Any managers out there?

[silencieux]

Wasn't really sure what to put as the title, but any input is welcomed.

I'll try to avoid making this lengthy. I work on a cardiac stepdown unit with a fairly decent nurse turnover. I've been there about 4 years and feel like I have a general good understanding of what goes on. I'm trained to be charge, deal with staffing and whatnot often.

We've had a lot of new hires lately and they come in groups. On a recent nightshift, we were told by the daylight charge RN, that our unit director said that we were under no circumstances allowed to run with the amount of nurses we required to have and must run 1 nurse short due to the fact our director 'messed up' the budgeting when it came to new hires on orientatioj on night shift (we had two on that night). So we all ran with unsafe patient ratios and while two of the RNs had new hires with them (which I don't feel like should be considered extra help), the other two of our RNs did not and actually had the harder of the assignments. I just am baffled by this and don't understand how she thinks this is acceptable.

Now if this were for some reason just a fluke and whatever, I would MAYBE understand. But this is the second time I personally have encountered her doing this on a shift I was working. Not only that, she doesn't come to us directly and explain what happened and why, she just pawns it off on the poor daylight charge RN to tell us.

Just curious if any unit directors or managers out there could throw there thoughts on this for just a floor RN who doesn't get it. But any opinions welcomed!

[klone, MSN, RN]

Even though orientees aren't counted in the nursing numbers, they ARE counted when determining productivity index (PI). I can tell you that when I have two nurses orienting/training during the same shift, it kills my PI. Depending on what the unit census is, having 2 orientees might have us running at 65-80% (target is typically 95-105%).

However, it's a necessary "evil" - but it's best for productivity if you can spread orientees over different shifts.

I would never ask staff to work short-staffed or with unsafe ratios in order to play "catch up" on my PI, though. Not only is it unsafe and bad for staff morale, but it's also in violation of our unit's staffing plan, which would make us in violation of state law.

If you can cut a tech or unit secretary and keep a nurse instead, PI only counts "bodies" and not what the roles are. That might be a way of reducing PI while not compromising patient safety.

Does your unit have a staffing matrix that the charge nurse fills out in order to figure out how many nurses are needed on a given shift based on census and patient acuity?