Help me understand this staffing model...

[catlady, BSN, RN]

I work on a 40+ bed telemetry unit that runs low census in the summer and high census in the winter. We normally take four patients on days and five patients on nights, with two CNAs, a ward secretary and a monitor tech. If we have to, we can go to five patients per nurse on days, six on nights.

Yesterday our census dropped to 14 by the middle of the day. Everyone was sent home except three nurses, the charge nurse, and a monitor tech. I had four patients, one nurse had four, and one nurse had five. The charge had none, but she spends most of her day doing payroll and QA and such.

I asked the charge nurse why we had to lose both our CNAs, and she said it was required when the census dropped below 15. Except that my workload didn't change one iota. The patients aren't any less sick than they will be in the winter. We three nurses had just as much work to do as we would have had if the unit were full, but now we had no aide or secretary to help. Then she told me that management had tried to drop our projected patient load to four instead of five, but because we're losing staff, we'd probably be bumped back up to five every day. I said that would really make people leave. She finally told me I'd have to ask our director.

Maybe I'm stupid. Can anyone help me understand this? I am counting the days until I'm allowed to put in my transfer application to ICU.

[Jolie, BSN]

I work on a 40+ bed telemetry unit that runs low census in the summer and high census in the winter. We normally take four patients on days and five patients on nights, with two CNAs, a ward secretary and a monitor tech. If we have to, we can go to five patients per nurse on days, six on nights.

Yesterday our census dropped to 14 by the middle of the day. Everyone was sent home except three nurses, the charge nurse, and a monitor tech. I had four patients, one nurse had four, and one nurse had five. The charge had none, but she spends most of her day doing payroll and QA and such.

I asked the charge nurse why we had to lose both our CNAs, and she said it was required when the census dropped below 15. Except that my workload didn't change one iota. The patients aren't any less sick than they will be in the winter. We three nurses had just as much work to do as we would have had if the unit were full, but now we had no aide or secretary to help. Then she told me that management had tried to drop our projected patient load to four instead of five, but because we're losing staff, we'd probably be bumped back up to five every day. I said that would really make people leave. She finally told me I'd have to ask our director.

Maybe I'm stupid. Can anyone help me understand this? I am counting the days until I'm allowed to put in my transfer application to ICU.

I can't explain the staffing model, but do wonder why the charge nurse didn't help out those of you with patients once the unit secretary and CNAs were sent home.

[neygray]

I too do not understand the staffing model. Most will determine acuity for nurses and CNA's separately. I'm with Jolie, the charge nurse should always pitch in when needed, and on our floor, that's why they are there and do not have assigned pts. Why does charge nurse do payroll anyhow? You do not have a DON or ADON? That's usually one of their jobs.