Should a nurse ask to be assigned to specific patients?

  1. 0
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  2. 10 Comments...

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    Most facilities do not work that way. Assignments are usually done by room numbers, or by acuity. It would not be fair otherwise.
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    If a nurse had that patient before or they were there the other day and had a specific group of patients, we try to keep the assignments the same where I work. Unless they specifically say they do not want someone back. Sometimes we have patients with such a high acuity that wear you out and nurses ask to not have that patient back. We try to rotate that patients to make it fair, that way one nurse isn't always stuck with that particular patient.

    Assignments are typically done by room numbers and we try to keep the rooms as close as possible but when you have a bunch of totals, we tend to split up the assignments. It wouldn't be fair to give a nurse all of the total care patients and everyone else the easier, less acute patients.
    nrsang97 likes this.
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    Where I work they strive for continuity and if you were there the previous day/evening/night they will try to give you the same bunch again but it's not always possible.

    No you shouldn't ask to have specific patients. You should take what you get assigned. I can't think of a good reason why anyone should be allowed to ask for a certain patient. Another nurse is just as capable of caring for the patient.
  6. 0
    When I worked in the hospital, people most definitely asked for their patients and some were VERY possessive. We did "primary nursing" so if you were a primary nurse, you could expect to be assigned your primary patients and, more often than that, the parents wanted you as well. Everyone had some patients that were "theirs".
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    we choose our own assignments on my unit (LDRP) with guideance from our charge. Acuity and room proximity (especially on a post partum assignment) is considered. For laboring patients is 1:1.
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    We use room numbers/hallways and give little mind to acuity. It's usually not too bad but there are nights when one nurse gets all the needier patients. We try to help each other out though.
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    In every ICU I have ever worked in nurses chose their patients. Nurses precepting a nurse resident or new grad got first choice. Then any nurse who had taken care of a particular patient the day before could take them back if they wanted, then the rest of us chose. I can't imagine not picking my patients.
  10. 0
    I disagree with being able to pick your own patients. In ICU Pts should (in my opinion) be assigned, with special consideration in this order: Staff Competency, Pt acuity, continuity of care and then proximity. Staff looking to expand thier competency may ask for more complicated patients as long as a resource member is available for support and as long as it doesn't interrupt continuity of care.
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    In the NICU it was encouraged to sign up for a "primary" patient. You would then have that patient every time you worked until the baby went home unless you decided you needed a break, you could come off the assignment for a bit. If the patient was paired you would have whoever was being paired with that patient at that time, which meant you could also basically be a primary for that baby too if they were always paired together.

    In the CPICU I work in now we can also request to have the same patient over and over. There is no list to sign up on like in the NICU but if we tell our supervisor that we really like a certain patient/family then they will assign us to them. In pediatrics I think having continuity of nursing care is really seen as family centered care, making the family as comfortable as possible, so we do it a lot


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