Patient nurse dependency systems (PND"S) are the latest "thing" - most of them are computer driven and not one of tehm adequately covers all that happens during the day. I got tired of hearing that just because the computer SAID we were staffed well that meant that all would BE well.
Here is my take on the problem:-
The Nurse's Day
It's been a terrible day - how can we explain?
The staffing was good no cause to complain
All senior staff - knew their job well
But still in all the day's been like Hell!
There was old Mr Bill who decided to fight
While we held his left he hit with his right
And sweet old dear in number eleven
decided right then to go on to heaven
And old Mr Rucheff spat out his morning feed
And then Mrs Roseway she started to bleed
We just got her right all under control
When in five new admissions started to roll!
The ward round started - the consultant was cross
Where were the staff? - had they got lost?
And then old Mr Parker ran off to the Bush
We still haven't found him in all the day's rush
And then Mrs Phyllis (she used to private care)
Started to demand why the staff wasn't there
And how could the cook serve her such a dish
And didn't we all know she just DIDN'T like fish!
And then Mrs Beamis she NEEDED the commode
"Five days of Prune juice I'm about to explode!"
The commode you all know the wheels are all skew
I cornered too fast and out the pan flew!
The pan hit the floor with a terrible smash
Up flew the contents and come down with a splash
I looked around in horror just what could I do
The floor, the walls, the ceiling all covered in..... EEEYOO!
And now they've told us- Oh! it just isn't fair!
The PND is not right it's all up in the air
We've too many staff we have to cut back
So I don't care anymore - please give me the sack!
Jul 24, '02
Where I work, we use what is called "PIN's", (Patient Intensity of Needs).... and in all of the cases you cite... the patients could have been listed as "complicated" with regard to "toileting, adl's, unexpected occurrence, emotional status, educational needs...ect....) This would PIN your patient's nursing needs at HIGH and one would hope you'd be staffed appropriately....
:: head falling and bangs the keyboard ::
OOPS, I woke up!!!! LOL Our PIN's do help when it comes to making nursing assignments based on Acuity...but so far we've not seen our staffing improve because of it.