On-call and pt acuity

[nurse nessie]

I work at a small hospital and usually we only have one med-surg nurse. In CA, our nurse to patient ratio is 1:5. However, occasionally we'll have our on-call nurse come in to work when our census does get higher. Whenever my nurse supervisor is on-call and I'm the primary, she takes the easiest pts while I'm stuck with the pts with abx, wanders, and who are more acute. I was wondering if other places give the primary nurses higher acuity than the on-call nurses.

[opensesame]

Yes, I think most places do this. It's a courtesy. Float nurses usually don't know the floor as well as the regular staff and usually appreciate a somewhat lighter assignment if staffing allows. It takes them longer to find things and complete tasks just because they don't know the routine. I wouldn't say they always get the easiest assignment, but you certainly don't assign them the most difficult one.

An exception I have seen to this is if the unit is extremely busy, sometimes the float will get a full patient assignment so they don't have to do a discharge (or several) or take an admission (or several.)

[Scarlette Wings]

usually the call back person, or in this case the on call nurse, is working their own full time load and hey offer to come in extra to help cover staffing crunches. it helps the hsopital becuase they know the policies and it helps the person by allowing them overtime within their own facility.

that said, because our call back staff is also working full time hours during the week, we don't want to take advantage of them or abuse them. we assign a decent group of patients whenever possible. it is not that they get it easy, patients can be demanding regardless of acuity and sometimes the less sick they are the more they grown and whine. i would rather have hospital $$ going to our own staff in call back time and realize they are "our own" people than see outside staff come in and then make my work harder having to stop and help them all the time because they are not familiar with the hospital. does that make sense? (and i don't mean to offend any agency or prn staff so don't e-hate me. lol)