Nik.S.RN

I work as a house supervisor, I do not know exactly how productivity is worked out, but I know we staff by acuity, assigning a number 1-5 to patients (5 is most care, there are never any 1s or 2s - otherwise why are they there?), we then have a math equation to solve so that icu patients are assigned the most care hours, then tele, then m/s (we have a combined unit - small rural hospital). We also have a staff matrix, to sort of double check our numbers. If there is a large gap between the two, we report on staffing sheets a short narrative or comment such as: high acuity patients, 6 total care and 6 confused patients, 1 suicide watch, 2 vented patients, 2 fresh postops w/ blood transfusions ordered....etc. - so that staffing numbers make sense to our director To answer your question, we do not "count" the sitter in our "actual staff" numbers, but there is a section on our staff report to indicate that we are staffing a sitter. Our sitters are usually a CNA, or more rare - a nurse from a low census unit, but sometimes a respiratory therapist, maintenance person or housekeeper...etc. Today we had 8 patients (4 m/s, 4 tele), per staffing grid/matrix it called for 3.7 staff, acuity called for 4.0 staff, we had 3 RNs, 1 CNA and 1 Sitter...the sitter (a CNA) was/is not counted as part of the floor staff.

We have made the decision on our combined unit (med/surg, tele, icu) to have a nurse on call every day, for 24hrs. I believe in a 6 week schedule it works out so that the nurses are only on call 2 times in the 6 weeks. We are on 12 hour shifts. Does any one else out there have RNs on call for medical departments? Of course they wouldn't be scheduled to work the day after their call shift, in case they had to work the shift. We often have ebbs & flows of low census and high census days. Nurses are put on call on low census days, and in that case the "on call" person would only be on call for the next 12 hr period, or called off completely if low census for the 24hrs. We have some teamwork issues, and often the same 3-4 nurses, the "reliable ones", will fill in the gaps. We are hoping to avoid burn out, promote teamwork and reliability, and create a sense of accountability to each other. How did you work it out, what has worked and not worked for you? Thoughts?

We have made the decision on our combined unit (med/surg, tele, icu) to have a nurse on call every day, for 24hrs. I believe in a 6 week schedule it works out so that the nurses are only on call 2 times in the 6 weeks. We are on 12 hour shifts. Does any one else out there have RNs on call for medical departments? Of course they wouldn't be scheduled to work the day after their call shift, in case they had to work the shift. We often have ebbs & flows of low census and high census days. Nurses are put on call on low census days, and in that case the "on call" person would only be on call for the next 12 hr period, or called off completely if low census for the 24hrs. We have some teamwork issues, and often the same 3-4 nurses, the "reliable ones", will fill in the gaps. We are hoping to avoid burn out, promote teamwork and reliability, and create a sense of accountability to each other. How did you work it out, what has worked and not worked for you? Thoughts?

I work at a small rural hospital in Illinois. We have a combined ICU/Tele/Med-Surg Unit. ICU staff take ICU & Tele patients, Med-Surg nurses take M/S & Tele. We are trying to get all M/S nurses ACLS cert'd and get them Tele training so they can read there own strips. There is a lot of resistance and we are having difficulty coming up with cost-effective education strategies to get the nurses Tele trained...ideas? There is