Acuity and staffing


I've been in nursing long enough to know that any acuity system is a complete joke, but lately it seems worse:confused: I work on a very small adult psych unit: our maximum capacity is 14. Regardless of the census, staffing does not change unless the census is low. Then the bosses break their butts, giving low-census days. When the census gets to ~four, staffing is identical to the staffing for fourteen, no matter what the acuity:( At times we are short-staffed, because, as everyone knows, "...nothing ever happens on midnights":rolleyes: Tonight was a perfect example: the census was seven but we had two 1:1s, two geriatrics (well on their way to dementia), two very nasty bipolars, and one delusional disorder NOS. There was me, the tech/CNA and the security guy. That was it!

Anyway, to get back to my topic (but thanks for letting me vent), is there anyone anywhere in whatever specialty who has staffing based on the unit acuity? I'm afraid one night all Hell will break loose, and there we'll be: all three of us:uhoh21: To make matters worse, none of us are youngsters:uhoh3: I guess I need reassurance from my on-line peers that I am not alone in my frustrations.


195 Posts


YOU ARE NOT ALONE !!!!!!!! Have laughed at attempts to develop an acuity based staffing system...Have seen perfectly stable patients worry the hades outta staff with their "hilton" demands and have seen perfectly stable patients become Hellishly unstable,very quickly and usually in pairs...all the while,supervisors calling for beds. Their opinion of "helping" is saying, "admissions mean job security,you know". Have had nights when we had full census and have spent most of my time deciding which leg to swing over the other....have had nights when all went well until one thing happened then the hounds of HELL broke loose. Have always said " management will not do anything about this situation until something really bad happens"...well...the didn't do anything about it then either.

The facility where I am working now, puts staff on low census when needed...not "on call" ...they are not obligated to be available if needed...thus those of us present when there are multiple admissions or changes in acuity, just have to do the best we can...are there any answers???????? Have seen no solutions in the quarter of a century I have been at the bedside... lots of committees appointed to brainstorm for solutions,but have yet to hear anything positive from the committee members other than the danishes are stale...ahem....and there has been discovered a need to do further research.

canoehead, BSN, RN

6,841 Posts

Specializes in ER. Has 30 years experience.

Why are you all answering the phone if you are not on call? If you are downstaffed you have every right to go get groceries, see a movie, whatever.:nono: No one has to work for free!

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