So I was in charge for the first time yesterday and had the "pleasure" of going to bed huddle - the blood-bath, er I mean meeting we have 5 times a day to discuss staffing for the next shift. So of course several floors are down and they're discussing who gets the extra nurses/aides and they're talking about how floor X is at 5 - 1 now and really needs the extra nurse from floor y who will be 7 - 1 if they give up the nurse (I'm flor Y). Because floor X is a monitored floor......Ummm....Floor Y is a monitored floor too(???) I kept my mouth shut because I always figure it makes sense to someone, but asked about it later....Floor X has drips, she told me. (We don't, but we did have 2 chemo's that day.) So Floor X is considered a higher level of care.
(Did what I wrote make any sense at all to you guys??)
Acuity seems to fluctuate sooo much, how do your hospitals handle staffing and acuity? Just before floor X "can" have drips, doesn't mean they do today. But they'll still get more nurses than us. Sometimes we have a bunch of walky talkies who need little care besides monitoring and meds. Sometimes we have a bunch of incontinant total cares who need to be cleaned up every hour. Because we are oncology, we often have patients who get pain meds q1h, plus blood, platelets, chemo etc and your day is packed. (One day I had to go to BB 5 times on three different patients and still didn't get all my blood products in.) So shouldn't staffing be handled based on what you have that day?? But how do you pull this off?
When I did clinicals, the hospital attempted a system where patients where scored on acuity level. They had some formula (I think) where they could determine staffing based on the type of floor and the acuity level. I don't think it really worked because, let's face it, most people are going to "bump up" their acuity level to get more staff.
i work night shift in an ltac and even though we have to fill out all these acuity paperwork things so the managers / supervisors can determine staffing, im under the impression they dont even look at them.
assignments are horribly unequal.
or...the lpn we work with being assigned the only patients who have tpn and iv push meds every hour or two.
it makes no sense.
it appears that if we are sitting down to chart, then we are not busy enough, so hey since youre not doing anything........can you.....?
its horribly frustrating.
the acuity of the patients, although tallied, is not even considered when making assignments.
mykrosphere
151 Posts
i work night shift in an ltac and even though we have to fill out all these acuity paperwork things so the managers / supervisors can determine staffing, im under the impression they dont even look at them.
assignments are horribly unequal.
or...the lpn we work with being assigned the only patients who have tpn and iv push meds every hour or two.
it makes no sense.
it appears that if we are sitting down to chart, then we are not busy enough, so hey since youre not doing anything........can you.....?
its horribly frustrating.
the acuity of the patients, although tallied, is not even considered when making assignments.