Who makes your assignments?

locolorenzo22, BSN, RN · Feb 10, 2008

the nurses at night collabarate about which nurses had patients the previous day, how "hard" they should be, how many to give LPNs, scheduled sx coming that have to go to an RN, LPNs can't admit, etc.....overall, it doesn't work out too badly, but if you don't write down who you have before you leave, they could end up giving those patients away....

EmmaG, RN · Feb 10, 2008

Here it's the oncoming charge nurse, which can make for a long wait to give (and get out of) report. It's especially frustrating to have them change the assignment multiple times after report finally has started.

NurseCherlove · Feb 10, 2008

Here it's the oncoming charge nurse, which can make for a long wait to give (and get out of) report. It's especially frustrating to have them change the assignment multiple times after report finally has started.

Grrrr - I hate that!

Ruby Vee, BSN · Feb 10, 2008

off-going charge nurses. they tell me that a lot of thought goes into making out the assignments. what i've overheard is "who don't we like that we can stick with this awful assignment?"

*ac* · Feb 10, 2008

We figure it out amongst ourselves after taking report.

The assignments are not the problem...

All nurses take report on all patients. Everyone gives report. This takes approximately forever. Everyone going off has to wait for everyone to give report so that the floor will be covered during that time. We often don't leave till after eight.

There are two reasons for it: the nurses want to figure it out for themselves and they can't do it without knowing about all the patients. The other reason is so you will already have report if you have to switch assignments later in the shift.

The waiting around during report is excrutiating.

Sunflowerinsc, ADN, RN · Feb 10, 2008

The day shift charge nurse makes it at the end of the shift for the next day shift. If same nurses are coming on, gives the same pt's, adjusting for discharges and admissions that happened durning the day. The night shift's assignment has already been made out from the night charge so day shift charge can adjust from what changed durning the day,new admits ,ect. For pt's that end up staying longer and have higher acuity we "pass around" so no body gets them to long. We get report on voice care(telephone) with a vocal update if needed from the off going nurse. Shift sheets and assignments are printed out for each shift at the end of previous shift. You come in pick up your sheets, put your pt's in computer on you status board and dial in and get report on yours and last shift is out of there! There is no waiting around for assignments or report. There is never any "splitting it down the middle" Sometimes someone will ask to trade for various reasons ,and we all help out. Discharges are tried to be spread out but of course there are always unexpected ones.

Having computer printed shift sheets on each pt and voice care report saves so ,so much time getting the shift started.

ReinventingMyselfAgain, MSN, RN · Feb 11, 2008

We figure it out amongst ourselves after taking report.
The assignments are not the problem...
All nurses take report on all patients. Everyone gives report. This takes approximately forever. Everyone going off has to wait for everyone to give report so that the floor will be covered during that time. We often don't leave till after eight.
There are two reasons for it: the nurses want to figure it out for themselves and they can't do it without knowing about all the patients. The other reason is so you will already have report if you have to switch assignments later in the shift.
The waiting around during report is excrutiating.

That HAS to be the most painful experience ever!! I have worked in places where they did that (on other units, and when floated had to deal with that), and not to be rude, but I really didn't have the patience to write down ever nook and cranny of report on all patients, only to have a fourth of them :bugeyes: .

I have worked on units where they have done it every which way, including taped report (we knew which patients were ours, but had to sit through the whole thing until we heard our patients).

I honestly think the most effective way is having the previous shift do it. They know what is going on, as they were just there taking care of the patients. It saves the most time, you don't have to wait for the charge nurse to get report on all, then only decide who gets who. And if the charge nurse is not obligated to come in earlier than the staff, this could take forever. I want to start my day as soon as I can.

I was wondering, sort of off topic, but are there still units that assign patients based on district only! When I worked med surg back in the day, it really didn't matter much what the acuity was, it was based on location. And if you walked into the shift with 3 empty beds, you got to fill them all by yourself:angryfire

*ac* · Feb 11, 2008

That HAS to be the most painful experience ever!! I have worked in places where they did that (on other units, and when floated had to deal with that), and not to be rude, but I really didn't have the patience to write down ever nook and cranny of report on all patients, only to have a fourth of them .
I have worked on units where they have done it every which way, including taped report (we knew which patients were ours, but had to sit through the whole thing until we heard our patients).
I honestly think the most effective way is having the previous shift do it. They know what is going on, as they were just there taking care of the patients. It saves the most time, you don't have to wait for the charge nurse to get report on all, then only decide who gets who. And if the charge nurse is not obligated to come in earlier than the staff, this could take forever. I want to start my day as soon as I can.
In the morning, I get cross-eyed taking report on as many as 18 patients. I'd rather do it almost any way but the way we do it. I get so irritable between 1900 and 2000 waiting around for everyone to get in there and get it over with. I can't believe the hospital pays us for this time, but they do. I'm too new to complain about it, though.

bollweevil · Feb 11, 2008

I'm in a long term setting so almost always have the same patients. I do get pulled occasionally but those are also long term patients. Therefore, after working with them a time or two, I know them well enough to feel at ease. Our workload is generally fine and our shifts decent.

In acute, I think the offgoing Charge should make the assignment and the oncoming Charge should modify it PRN, with input from all of you. That is, if you want the same patients from yesterday, you should usually get them, that type of thing.

Patti 2nd gen RN · Feb 11, 2008

We have permanent room assignments--no acuity involved--and then just help each other as things come up---admissions are spread out as they come in....

jojotoo, RN · Feb 11, 2008

The night charge nurse makes it for the following AM and PM shift. But we're pretty fluid with it. Usually it's not a problem if someone wants to change it.

blueheaven · Feb 12, 2008

The off going and on coming charge nurses. The unit I work in is only 10 beds, so not a whole lot of opportunity for drama (usually)...LOL