Where I work, we use room assignments at my one job and dont at the other. I seem to find I like the room assignment option. We have a specific set of room assignments we use each day. My ER has 1-4 cardiac beds 5-7 general medical, peds, ent, gyn, and othro, we also have 3 basic urgent care rooms a,b,c and the trauma room that is not assigned generally. Our max staffing for the er is 5 nurses during the week and 6 nurses on the weekend. And usually 1 secretary and 1 er tech, our room assignments go as follows. 5 nurses 1, A - Charge nurse 2, 5, ortho, ent 3,7, peds, c 4, 6, gyn, b triage with 6 nurses, 1, ent - Charge nurse 2,5, ortho, 3,7, peds 4,6,gyn a,b,c triage. I like this you are typically not suck with the same room every day of the week. the triage nurse decides which pt goes in what room and if needed consults with the charge nurse. If we happen to have a good triage nurse she will divide up the rooms appropriatly, and not give one nurse 2 pts back to back unless she has to and the triage nurse with come out and talk with you about how busy you are and give you a heads up. Last year I believe our census for the year was around 35,000. AT my other job the 2 nurses on for a small rural hospital take turns with pt. it is a 10 room er with a trauma room. I personally perfer the room assignment aspect and works well with the enviroment and pt complaints we usually have.