Staffing

[matchildrn]

Hi everyone, the hospital I work at moved to a new unit. We went from 6 rooms with a team nursing approach to 40 private rooms and no idea how to staff.

The problem we are having is that many parents are complaining about nurse consistency. Getting new nurses everyday, explaining to nurses their babies habits, etc.

We are developing a task force to address this need.

I am coming here to seek advice about how other units with private rooms handle their staffing. Do you do a team approach, primary nursing, or another form of staffing. Any all feedback is welcomed.

Thanks!!! Heather

[notsosupernurse]

At my workplace primary care nursing is used. If the nurse is working consecutive days they will try to give the nurse the same assignment to try to encourage continuity. However, if there are admissions or discharges the assignment may slightly change the next day to accommodate acuity and staffing availability/needs.

[prmenrs, RN]

Can you help mom and dad write a list of baby's (and their) preferences, then make a cute poster and place it in/on the child's incubator or crib? Nurses then have the responsibility of reading this poster and honoring the requests. When things change, the poster can change too, so be sure and date the original and revisions.

I know, just one more new thing, but it might be worth a try.

[prmenrs, RN]

In re: staffing--use an acuity based staffing tool. It works, really.

[babyNP., APRN]

We try to give babies the same nurse if they're back the next day, but priority goes to those on orientation unless the parent specifically requests no new nurses. Other than that, nurses are allowed to sign up to be a "primary" nurse so that they should always get the baby when they're on (although again, unless an orientee needs the assignment). But it is nurse driven (parents cannot request RNs to be on the list) because we don't want to force any babies (or most likely, parents) on any RN who doesn't want it.

We also have a list for those infants that RNs need a break from.

Private rooms are great! I started out with a few open bays, but our parents, babies, and RNs love the private rooms. It took getting used to at first, but so much better than the old model, especially if you have screaming kids next to a PPHNer!

[meanmaryjean, DNP, RN]

Just read a study demonstrating that kids in single-room NICUs have lower verbal abilities than those in open-room NICUs.

Just an observation- no real help for your issue.

[babyNP., APRN]

lol...I'm trying to imagine, but can't. Citation?

[meanmaryjean, DNP, RN]

https://news.wustl.edu/news/Pages/25983.aspx

I wasn't making it up you know! :)

[babyNP., APRN]

Fascinating. I wonder if it would be better for the preemies to be in private rooms until they graduate out of the box and then be co-horted out in the open with other babies for more interaction.

I didn't say you were making it up, but was having a hard time imagining this kind of scenario when it's against everything I've ever read on the subject. Having a citation is key in these types of situations before it becomes a "I heard on the internet that..." with no references and only told through a stranger.

Thanks for the link!

[JRich]

"Other than that, nurses are allowed to sign up to be a "primary" nurse so that they should always get the baby when they're on (although again, unless an orientee needs the assignment). But it is nurse driven (parents cannot request RNs to be on the list) because we don't want to force any babies (or most likely, parents) on any RN who doesn't want it." babyRN

Wow, we have the opposite. Parents are the ones that can request primary nurses. This way they feel they have more say in the care of their baby. The only times a nurse can request to be a primary is if it is a chronic baby, or if it is a baby where the parents are MIA.

[NicuGal, MSN, RN]

So what happens of the nurse doesn't want to primary that patient?

[JRich]

So what happens of the nurse doesn't want to primary that patient?

The nurse is allowed to refuse and take their name off the primary list. We are allowed to ask for a break from the patient if we feel the need for it as well.