Is Anyone in Management Here?

[RuRnurse?]

I'm new to this board, so bear with me...I'd like to know if there is anyone in an administrative position here? I ask because I'd like to ask a question. Why is unit assignment such an agony? At my place, there are several distinct types of units, and there are floats and per diems who like working each of those particular units. So, what do they do? They place nurses on units OTHER than the ideal. Even when nurses want to switch, more often than not the answer is no. Why? No particular reason, just because.

Doesn't it make more sense to assign staff based on suitability and, when possible, preference? Does that not make for a better-run unit? We have a locked dementia unit where I work, and there are people who do NOT want to work there, they can't handle that population. So why force-float those folks there, when you have plenty who DO want to work there, and are good at it? All it does is agitate the 'locals' and increase the odds of an accident/incident.

And I don't know how things are at the places you folks work, but in my place they will close a unit say, for the flu, and then float staff on and off those units at will. Why? No particular reason, just because.

What is UP with that? I'm told that it is because they want to make sure nurses can float to different units if needed. And as for the flu scenario, I'm told it's because it's unavoidable. (It's not.)

These decisions come from admin, so I want to ask anyone in that position what their reasoning is. Proper placement of staff is as important as ratio, and in some cases, can allow for a less-than-optimal ratio if needed without adverse outcome. Having staff able to float to a particular unit isn't a problem...as I said, there are always staff who LIKE working a particular unit. So why not match them up?

This is a no-brainer to me. When you have a nurse and aides who know a particular set of residents/patients, and who work often together and have developed a routine with each other, AND, it's working, why wouldn't you KEEP it that way? This is strictly a business question. You run a business and want to get the most out of your employees, you pair 'em up with the job they do best. Then you get your money's worth.

I work in LTC, so I can tell you that familiar staff are important to the residents. The ones who are A+Ox3 will tell you they prefer the staff who know them. They know their routines and plan for them ahead of time. The floats who don't know them will give them their PM tylenol at 9:30 instead of 8 o'clock, and the float CNA will put them in at 10 instead of 8:30, or give them their bath before dinner instead of after. Having staff that know the routine makes for a unit less likely to have a problem needing supervisory attention. As for the dementia units, it is acknowledged by ALL experts that having familiar staff is critical-this population NEEDS the continuity and structure of the familiar in order to have the best shot at having a good day.

So, any administrators out there who can 'enlighten' me?

[morte, LPN, LVN]

i am not management, as will be obvious by my answer...lol.....it keeps the staff at odds,and in turmoil.

[CrufflerJJ, BSN, RN, EMT-P]

The general rule of thumb in many companies is "if it makes sense, we can't do it that way."

[Trishalishus, PhD, CNS]

RURNurse - I agree with everything you've said. I disagree with some of your assumptions. Have you heard of the Peter Principle?

Writing as an ex-managerial type -

"Great fleas have little fleas upon their backs to bite 'em,

And little fleas have lesser fleas, and so ad infinitum.

And the great fleas themselves, in turn, have greater fleas to go on;

While these again have greater still, and greater still, and so on." (Source)

It's not that they don't care or can't see the pain they cause - it's that they don't care. They are being measured by a different set of rules than you - and what gets measured gets done gets measured gets done "and so ad infinitum"

My tactic for dealing with the pain you are feeling is focus on the little things and on what you are doing to lighten a heart or ease a burden; keep venting; write letters to congresspeople about the politics and philosophies at play in aged care; laugh; be the best you can be and become respected for your contribution - so that they are more likely to listen to you. You'll go mad, otherwise.

Best wishes

[masry123]

That really remind me of my ex-nursing home as aC.N.A . The weekend shift is very very popular cause alot of cna's are going to school. I was working 16 h in sat and sun which gives me almost fuul time hours. The DON dosen't want to give full time staff weekends off so they can work m-f. It will make every one happy full staff will be off every weekend and the weekenders will have 32 h every week. we never ever call off I worked there for 2years My question is why ?Why make it unhappy place? and if some of you will say what will happen if some of the weekender's will call off? I will say if I am the DON I will assigne on call staff every weekends. for example if this is your week end off {before m-f }you will be on call. i bet no one will quiet !!!!!!!!!

[Bokyo]

we have floaters and permanent staffs.....

those floaters mostly are our cream of the crop....

but hey last night...this pm shift nurse a floater gave me a hard time....had heated argument with the families of one of our patient another one resident is complaining "my antibiotics was not given"....the mar is not signed.....should have been given at 9pm, 12mn when i was able to give it. one patient was so agitated...xanax was not also given, feeding machine kept beeping...the g tube was not flushed, occluded, wound vac is off, unplugged and battery was drained.................the next day all i heard about the nurse....she was waving goodbye!!:thankya:

rurnurse....we do keep a permanent nurse in its stations, we have a nurse who worked 18, 15, 10 yrs in their particular stations., which is really good...base on what you've mentioned.

but i still would like to be rotated in all the corners of our facility.

[ChihuahuaMamaX2]

The general rule of thumb in many companies is "if it makes sense, we can't do it that way."

lol Aaamen! Though I'm not yet a nurse, at 33yo and having worked in a few different fields I've come to learn that is the truth.

[Daytonite, BSN, RN]

i was a supervisor. we had rules we had to follow when it came to floating people. the answer to your question of why nurses are floated to certain units and not others is because of fairness and the rules we had to follow. we kept records of whose turn it was to float and to where. prns and part time nurses were the first that were picked to float followed by the regular staff nurses. sometimes it was simply a matter of which of the prn nurses had clocked in first and showed up in the nursing office to get their assignment for the shift. despite what some of these nurses may be telling you on the units, they told us a very different story down in the nursing office such as, "i don't care where you send me." we did ask, and i often gave them, a choice of where they would like to go. i was a staff nurse for many years and i can appreciate being assigned to one unit. we also assigned floats according to the acuity program we were using and if our director of nursing came in the next day and found that we had not pulled nurses off a unit and floated them to a unit that needed the extra help according to what the acuity program had dictated us to do then the supervision staff got in trouble. i was very careful of where i sent staff nurses who were floated and assigned them to units very similar to their home unit or else followed up with them during the shift to make sure they were not having problems during the shift. i am also aware that not all supervisors are that attentive to their staffs. floating, however, is a fact of life in many places. it doesn't mean it has to be a horrible experience.