need help with a rehab case study

[mamakc]

Hi everyone! I am a senior nursing student and I'm doing a case study for my management class about a rehab unit. The case involves a nurse manager of a 25 bed unit trying to make decisions about staffing. She wants to take a FTE staff member from the day or evening shift and place him/her on the night shift because the budget only allows her to move a FTE member to another shift instead of adding a FTE member to the busy night shift. One of the questions regarding this case is which shift would it be better to take a FTE staff member from, the day or evening shift. Another question is asking about what tasks could be moved from the day or evening shift to the night shift to reduce the overload since one FTE member was taken off the day/evening shift. And can any tasks be eliminated at all? I was hoping a rehab nurse could help me some ideas and suggest certain tasks that could be moved to night shift, if any? Your help would be greatly appreciated!!

[nick98]

It would be better to take an evening person. The day shift is usually the most hectic in rehab due to not only getting nursing things done but also trying to do these things around the pt's rehab schedule and also having all the pt's up and ready for therapies on time in the am. It would help out the day shift if some of the patients who have early therapies would have their am care done before the night shift leaves in the am, since some have therapies starting at 8am. Day shift should do things that are scheduled for 3pm (evening shift is 3pm-11pm) at 2pm before the next shift to help the evening shift out.

[Patti 2nd gen RN]

They are setting you up with an incomplete (and very poor in my opinion)question--much depends on who you move--their willingness and past experience at other shifts--in the real world the individual you move would make the biggest difference and how the groups on nights works as a team or not---- and how physically able this person was--we have so much less staff at night, we need to be FAST in emergencies---we have had nurses with asthma or joint problems or huge obesty, who have had to leave the shift because they can't keep up----also--are you talking about moving an aide or a nurse--that would change what tasks you can move---at night we have picked up all the care plans, days and eves do all the skin and wound documentation--when we are short on aides, we use extra nurses--whether to do primary care or have one volunteer to be an aide for the night--also take into consideration that many people refuse to get up before 7 am--in my facility we DON'T do AM care as a routine on nights because they all wake up and need to use the bathroom at the 5-7am time, so we can't make promises as a routine that we can't keep--and to get people up before 5 am is bad in the state's eyes--forget about the confused people getting nuts at night shift's "witching hour"---my suggestion would be to stagger the nurses aides---perhaps have an evening aide work from 5p-1a and a day aide work from 5a-1p--to cover the busy times for nights--but if you need to move a nurse, it's a different cup of tea entirely.....

[nab12]

what are the components of early AM care and AM care?