized enough to travel upstairs yet or something and the nurse needs to provide 1 on 1 care and can't take any other patients) we take that into account and change the room assignments up as needed. We are "supposed" to have 12 nurses on duty all the time but we generally only hit this mark on day and evening shifts. Nights typically makes do with fewer, resulting in up to 5 patients per nurse, but as we increase our staffing we are able to more closely mirror on nights what happens on the other shifts.


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