Colts1RN

Hi I am looking for anyone and everyone who can help me with their input on a staffing model/ or grid for a surgical floor. I currently work on the busiest floor in our hospital...it is a 47 bed unit and we are the only floor in the hospital that houses all the surgeries excluding women's surgery. We also are the pediatric floor too. Now the problem is the staffing. On a typical weekday we may discharge 15 or more people and we may get 15 or more back in the same shift (7a-7p). We have anywhere from 6-7 patients at any one time and that may not sound bad but these could be split up on anywhere from 2-4 different long hallways making it CRAZY!!!! Our techs are supposedly responsible for keeping up with I/O's, post-op vital signs, ambulation, and any other needs. They cannot perform accuchecks, or empty any drains or tubes. Half of the time we are doing their work and our current staffing model is not working. We usually have about 6 nurses on day shift and 2-3 techs. Several of us are meeting to discuss what we could do different to prevent the nurse turnover on our floor and increase patient satisfaction. (LOT OF OUR NURSES HAVE LEFT BECAUSE THEY JUST CANNOT HANDLE THE STRESS AND CRAZINESS!!) I am thinking about suggesting team nursing, but need some input. I have worked alot of places and this has got to be the busiest, most stressful place I have ever worked. Some of the suggestions i have mentioned the Director of Acute Care said that we could probably not do because of budget, however I believe patient safety and satisfaction is more important and we are losing nurses left and right. I need input from people who work on a VERY BUSY SURGICAL unit, keep in mind we also have the sick little babies and kids but they only make up a small portion...90% surgical 10% pediatrics. by the way we do not use an acuity tool (which actually would be very useful). Also our charge nurse (not unit manager) on days does not USUALLY take pts, but helps the secretary put in orders and gets charts ready for the new surgeries coming to the unit, so basically she is of no help to us on the floor. On busy surgery days she informs of post op pts coming back by calling us down in our pt rooms and says "you have a surgery pt coming to rm 441 and they are on their way right now from PACU". So no matter what you are doing you pretty much have to stop and go receive the pt via bedside from the PACU nurse immediately. Any and all input is vital and would be appreciated ASAP!!! Thanks!