Patient assignments by room # not acuity

[PediLove2147]

Okay, this might have been asked before but I just got off a 12 hour night shift and I am tired and lazy so bear with me.

Our floor is changing up how they do patient assignments in the next couple of weeks. Currently the charge nurse assigns each nurse, 3-5 patients, it is done by acuity. Room numbers have nothing to do with it. It has been mentioned that we run around too much and it would help to have our patients assigned geographically. Also, each tech, would only have 1-3 nurses this way. This new system would mean I have rooms 81-85, regardless of who is in there. The problem is, with most units I am sure is the rooms closes to the nurses station are usually higher acuity. Can't wait to have those 5 rooms!

One nurse in particular is very on board, saying we are giving sub-par nursing care because we have to run from one side to the other. She doesn't care if she has a new assignment each day since our turn over is so high. I personally like having the same patients, regardless of whether or not they are being discharged.

Anyways, the point of my rambling, does anyone else do this kind of patient assignment on their floors? If so, does it work?

[classicdame, MSN, EdD]

Literature (and maybe your NPA) recommends assignment by acuity and by nurse's own competency level. That said, assignment by room would suit me IF I got only 3 rooms when the acuities are higher and 5 if lower. But not the same rooms each shift

[gatoraims RN]

The hospital I am doing my clinicals at now assigns the nurses their pts by room number. They however do "try to "give those with higher acuity less rooms. However there are times that the floor has gotten slammed and the nurse with less pts has to pick up a room. I am not sure I like it that way. This new hospital is harder to get into the flow of things even as a student.

[Do-over, ASN, RN]

I think they try to use a combination of both where I work. I really like having two semi-privates right next door to each other... We try to give a heads up if a group is just too heavy so that certain patients can be split up for the next shifts.

[Pneumothorax, BSN, RN]

some days...the assignments are awful...like there was no thought or consideration put into making them

[FurBabyMom, MSN, RN]

Oh my gosh! I have had it done both ways. As an assistant while I was in nursing school - as part of a large university's nursing float pool, I was assigned everywhere. My assignments on med surg units were based on RN assignments, but sometimes they were all over the place and high acuity. Other times, when I was sent to the ICUs - I was assigned a cluster/pod based on staffing need (sometimes if I was really lucky, two clusters...and had up to 20 patients). In the ICUs if I was given more than one pod, the nurses often did most of the small things (vitals, accuchecks) for me to be able to more readily help the nurses transporting patients and/or turning, repositioning etc. If I was sent to the ED I was given a team assignment and helped those 3-4 nurses with their assignment.

My first nursing job (I was there for 13 weeks) did it by "acuity"...but it really meant that the charge RN gave their favorite coworkers the easy patients and the staff that was left got the totals, and higher acuity patients. Not fun. My second job, I was there for the remainder of my year as a floor nurse - was neuro med surg tele and basically a stepdown unit. That unit did assignments in a cluster fashion. As a nights nurse sometimes I would get (for example) 14A, 14B, 15A, 15B plus an admission that gets put in 3A, and then have to cover the LPNs patient's and do 90% of their admission... My least favorite assignment was, we had 5 private rooms often isolation or critical patients because of the space in the rooms. Those 5 rooms used to be part of an ICU and are not right near the rest of our unit. Okay, fine, but that assignment was a pain.

On my old unit (2nd job, done by room numbers), it was nothing to have 5/7 patients on telemetry, 4/7 patients on insulin, a critical drip (heparin, insulin, cardizem, nitro), at least one patient fresh transfer from ICU post CVA or crani requiring intensive neuro monitoring and/or receiving mannitol and/or on a q2 vitals schedule with PRN IV meds for HTN available q2. We had foleys frequently, PEGs, trachs (we were the only non-ICU unit with RN/LPN competencies for trachs - we got 'em all), we primarily got the neuro patients, but because we were a monitored unit with a larger number of available tele packs than other units - yep, we got just about ANYTHING (renal failure, trauma stepdown, so on and so forth...anything we got it). I don't miss most things about that last job. I miss some of the patient interaction...but then I remember what it was REALLY like as a floor nurse and I'm not so positive I'm missing it.

But, I suppose none of this matters anymore. I'm now working in the OR.