Shift Staffing Question

Nurses General Nursing

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Specializes in Pediatrics.

...never mind

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Specializes in OB, M/S, HH, Medical Imaging RN.
How does your hospital do staffing between shifts?

Rather than having simply a ratio staffing number, acuity should be used to determine staffing but it never has and probably never will. Unfortunately we are stuck with staffing ratios. My hospitals ratio on days is 6:1 on days and 7:1 on nights. Another local hospital has a ratio of 4:1 for both shifts. If I were to ever return to floor nursing I'd be running to the other local hospital.

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Rather than having simply a ratio staffing number, acuity should be used to determine staffing but it never has and probably never will. Unfortunately we are stuck with staffing ratios. My hospitals ratio on days is 6:1 on days and 7:1 on nights. Another local hospital has a ratio of 4:1 for both shifts. If I were to ever return to floor nursing I'd be running to the other local hospital.

There is nothing wrong with staffing ratios, per se, as your own local example demonstrates. Minimum staffing ratios are clear and understandable unlike acuity based systems which contain tons of "wiggle" room. Your hospital's problem is the adequacy of the selected ratios.

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Specializes in OB, M/S, HH, Medical Imaging RN.
there is nothing wrong with staffing ratios, per se, as your own local example demonstrates. minimum staffing ratios are clear and understandable unlike acuity based systems which contain tons of "wiggle" room. your hospital's problem is the adequacy of the selected ratios.

minimum staffing ratios are not that simple. 6:1 leaves no "wiggle" room either. how many times did i have a patient or two go bad leaving little time for my other patients...

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minimum staffing ratios are not that simple. 6:1 leaves no "wiggle" room either. how many times did i have a patient or two go bad leaving little time for my other patients...

perhaps my previous post was unclear. with a staffing ratio model there can be little argument with respect to compliance; for example, if the mandated ratio is one nurse for every four patients and your unit has a census of 16 patients you need to staff at least four nurses. you've either staffed to meet the minimum ratio or you haven't------no "wiggle room".

this in contrast to purely acuity based systems where administration can always argue, "yes, that seems like a lot of patients for one nurse to take care of but we don't think they were all that sick so the number we staffed was adequate." too much room for interpretation in my view.

mandated minimum staffing ratios are just that....the minimum, a required baseline. there is nothing to prevent a hospital administration from exceeding those minimums should they determine the acuity either temporarily or chronically requires additional nurses.

granted, there is nothing magical about ratios, per se, because ability to determine compliance is not the only issue: the mandated ratios must also be adequate/appropriate in the first place. a single icu nurse will struggle trying to take care of four critically ill patients regardless of the method used to arrive at that assignment.

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