Staff Assignment

[brandi smith]

Hi, I currently work on a medical-surgical unit where we do our staffing assignments based on block. For example nurse A gets rooms 1-5 nurse b get rooms 6-10 and so on! I am looking for a new way to our assignments based on continuity or care. I feel strongly that if you had a patient the day before you should get them again the next day. However doing blocked assignment if we get addmissions or discharges in that particular group you team might get shifted. Another issue I have seen is if you get an admission that is not in you team you will not get that patient back the next day because it is in someone elses team. I am looking for a way to assign patients based on continuity of care. I believe that continuity of care increases patient safety and patient satisfaction and would really like to implement a new way to assign patients based on this.

[loriangel14, RN]

Where I work we just eyeball it.Try to make sure that everyone's assignment is fair work load wise.Quite often we won't have the same staff from one day to the next so continuity isn't really an issue. Plus sometimes if someone has had a difficult patient/family for more than a couple of days we will give them a break and assign that patient to someone else.Having the same people all week isn't always a good thing.Some of the staff work 12 hour shifts so they are not here more than a couple in a row.

[kcksk]

We don't do block assigning. We take whoever had the pt last and they get them back. That seems to work for us. We also try to split up the precaution rooms, acuity, etc. Then we try to take the remaining pts and split them evenly. We try not to have people go from one end of the floor to another but sometimes it just happens.

[StrwbryblndRN]

I work noc and will make the assignments for the day shift. My first priority is to assign previous days nurses to the same pts. I will even go back 2 days.

Some times they get a different pt just because there may be more total care and would not be fair to the other nurses.

Otherwise we divide up the pt's based on degree of care, questionable d/c, pending procedures. Some pt's who look a mess on paper are easy and vice versa. So that is taken into consideration. It works well. However you will always get that nurse who is never satisfied or rearranges the assignment to make it easier for them.

We do not assign by blocks since the assignment would be uneven.

We try where we can but usually does not work that way.

[sapphire18]

Usually assignments should include acuity and continuity of care. Location is not a big factor (that I've seen) except in the ICU or extremely large units.

[turnforthenurse, MSN, NP]

We try to do block assigning, but that doesn't always work. Typically the charge nurse in the front takes rooms 1-4. We try to keep all of the rooms close to each other but that isn't always possible. I have had times where I had one room on one end of the hall and then I would get an admit on the opposite end of the floor. I usually don't mind, unless this patient is confused or something.

[classicdame, MSN, EdD]

another problem with your system is that the charge nurse really ought to be considering the best fit between patient-nurse. I would avoid putting new nurses with really complex cases, or LVN's with someone who has a central line and needs labs drawn. The Charge nurse should assign according to the PATIENT's need, not the room number.