Staffing

Jules A, MSN · Jan 9, 2015

Both. There are standard staffing patterns based on census but extra staff are added as needed for acuity.

imapsychrn · Jan 10, 2015

Is there a system you use for staffing for acuity or do you just use general judgement?

Meriwhen, ASN, BSN, MSN, RN · Jan 10, 2015

Does your psych unit staff for the number of patients or for the acuity of the patients?

Both. Acuity and census are both assessed each shift to determine how many staff we will need and of what mix, and if we'll need any dedicated staff for 1:1s. Acuity is determined based on their current mental and physical status, whether they need frequent medications, whether they need any assistance with ADLs, how often they may need reassessment, and other factors.

Also, California has mandated nurse staffing ratios--in psych, it's 6:1...and the nurses are not shy about filing grievances should that ratio be exceeded. So staffing has to keep that in mind when they schedule. Where I work, I have on average 4 patients a shift.

Jules A, MSN · Jan 10, 2015

Also, California has mandated nurse staffing ratios--in psych, it's 6:1...and the nurses are not shy about filing grievances should that ratio be exceeded. So staffing has to keep that in mind when they schedule. Where I work, I have on average 4 patients a shift.

Those are very nice numbers, when I worked for VA it was similar usually 4-6. At the hospitals I work now it seems the nurses usually have between 6-8 patients each.

GeneralJinjur · Jan 11, 2015

My first hospital had 3 nurses to cover 26-32 patients, with the same number of techs. I left there for a better staffed facility, which also happens to pay more. Now I have 5 patients per shift and it's lovely. I feel like I'm on vacation every day.

Meriwhen, ASN, BSN, MSN, RN · Jan 11, 2015

My first hospital had 3 nurses to cover 26-32 patients, with the same number of techs. I left there for a better staffed facility, which also happens to pay more. Now I have 5 patients per shift and it's lovely. I feel like I'm on vacation every day.

That's how I felt when I first moved to California. Day 1 of inpatient: I had 3 patients. The next day it was 4 patients with the possibility of a 5th, and the charge nurse was apologizing for giving me so many patients. It was all I could do to keep from laughing hysterically :)

I really do appreciate the ratios, as it gives me a chance to spend real quality time with my patients. Instead of doing what I would have to do when I was responsible for 8-10 patients, which is rushing through assessments, meds and charting for all of them, while maybe--maybe--having solid interactions with a few.

GeneralJinjur · Jan 11, 2015

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I really do appreciate the ratios, as it gives me a chance to spend real quality time with my patients. Instead of doing what I would have to do when I was responsible for 8-10 patients, which is rushing through assessments, meds and charting for all of them, while maybe--maybe--having solid interactions with a few.

Exactly! I know my patients well and no longer have to hope that I met their needs. My job satisfaction is through the roof because I have the tools to take great care of all my patients.