Who should make patient assignments??

[D.R.A.]

Ladies and Gentlemen,

I am curious who makes patient assignments on your units. Particularly, new pt assignments. Pts arriving to the floor after shift start. Is it your Director, your Charge Nurse, or you HUC/Unit secretary? Please include why or why not you think it is appropriate for that person to make patient assignments.

Also, do you believe that it would be appropriate/safe for a HUC/Unit secretary to make patient assignments? Why or why not?

I have included a poll.

Thanks in advance.

[Caffeine_IV]

The offgoing charge nurse makes the assignment. They should have less patients and/or a low acuity assignment so they can be a resource for the rest of the staff.

[ADeks]

So I used to be a night shift HUC during nursing school. The initial assignment was usually done be the oncoming charge nurse. Sometimes if she was running late or something came up then I would make one. There were "assignments" usually rooms paired together to try and keep the assignment even, together and not over the whole floor. The charge nurse would usually have to take an assignment so in the beginning I would be the one to assign admissions to the nurses.

I would try and make it fair, but I was aware of what was going on on the floor. Probably more so than the charge nurse because she was busy with her assignment. I would consider if someone was struggling and if that struggling nurse was next, if possible I would ask another nurse if they would be willing to take another pt or help with the admission to let the struggling nurse catch up. There were also times when everyone was drowning, but they kept giving us patients because we had empty rooms though at times not enough nurses to cover everyone. I would be the one to alert the charge nurse our staffing needs and if she was busy, I would be the one calling the nursing office.

I understand at the time I was not clinical but as a HUC and seeing some of the HUCs who had been doing it for a very long time we knew what was going on in the floor. The nurses pass us to get to the Pyxis, asking us to page doctors, we are answering the call lights, notifying the nurse of their patients request, and directing incoming calls. We know what's going on and when a nurse has a heavy work load.

I will admit that some HUCs could be mean and vindictive.

[K+MgSO4, BSN]

Everywhere I've worked pt assignments are usually handed out by the fattest, laziest, grouchiest nurse on the unit.[/quote']

Im not as fat as I used to be ..........however the not being fat is due to a diet so no chocolate so even more grouchy (:

[malestunurse]

I couldn't agree more. To expand a bit, as a charge, do you feel you can have adequate scope of the entire floor while caring for 6 pts of your own?

At my hospital we have Charge Nurse Managers that do not have their own patient load.

[D.R.A.]

Thanks for all your responses. I really appreciate them. Sometimes, we are made to feel like we are crazy, that our requests are unwarranted. I plan to address my concerns with a superior. It probably won't do me any good, but at least I can say I gave it my best shot. If I don't see a change, then I know I have done all the good I can do at my current facility, and it will be time to move on to bigger and better things.

[workingmama77, BSN]

I work nights & we don't have a charge nurse. Nursing staff decide and we base it on either who has less patients or less acute patients. Or we mostly work together to get everything done, although one of us is the main nurse in charge of the admission.

[Katie71275]

Assignment is made by the charge nurse. Many factors should be taken into factor. For example, I work on a Labor Unit...depends on how many and the types of patents we have, but the CN looks at the acuity, what's going on(are they laboring, do they have Pitocin, are they on Mag for BP issues? preterm labor) and bases it off that. In general I usually have 1 labor pt, and a recovery(from delivery/section) or antepartum pt who may be there for something simple.