Advice please!!!

  1. I need some advice on a couple things. So the ortho unit I work on isn't doing too well right now. For RN's- what is the best start time for a shift? Most of our post ops come up between 10am and we usually get our last around 8 or 9pm sometimes. Shift change is horrible, nurses are trying to get report, post ops coming up, lights all over the place, and the aides are running like chicken with their heads cut off. Now our nurses start at 7a, 11a, 7p, and 11p. The 7a and 7p times are the worst. The aides start a half hour earlier than the nurses, to try to answer lights, get vitals, etc. what would be an ideal start time to work more efficiently and make sure patients aren't waiting for things that they need?
    number 2-charge nurses. Now in my opinion , the charge nurse is very important. Some people are trying to eliminate charge all together, and just have floor nurses. Is this a good idea?

    our patient ratios are 1:5/6 for Rn on daylight, 1:6/7 for nights, one charge, huc during the day, 1:15 or more for aides
    please send me your comments so we can get our unit to be the great ortho unit we once were. Thank you!!!