Patient assignments - Are nurses assigned to empty beds Patient assignments - Are nurses assigned to empty beds - pg.2 | allnurses

Patient assignments - Are nurses assigned to empty beds - page 3

Hi, I am trying to understand how the nurse patient assignment works. Can you please shed some light on how the assignment process works? Are nurses assigned to empty beds - If known there is a... Read More

  1. Visit  Esme12 profile page
    #13 0
    Quote from Learning About Nursing
    Thanks, that's very helpful.

    I had a few more questions -

    Does it ever happen that the patient needs to moved from one bed to another within the unit? If so, what happens to their assignment - does the nurse follow the patient? or a new nurse is assigned?

    What software are these assignments done in other than the printed assignment sheets? If there are systems where this is electronically done in and made visible at/near the nursing stations, does that remove the need for the assignment sheets?
    Various hospitals have various methods. The nurse usually will follow the patient unless the patient is moved off the unit. Sometime the assignment is rearranged for ergonomics and efficiency for the nurse of the patient is moved to the end of one hall and her assignment is at the other.

    Is this a home work assignment? What exactly is the assignment looking for?
  2. Visit  Sun0408 profile page
    #14 0
    In both hospitals I have worked in; yes a nurse can be assigned an empty room. Rooms don't stay empty for long. When I was a floor nurse, we had pods that had 6 pt room in each. One nurse was assigned that pod, didn't matter what the acuity was. Now in the ICU acuity is divided as much as possible as well as distance between rooms are kept in mind. Nurses are never given room 1 and room 10, too far apart. And yes, even in the ICU we are assigned empty beds. If we have an empty bed, we can beat we will get a code or rapid response off the floor or a new admit through the ED.

    Assignments are not done by software. It is a hand written sheet with the pts name and the nurses name only.
  3. Visit  kylee_adns profile page
    #15 0
    At my hospital the nurses are not assigned empty beds. Our max nurse patient ratio is 5:1. If two nurses have 5 patients and another nurse has 4 patients, then that nurse is "open for the admit". If census is low, we will have nurses on call. If the three nurses all have 5 patients a piece. then we call in the on call nurse to take the admit. I work on a unit that has 15 beds of med-tele & 15 beds of progressive care. We often have to move patients to different rooms, and reassign the patients to different nurses. An example: A med-tele patient was previously in NSR, but has now flipped into afib. The doc orders Amiodarone drip, but this drip is not allowed to be administered on med-tele. This patient now requires a progressive care bed, and must be moved and reassigned. Likewise if a patient was in Progressive care, but does not meet the criteria anymore, then they will have to be transferred to a med-tele bed if another patient needs a PCU bed. This is to maximize profit, since PCU has additional charges. The actual room number assignment is in a program called "bed board", which I know nothing about since I am not a charge nurse. Our patient assignment sheets are written in pencil, and things are changed as necessary throughout the shift.
  4. Visit  blueheaven profile page
    #16 0
    I work in a MICU. If we are not full, we are assigned a patient and an empty bed. We also determine who will get the first patient admission by looking at the acuity of the patients that the nurse(s) may have. We may also get pulled to another unit :P
  5. Visit  KelRN215 profile page
    #17 0
    Quote from LearningAboutNursing
    Thanks, that's very helpful.

    I had a few more questions -

    Does it ever happen that the patient needs to moved from one bed to another within the unit? If so, what happens to their assignment - does the nurse follow the patient? or a new nurse is assigned?

    What software are these assignments done in other than the printed assignment sheets? If there are systems where this is electronically done in and made visible at/near the nursing stations, does that remove the need for the assignment sheets?
    Yes, it happens all the time. Family pitched a fit to get a private room for their child and at 2 am an admission with MRSA needs to come to the floor and there are no private rooms available. That means the patient who doesn't need a private room needs to move to make room for the admit. This was possibly the thing I hated most about working nights... bed changes that need to happen in the middle of the night and somehow it's YOUR fault that the kid in the ER has MRSA/is on contact and then the family is mad at you for the rest of the night for waking them up to move them into a private room. And then of course they don't get along with their new roommate who keeps the thermostat too cold. When a patient moves rooms, if they are still on the same unit, they keep their nurse. The nurse is assigned to the patient, not the bed.

