Looking for Effective Staffing Model

[KimRN41514]

Our med-surg unit is falling apart. I'm hoping for some insight to things that work. Our unit is 57 beds. We have a separate but adjoining NBN and post partum unit there as well (10 beds). We have very few OB's. Our unit mainly consists of pediatrics, respiratory patients, new CVA's, CP on telemetry, nursing home patients and a newly acquire orthopod who needs a particular area of 11 beds sectioned off. Currently, we do staff Rn's, LPN medication nurses and LPN & NA's for patient care. There seems to be little communication between the RN's/patient care providers. the RN's stay crazy busy doing assessments, notes, answering family calls, updating Kardexes, IV pushes, new admissions, same day surgery overflow. They are constantly complaining. The med nurses complain that they can't do meds and IVPB's when the census is in the 40's-too busy. Patient care providers (LPN's and NA's have about 9 pts each). Do you have any ideas as to how this unit could be staffed/scheduled more effectively? The RN's have a ratio of 1:8-9 and usually provide little direct patient care. Email me please if you have any suggestions or ideas. I've talked with the staff many times asking for their input without success.