Accuity Vs Staffing Needs: Are They Taking Us Seriously? - page 2
Question: When your accuity ratings are reported to staffing at your facility, are they taking them seriously :) and staffing accordingly or are you feeling like they are just blowing them off?... Read More
Jun 2, '04In the facility where I worked before we had an acuity scale that was a points-based system with points given for the usual tubes, method of feeding, number of IV meds in a day, frequency of personal care etc. We had to have the numbers in the computer by 1400 daily and the unit clerk would come around and check to see that we'd done it. It never made a schmick of difference in our staffing, and we frequently had doubled assignments (excluding intubated patients who were 1:1 by policy) so lots of staffers didn't bother to do them or update them. Then it was decided that the tool wasn't valuable and it was scrapped.
I'm not exactly sure how acuity is calculated where I work now. I know that it's done by the charge nurse on nights based on the change-of-shift report received. We have a baseline number of nurses scheduled for all shifts whether we're full or only at 25% capacity. We must have 16 staff nurses, a resource nurse, a new admissions nurse and a transport nurse, for a total of 19. If our census is low, we often are offered vacation or stats; occasionally we'll float :angryfire . Our unit is a 16 bed pediatric ICU in a university setting; our patients are about 60% post-op CV patients. We provide ECLS and dialysis (hemo, CVVH and PD), trauma, neurosurgical and transplant (heart, liver, kidney, islet cell) services as well. It's very unusual for a nurse to have more than one patient, regardless of how stable.
Jun 4, '04Most facilities just look at the acuity of patients to make sure the minimum number of nurses is on duty. Never mind if there is a real problem, several admissions coming, a truly ICU patient but no bed, a disruptive patient or family, or a death. Charge nurses are the thing that I do not understand these days, when did it become their job to attend HN meetings, take hour lunches, and waste time on reports that no one ever reads? They used to be there to help staff and intercept problems when staff was tied up. Now they just pile their 'issues" onto the staff and sit in front of a computer all day.
Jun 10, '04LOL
The only time I have ever seen enough staff on my unit was also during surveys.I have often stopped and wondered in the middle of one of my superhero nurse shifts if the town, state, or feds were here on one of their "unscheduled" surveys (joke)how the unit would be staffed? You come in get what you get and fill out a union unsafe staffing form . But, ya what about those surveys? Why don't they ever really just pop up? Because they don't want to know!