why we added positions: the positions posted.........1100-2330 were not dedicated to fast track. the positions were added to cover all the assignments.
we had 13 beds, with a 4 bed fast track prior to what we have now. the problem came as we got busier and busier with increased acutiy. the fast track patients go shoved aside, and next thing you know we had icu/ccu/tele/rnf patients admitted out of fast track.
the answer: expanded by adding four more beds dedicated to fast track only. we then made the old fast track, regular er patients.
so we went from 13 and 4, to 17 and 4. last year we saw about 40,000.........and the census keeps growing.
curently: we rotate staff in and out of fast track...........basically it depends who wants what? we staffed prior to the new fast track area, 7 rn's and a medic. now because of the 4 additional beds, we need to increase it to 8 rn's and a medic. those two 1100-2330 shifts cover our fast track hours from 1100-2300. it doesn't mean that they are assigned to fast track.
why i asked: because switching those two people now........would short me, 6 days a week from 3-11pm. we are already short d/t some people leaving for agency, etc already. we may not be able to keep it all open from 1500-2300, if i make the move for them now.
i am not mad or upset, for any suggestions. it just seemed to get off track a bit, with the new positions....they are not dedicated to fast track.............it is in general over all to help cover all the assignments........if all the holes are filled.
as far as the prn's? we have always had holes to fill............and with the prn's we have managed. the problem now is.......they take all the holes left on dayshift, after everybodys schedule is finished. the one valid point someone brought up..............is if i move these people now........it will use up many of the dayshift holes.......which either could force the prns to pick up evenings, or force them to leave period.
keep up the suggestions........it's got me really thinking now