Patient assignments - Are nurses assigned to empty beds

[LearningAboutNursing]

Hi,

I am trying to understand how the nurse patient assignment works. Can you please shed some light on how the assignment process works? Are nurses assigned to empty beds -

If known there is a patient that might come in or irrespective?

Thanks in advance.

[rn/writer, RN]

In every place I've ever worked, nurses are assigned to actual patients, not rooms or beds. Staffing is supposed to take into account the acuity (seriousness) of the patients' conditions so that one nurse doesn't get all easy people while another gets all challenging ones. There is no point in listing empty beds, because there is nothing that needs doing. A nurse might have a room number listed on the assignment sheet for a patient that is expected to arrive in a short time, but, again, it's really the patient that is being assigned, not the empty bed.

[awalker1015]

On the med surg tele I worked we were evenly assigned patients and empty beds. We always got admissions and those were heavier than existing patients. I always hoped for an all patient assignment. Having more than one empty usually didn't bode well for my shift.

[picurn10]

In my unit we typically have one nurse "open for an admit", meaning one actual assignment, and one empty bed. They don't actually decide which room until there is a pt on the way, but its near the nurses other pt. I'm in ICU though, so that may be different from floor nursing.

[LearningAboutNursing]

Thanks for the comments.

In cases where the nurses are assigned to empty beds, how does one ensure that the nurse that was initially assigned to the empty bed is still the appropriate one based on the incoming patient's acuity? Does a CN need to constantly monitor for this?

Are there cases where patient acuity levels change while the nurse is caring for the patient and because of the changes, the nurse is no longer the right one to care for the patient?

[Meriwhen, ASN, BSN, MSN, RN]

To be honest, I've never heard of a place assigning a nurse to an empty bed. Not saying that it can't happen somewhere (see the ICU example above), but I imagine it's pretty uncommon.

[picurn10]

In the ICU, everyone can typically handle high acuity. If the pt is just a train-wreck from the get go, they will typically reassign the nurse's first pt to someone else so that nurse only has one pt, or the charge nurse ask us to help take care of pt 1so the nurse can focus on the new, very sick pt. If it were a total newbie, then the charge nurse would likely reassign one of the more experienced nurses pts so he/she could take the really sick pt, and the newbie could have two low acuity pts. But ICU we only have two pts assignments, so its not too much of a juggling act most of the time.

[loriangel14, RN]

I float to a tele/medical floor quite often and empty beds are assigned.Empty beds don't stay empty for long and you are almost guaranteed an admission.

[itsmejuli]

Is this a homework question?

[IdislikeCODEbrowns]

At my hospital nurses are assigned empty rooms all the time...I work med-surg and pt. ratio is typically 1-4, our pt. assignment goes by acuity/location (room #) and skills/talents of each nurse. We do rounding with administration 1-2 per shift to update status on each pt. and where they are in terms of needs/discharge planning so our CN's have an 'idea' of what to expect staffing-wise for the oncoming shift. Our pt's are initally admitted/transferred to our floor by our Administrative Coordinator who oversees the 'new' patient and what they may need and which room on each of our med-surg floors they anticipate bringing them to. Our AC makes placements based on many diff things but it usually tends to work out pretty well. Of course there are times when a pt.'s status may change drastically throughout the shift making them more 'acute' than others and some of us may have a 'heavier' group once in a while, but as a floor when are usually pretty good about working as a team and pitching in to help others out. The only thing being assigned an 'empty' room on our floor means, is a new admission, that is a guarrantee, so while it may be good for a little bit, it just means that you have the opportunity to get that pt. w/ a bag full of new 'tricks' haha.

[hiddencatRN, BSN, RN]

I work in the ER, so it's a bit different. We get assigned a set of rooms- whatever patients are in those rooms or wind up in my rooms are my patients. Sometimes you have a heavier or lighter assignment depending on how the cookie crumbles, but the folks I work with are pretty good about recognizing who is struggling and needs help and pitching in. Patients are placed in different assignments somewhat by acuity (we have one really high to high acuity area, two medium high to high areas, and then fast track). If patient acuity changes in a major way (or they turn out to be way sicker than initially determined) they can be moved pending bed availability, but usually other nurses help with your assignment while you are getting the sick patient stabilized.

[LearningAboutNursing]

Thanks, that's very helpful.

I had a few more questions -

Does it ever happen that the patient needs to moved from one bed to another within the unit? If so, what happens to their assignment - does the nurse follow the patient? or a new nurse is assigned?

What software are these assignments done in other than the printed assignment sheets? If there are systems where this is electronically done in and made visible at/near the nursing stations, does that remove the need for the assignment sheets?