    To answer your original question...when I worked in the hospital, nurses were not assigned empty beds and they only staffed for the patients they knew about. So, on a 26 bed unit, if there were only 15 patients at 5pm, they canceled 2 night nurses and if you happened to get 10 admissions overnight, too bad for the nurses who have to absorb them. It could happen that you are assigned to a patient who is scheduled to be admitted but has not arrived yet but in that case, you are assigned to the patient not the bed... and if Joe Smith is scheduled to go into room 102B but when you get report you find out that he has C-Diff and needs a private, you will still be his nurse if he is admitted into room 105 (private room).
  6. Visit  LearningAboutNursing profile page
    #18 0
    Thanks for all the great input. I really appreciate it.

    How does one ensure they are doing the best assignments? Say, a charge nurse has a list of caregivers that are working for the next shift and has a list of patients/beds that these caregivers need to care for. How would one go about doing the actual assignment? Pick the first patient and see which caregiver is best suited based on the patient acuity? Or group patients by acuity levels and then choose from the list of caregivers best suited for that acuity etc?
    Last edit by LearningAboutNursing on Aug 24, '12 : Reason: Grammar
  7. Visit  psu_213 profile page
    #19 1
    Everywhere I have worked, assignments are done on a shift by shift basis by the charge nurse. Assignments are much more and art than a science. Factors that go into assignments are acuity, which pts will be off the unit/have procedures during the day, what pts did a nurse have yesterday, etc. With all that taken into account, there is no given "formula" for making assignments. I have never been a unit that assigns empty beds at the beginning of a shift; however, if one nurse has few pts than all the other nurses on the unit, that first nurse can pretty much presume that if an empty bed is filled, it will be his/her pt. Of course, if that nurse has much 'heavier' pts than the rest of the nurses, than he/she may not get that admit. At that point, it is just up to the charge nurse to use his/her judgement.
  8. Visit  psu_213 profile page
    #20 1
    Quote from LearningAboutNursing
    Thanks for all the great input. I really appreciate it.

    How does one ensure they are doing the best assignments? Say, a charge nurse has a list of caregivers that are working for the next shift and has a list of patients/beds that these caregivers need to care for. How would one go about doing the actual assignment? Pick the first patient and see which caregiver is best suited based on the patient acuity? Or group patients by acuity levels and then choose from the list of caregivers best suited for that acuity etc?
    With this post, it kinda sounds like a homework question (if I am wrong, forgive me). Going with the 'homework question hypothesis,' how would you make the assignments? Based on you answers we will be glad to offer suggestions/other points to consider.
  9. Visit  LearningAboutNursing profile page
    #21 0
    Maybe create buckets for different patients based on their acuity levels. Start with the patients with highest acuity levels and consider all my expert nurses first for those patients (keeping in mind the ones that took care of the patient previously - if the patient has been there for couple of days). Continue in this order till I assign caregivers to all patients (keeping the patient to caregiver ratio in mind while assigning).
  10. Visit  psu_213 profile page
    #22 1
    Quote from LearningAboutNursing
    Maybe create buckets for different patients based on their acuity levels. Start with the patients with highest acuity levels and consider all my expert nurses first for those patients (keeping in mind the ones that took care of the patient previously - if the patient has been there for couple of days). Continue in this order till I assign caregivers to all patients (keeping the patient to caregiver ratio in mind while assigning).
    Just to play devil's advocate...wouldn't you want some of your "non expert" nurses to have some experience with higher acuity pts? Now you don't want to overwhelm them, but you are not going to have you expert nurses forever, and as they leave you want to have nurses that will be comfortable taking care of the more acute patients.
  11. Visit  CorazonDeOro profile page
    #23 0
    We have a pod set up, you get assigned 5 or 6 consecutive rooms (acuity doesn't matter but they will try to split up contact isolation and trach rooms). Sometimes empty beds are part of your 5 or 6 sometimes they are not, based on staffing. We are surgical and have a million admissions a day.

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