Staffing in a level III NICU
- 0Sep 25, '09 by grinbyrd2I am looking for information on how other NICU's calculate their staffing needs. Do you staff by acuity or Hours Per Patient Day (HPPD)? Any feedback would be greatly appreciated. Thanks
- 0Sep 27, '09 by RM-RNWe staff by acuity. We've gone back and forth with regulations like, "CPAP infants should have no more than 1 additional stable, room air patient," but we end up back to basic acuity.
I'm still holding out for adding the level of parent care into the acuity guidelines, but no luck yet. :chuckle
- 0Sep 27, '09 by ImafloatWe plan by acuity.
By this I mean that we know how many nurses we should have. We rarely have the number of nurses we need and sometimes our assignments aren't the safest.
If you can't tell, I'm getting a little sick of it. Part of the reason I love the NICU was that it was closest to the ivory tower nursing we learned in nursing school.
With the economy and hiring freeze we are suffering staff wise. We have lost a lot of nurses because they are burned out, and they haven't been replaced so we have to do more with less staff.
I had a kid on INO and 2 feeders the other day...yes you read that correctly.
- 0Sep 27, '09 by neonatal_nurseour staffing is based on how "toxic" our unit is for the day. of course we have the official on duty nurses for the day, but if more patients are being admitted someone definitely has to do overtime, or someone who has the day off could be called in. just a day in the life of a nicu nurse.
- 0Sep 29, '09 by RainDreamerWe staff by acuity. Fortunately the unit I work in is well staffed and our assignments are usually staffed the way they should be.
We have "acuity sheets" that each baby has in their chart. We score them based on a number of things (type of vent, unstable or stable, number of lines, IVs, number of meds, labs/gases, ECMO, INO, post surgical, drips, feeds, teaching for parents, etc, etc.) Whatever their score is will give an idea of what kind of assigment to put them in (3:1, 2:1, or 1:1).
Of course it doesn't always work out perfectly, as there are admits, transports, stable kids that get sick, etc. In those cases we just do the best we can and help each other out.
- 0Sep 29, '09 by Coffee Nurse, BSN, RNWe staff by acuity. We don't use any formal system of grading (maybe we should; it would probably have saved me from getting stuck last night with a 24-hour-old micropreemie plus "sharing" a 3-month-old, who refuses to eat, with my preemie's twin's nurse), but we always have adequate staffing for what the acuity level dictates. See, there are (some) perks to living in California!