Staffing and Change of Shift

[LJR89]

Hello all!

I currently work in a 24 bed TCU and we've been having some staffing issues.

Let me first start by saying that we have pretty awesome ratios compared to most of you out there in rehab/TCU Nursing. We have 8:1 for nurses and 12:1 for our nurse assistants. so I really feel for those of you that have worse ratios. But we've also have been taking higher acuity patients as of late and are now approved to take more memory care patients some of which require 1:1 attention for large portions of the shift.

My first question is... um how do you even do it with even less staff?

Shifts feel out of control so any tips or tricks are appreciated.

Second, we have a serious teamwork problem on our unit. Any ideas that have helped your units with teamwork and team accountability would be helpful!

finally. On the team work note, I know some of my nursing friends participate in a short unit wide report. Where they can talk about census and admits and any issues that would help the group to know.

Even if it's not their patient, things they could help keep an eye out for or even know that there coworkers might run into problems with? Or offer input if someone has had that patient or similar problems in previous shifts and might be able to offer ideas?

Has anybody done this system and think it's worth the time? In my mind are unit is small enough that it would help with accountability and teamwork but I could see my coworkers not being as enthused.

Thoughts?

[Been there,done that, ASN, RN]

Of course your shifts are out of control. There is not enough staff to take care of the residents.

The fat cat owners, that will only pay for minimal staffing, are on their yachts...while you are trying to find ways to manage an impossible workload.

[Crush]

If acuity goes up then staffing ratios should be adjusted accordingly if at all possible. Hard to get teamwork when everyone is stressed. Yet, it is when staffing is like this that teamwork can also help with the stress levels.

[smf0903]

We do a sheet that's updated qshift that has every patient and pertinent info on each patient (docs, dx, diet, activity order, O2, tele, if accucheck and how often, pertinent hx, discharge plan, if pt has ostomy/tube feed/lines/foley/etc). It's great because everyone on the floor gets a copy and it's a quick reference without having to open the chart. It sounds like a lot to fill out but each nurse fills out on his/her patients and it really takes maybe 5 minutes (we usually have 5 patients).

I love having the sheet. We put our own little notes on it in report. Fold it up, stick it in our pocket and we have it for the shift.

The staffing issues will be addressed when it starts cutting into their bottom line--multiple falls, lawsuits,etc.