patient assignment

[nurselyman]

How does your hospital divide patient assignments at the beginning of the shift?

[RN0820]

Strictly by number...unfortunately. also depends if we have an LPN. Also, the nurses that work 12s like to stay where they are and the nurses who have worked the day before keep their sections for continuity of care. Hope this helps.

[loriangel14, RN]

Usually it's done by number, they try to keep you in consecutive rooms and if you worked the previous day, try to keep you with the same people. Where I work PNs and RNs get the same assignments, there is very little I can't do, like PICC lines flushes and starting blood, so I get an RN to help if I need any of that done.Also where I work if there is a patient that is very trying to deal with and you have had them for a couple of days you can always ask to not have them on your assignment. We usually try to have these patients rotated so no one has to deal with them ALL the time.

[nursynurseRN]

by acuity... They divide up the hardest patients on the floor, like those with dressing changes, A Lot to of meds, ACCUchecks, and attiude problems :). They also keep in minds the patients who have who have sitters. Then they see who will be discharged and divide them up to soi that not just nurse gets all the discharges. It sa littel complicated but depending who is in charge they do a better job at it.

[Horseshoe, BSN, RN]

by acuity... They divide up the hardest patients on the floor, like those with dressing changes, A Lot to of meds, ACCUchecks, and attiude problems :). They also keep in minds the patients who have who have sitters. Then they see who will be discharged and divide them up to soi that not just nurse gets all the discharges. It sa littel complicated but depending who is in charge they do a better job at it.

That's the way it's done where I work, though I think it is not necessarily hospital policy, but the culture in my own unit. Outgoing charge nurse reports to incoming charge nurse, and the incoming charge nurse makes assignments based on that report. On our unit, the assignments are always open to negotiation if a nurse has a legitimate concern about it.

[JSTARZ]

on my unit we do a modified team nursing...1 RN 1 LPN and a CNA who is shared with another RN and LPN. So we usually take on ten patients per team me as the RN will take the most acute or the patients who "NEED" a RN (Numerous IVP drugs, blood, and the most critical). So I usually take on the 4 or 5 busies and give my LPN the other less critical 5 or 6. It works great (when I have a good/competent LPN) and I float as needed to those patients assigned to the LPN!!

[evolvingrn, BSN, RN]

Strictly by number..... The weakest nurse gets the lower number regardless of acuity if it doesn't divide evenly......a little frustrating because it's always the same nurse that gets the easier load.

[HonestRN]

strictly by number and room location which inevitably leaves one nurse with a crummy assignment while another usually has a cush one. I think patient assignments really should be done by acuity for better care.

[Orange Tree]

Ours is also divided by section, although some effort is made to even out the admissions and discharges. It's nice when a good nurse gets an easy assignment, because that nurse helps everyone else out. But unfortunately, the bad nurses often end up with the "best" patients and play on the internet while the rest of us suffer.

[HRSBSNRNC]

How does your unit figure out the acuity? Is there a tool they use? This sounds similiar to my unit, however, the acuity tool is not always accurate, or the nurse who is determining the acuity is under estimating or over estimating the acuity. I would love to see the acuity tool you use.

Thanks,

Heather

[3dayRN]

off going charge nurse makes assignment. Some charge nurses pay attention to acuity, others don't consider it at all. We never take more than 5 patients. So, I would rather start with 5 so that means no admission for me :) If we were there the day before the charge tries to assign the same patients but can't always get all the same patients back d/t room changes etc.

[amarilla, RN]

We divide by number; usually we all start with 6 or 7, unless you're one of the unfortunate folks to come on in-between at 3-11 and get whoever is left as well as 2-3 admissions. Our unit is shaped like a L, so they try to keep people on the same hall to minimize being split. If you work consecutive shifts, you'll most likely get your people back if they're still on the floor.