Hi this is the first time I have posted here but I need some help before we all leave my current NICU!!
I work in a small (18 bed) NICU that is mostly single rooms except for 2 3 bed rooms. Our staff is about 56 nurses and that is a mix of full and part time nurses. For as the past 20 plus years the staff has self scheduled in 6 week blocks with a few rules regarding nights and weekends and we also signed up to be part of a primary team. The problem is last year when my nurse manager complained that no one was signing up for teams so she wanted to make preassigned teams. We tried it out on one baby and it worked but when we had 6 teams it was terrible.
One time switch and the whole week was a bust because now there were 3 team 2 nurses and no team 1 nurse. After 6 months of this we transitioned to 4 teams with more nurses but now our self scheduling has been taken away and we have to schedule around the other 10 nurses on a team, needless to say people are not happy with their schedules so they are again making switches and if we are not able to switch within the team then we go to the whole unit ... the moral of the unit if terrible right now, no one feels like they have any consistency and we all just feel like a number and not a nurse. Our CCI numbers are no better with the current 4 team plan than they were with the 6 teams but someone at work just suggested that we go back to the 6 teams again!! My boss wants our ;cci number to be less than 0.6 and we have been in the 0.6-0.9 range...
Our unit is hard in that it is small, we do transport, CVVH, ECMO and surgeries...so there needs to be a nurse on every shift that can cover these istems also we have 2 nurses that are pulled every time plan to do charge, so they are out of the basic staff numbers. We traditionally staff with 7 or 8 nurses and then a nurse for transport. When we are busy we do not have a large per diem pool so we pull constantly form other days of the week.
My questions are:
1. Is your NICU looking at the CCI and if so what changes if any have you made to improve this number?
2. How are you assignments made? Primary, team or something different?
3. How do you make out your schedule?
4. Any thoughts on what might help us??
THANK you so much for taking the time to look at this and offering any help you can!!