GRRRR. Sometimes administration makes some really dumb decisions that are a train wreck waiting to happen. Here is a prime example.
Past practice has been when patient census drops nurses are cancelled by sign up on a voluntary list first and then it goes mandatory with low senior first. This same scenario below is supposed to occur on the med-surg floors.
So, we have 4 ICUs in our hospital: MICU, NICU, SICU, CICU. Rarely, the unit census will drop down and nurses are cancelled. Recently management decided when the numbers drop that certain units will close and their patient census will be moved to another ICU, however, the nurses will go with their patients. (So, if NICU patients are moved to SICU, then the NICU nurse go to SICU and take care of the NICU patients.)
Here is the plan:
Bring in extra nurses so there are nurses on both ends to take care of the patients and nurses to move the patients too. Of course, pt's on vents will need respiratory therapists too, so bring in extra RTs. After the move, the nurses will stay with "their" patients in the new unit. Additional nurses are needed on the closed unit to purge rooms for cleaning and then an inventory must be done of all the equipment. A security guard will be posted on the unit to protect it from theft or "borrowing". There are 5 points of entry to the unit and none can be locked.
As soon as the numbers go back up then the process will be reversed: bring in extra nurses to open the rooms and ensure supplies are present (and haven't been stolen when the security guard took his break). The extra nurses will ensure that there are nurses to take care of the patients on both ends, and transport. Extra RTs to move vent patients. And extra staff will be available for admissions.
BTW, CICU nurses are the code nurses. If they have no patients they will be assigned to the other ICUs but not take a patient load so they are available to go to codes. So, two nurses paid to not have patients.
Can anyone tell me how this would be cost effective???!!! They will be paying for extra nurses all over the place and could be playing musical beds on a daily basis. One day the census might be 3 patients, but then the unit fills up within 8 hours. And H1N1 is just starting to hit this area and this is their plan??? Really??? Is it just me or did someone have a bowl of stupid for breakfast? Has this ridiculous plan been tried where you work? If so, what were the results? It just does not make sense.
Thanks for letting me vent.