Matrix???

Crocuta, RN · Jun 16, 2007

Ok, what is exactly is "the Matrix" when referring to hospital/floor staffing. I'm asking this because I work on a busy Med/Surg floor and our new Director said our old Director over scored us and we should be taking 7-8 instead of 5-6 :uhoh21: !!?? I'm just not sure what the term means, I'm new to nursing so forgive me.

It is the world that has been pulled over your eyes to blind you from the truth that you are a slave, Neo.

Oh, sorry.

A staffing matrix is a tool that nursing managment uses to determine appropriate staffing levels based on patient count and patient acuity. The staffing person will look at how many patients are in a unit and the matrix tells them how many RN's, LPN's, CNA's etc should be staffed for each shift. They'll use it to determine whether staff should be sent home due to low patient counts. They are determined by various formulas taking into account nursing hours per patient day, budgets, and so on.

Basically, what your new Director is saying is that she's going to slightly increase the number of patients cared for by a given number of staff. It usually comes down to profitability.

Michellex1013 · Jun 16, 2007

Crocuta puts it nicely to say that your director is "slightly" increasing the number of patients you have. Going from 5 paitents to 8 on a "busy med/surg" unit...lets just say I feel for you. Your director is trying to make a profit (or more of a profit) for whatever reason. A matrix tells how many nurses and aids you can have for a particular shift on a particular unit. I have never seen a unit make frequent adjustments of a matrix for pt acuities (even though it is apart of it). They usually just take the "average" patient acuity and stick with that. If you have a lot of total and high care patients don't expect them to give you an extra nurse. Talk it over with the other nurses and come to some agreement on whether your co-workers believe it is a fair thing and have many talks with your director. Don't be afraid to stand up for yourself. Hope everything goes well.

Michelle

PoppaD · Jun 16, 2007

Your director is trying to make a profit (or more of a profit) for whatever reason.

You said that you have a new director. What happened to the old one? Is your facility under new management?

If your old director was overstaffing the unit and wrecking the budget, the new director might be forced to make a tough call and attempt to right the boat. Sometimes hospitals merge or are outright bought by other business entities who have different management strategies.

My point is that there may be more to this situation than you realize.

meownsmile, BSN, RN · Jun 16, 2007

Oh yes and please be aware the hospitals have paid some company to come in and do a very expensive staff survey that entails them following around staff and timing how long they are in a room with patient contact. And these little surveys are how their almighty matrix was derived. The matrix is like a second Holy bible and should never be argued with.:angryfire

It in no way takes acuity into account. I know they want everyone to think it does but only as far as if the state comes in they can prove they are documenting acuity. It plays no part in what your patient acuity ACTUALLY is.

We have a separate program to log in acuities, which is not used at all to justify staffing. Its just another hoop to keep them out of the hot water with the state. OK need sleep , sorry a little negative this morning. :)

LUVtxNursing · Jun 16, 2007

Thanks for all the comments, our old Director took a position as a House Supervisor, the new one said we would just have to get used to this new Matrix and Med/Surg nurses should be able to handle 7-8 patients :angryfire !! She is supposed to be temporary until they find another one for my floor, because she is the full-time Director of Tele. She's kinda treating us like her "step children", for example, Thursday we had 3 nurses on the floor and 2 CNA's, one of our nurses was pulled to Tele or we would have had 4, we all had 7 patients, some ended up with 9 until we finally got some help!! Well, Friday I come in and same thing, all nurses had 7 patients and I and another nurse was pulled to Tele. Well, we all had 5 patients on Tele and 4 CNA's, it made for a nice day, but I felt really bad for my floor!! Our ortho nurse had 8!! Trust me, we have some very high acuity patients on our floor right now and we need the staff. Maybe I'm just reading more into it, but it seems like we're getting dumped on while Tele is always fully staffed, she even pulled a CNA off Med/Surg yesterday to do 1:1 with a pt on Tele, that left them with 1 CNA!! Well, thanks again for explaining the "Matrix" to me, I understand it a little more now, but still don't agree with what's going on!!

meownsmile, BSN, RN · Jun 16, 2007

Lvntx-- keep fighting. We work with teams of RN/LPN/CNA's. Our "matrix" would call for 2/2/3 for 15. It drops to 2/2/2 on evenings and down again on nights to 2/1/1. However, if you are routinely having to deal with 7-8 patients doing TPC with no LPN to pass meds or assist your CNA you are pushing the limit. We get our staff stripped for floating to tele on occasion too. They tend to staff tele units better because they are required by law in most states to have a certain number of staff to read tele on the unit.

I have seen the times i have had 12 by the end of my shift, but i do have a LPN for meds and a CNA to do ADL's for the most part. Im out there in the mix answering lights, giving iv meds etc too. But it does get hairy.

Oh by the way,, you should have a copy of the almighty matrix posted wherever they have the staffing board. If they dont insist on it,, and hound them to death if they dont adhere to at least what THEY have deemed adequate staff. They will try to short you as much as possible for their own bottom line.

Roy Fokker, BSN, RN · Jun 16, 2007

Oh yes and please be aware the hospitals have paid some company to come in and do a very expensive staff survey that entails them following around staff and timing how long they are in a room with patient contact. And these little surveys are how their almighty matrix was derived. The matrix is like a second Holy bible and should never be argued with.:angryfire
It in no way takes acuity into account. I know they want everyone to think it does but only as far as if the state comes in they can prove they are documenting acuity. It plays no part in what your patient acuity ACTUALLY is.
We have a separate program to log in acuities, which is not used at all to justify staffing. Its just another hoop to keep them out of the hot water with the state.

We must work at the same hospital/unit :selfbonk: