Charge Nurse dividing Assignments

mrsboots87 · Jul 7, 2017

It's not about the contact precautions. It's about the patient acuity. If you are following proper precautions for each pathogen, then your risk of sharing these issues between patients is minimal. Charges generally focus on what is going on with a patient and the amount of time they will require in care. Not how many people you have to dress up for the ball for.

Sour Lemon · Jul 7, 2017

Im just wondering how the charge nurse assign the patient to the nurses at the beginning of the shift. One night I have 7 patient and 6 of which are in some types of precaution tb, (2)MRSA, (2)c. diff. meningitis. Im a new nurse, so I have no idea how this division of assignments goes. I follows all the precaution, but I am still afraid to catch anything. Some nurses will have a couple but they never had 6 at the same time.

If an assignment is very unbalanced, it's appropriate to speak up in a respectful manner. In a lot of cases, the nurse who made the assignment just may not be fully aware of the circumstances. They'll usually alter the assignment or explain why it's appropriate if you ask.

AceOfHearts<3 · Jul 7, 2017

My old tele unit used to take isolation precautions into account when making assignments (normally). If one nurse has the majority of iso patients the additional time iso precautions take can really add up. It wasn't unusual for half my unit to be iso patients in the winter months.

I once was given half the iso patients on my unit while everyone else only had 1. The assignment had to be changed 4 hours into the shift for a reason other than that and I took that time to point out the disparity. If I had to give up a patient that I had already assessed, charted on, done the big morning med pass on, etc. in order to take a new admission it sure as crap was going to be one of my many iso patients and not my single patient not in isolation (that I was giving up).

OP- I would ask the charge nurse one day how the assignment is determined. Some places take the workload of the patient into account but some places do it strictly by podding. Next time you feel you have an unfair assignment calmly ask the charge nurse about it, just make sure you aren't accusatory about it.

There have been other times when I def. had the short end of the stick and had an unfair assignment. Most of the time I just dealt with it, because that is my nature, but when the assignment was being made for the next shift I'd speak up about it and say if my group needed to be split up.

saskrn · Jul 7, 2017

Im just wondering how the charge nurse assign the patient to the nurses at the beginning of the shift. One night I have 7 patient and 6 of which are in some types of precaution tb, (2)MRSA, (2)c. diff. meningitis. Im a new nurse, so I have no idea how this division of assignments goes. I follows all the precaution, but I am still afraid to catch anything. Some nurses will have a couple but they never had 6 at the same time.

Isolation patients are often time consuming, and this should be considered when assigning patients. They should be equally shared among the staff as much as possible.

I'm surprised that a charge nurse would assign so many isolation patients to one nurse. If I were in that position, I'd politely ask the charge nurse to reconsider my assignment. Additionally, I'd also mention it to the nurse manager, and ask if a policy or guidelines could be established to prevent similar staffing in the future.

Good luck!

AJJKRN · Jul 7, 2017

I personally take into account acuity, the acuity you can't see (call light happy, crazy pt/family, etc), isolation, tracheostomy's, high alert drips, who had the pts for continuity of care, discharges, and other things like personality/capabilities of the nurse to certain patients...and I'm a floater for the hospital...so I guess every charge is just different.

Cat365 · Jul 7, 2017

From my observation it was always a balancing act. The charges I worked with tried to take precautions into consideration, but they also had to add in patient acuity, time considerations(some patients can be time suckers for one reason or another) and physical location (you didn't want the same nurse running from one end of the hall to another all night). Sometimes it worked and the workload was balanced sometimes they misjudged or a patient had a change in condition (the previously oriented patient suddenly keeps trying to jump out of bed)

I wouldn't complain about it for one night but if that charge keeps doing it I would question their logic. Politely of course.