Working on a large nursing unit

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I work on a Medical Unit and we are moving into a new, MUCH LARGER building. We will have all private rooms (we currently have some double rooms...) and our hallways will be the length of a football field! Each room will have a Nurse Server with some of the supplies needed right at the door of each patient's room, plus a central core area with IV fluids, narcotics, and other supplies. Any thoughts/ideas on how to make this transition as smooth as possible, especially dealing with the increased distance each RN/CNA will have to walk to care for their patients. Our current practice is to assign admits to whomever has the least patients or who has had a discharge, which means you could end up with patients at each end of the unit. It is an exciting time for us and we will have some fabulous views from our floor. Those of you that currently work in units that have a lot of 'area', how do you manage it? Thanks!!

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You could section out the rooms and assign nurses and techs by section or even have teams with one RN, one LPN and a tech......and work the sections using the team nursing care model. Some large place use an admit RN who does nothing but admits. Gets the pt to the room, assessed, a line in if needed, a cath in, orders taken off, first dose of ABX for surg pts. hung, fluids hung, "give now" doses of meds given, with a tech to assist with getting the patient settled. Chart put together. This way the nurse taking over the "new patient" only picks up from where the admit nurse leaves off-- with nothing to do more then they are for the rest of the patients. This is really helpful if you can get management to buy into an admit nurse. If you have high turn over on the unit you can even use two, if not a lot of turn over the admit RN can do D/Cs as well.

Well good luck to you and enjoy your awesome new unit.......its always nice to have new stuff!!

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Specializes in acute care med/surg, LTC, orthopedics.

Rollerblades?

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Specializes in pulm/cardiology pcu, surgical onc.

We use voceras so we don't have to run all over looking for help. Our unit is spread out with 3 different substations so you can go awhile when it's busy wihout seeing another staff member. The voceras sure have saved on walking needlessly and knocking on patient doors looking for another nurse or CNA. It will tell us if our patient has turned on their call light, esp helpful if our rooms aren't grouped together. We can also place calls from them and call someone at work from home. There is the option to actually talk to your patient from the vocera but it was disabled since it didn't work very well with our call light hand sets. I can't imagine not having them!

ETA: our assignments are usually made with distance in mind but occ with new admits we may have to pick up a patient in a different corner of the unit. Not too much of a big deal since all the central supplies are in the center with doors you can walk thru either side so one usually wouldn't have to walk the length of the whole hallway for any reason.

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I think the current practice of assigning patients to whoever has the least patients will have to be changed. I for one will be ****** if I have patients in 302 - 304 and then get a new admit in 340 ( LOL just an example). I work on a 40bed unit. You didnt mention how large the unit is but it gets old walking up and down a large unit.

Instead divide the unit by sections and assign admits by sections.

We also have an admissions nurse that does the assesment and the charge nurse does discharges.

Bottomline is whatever y'all do, dont assign patients that are far apart to nurses, it is cruel and unusual punishment. :no:

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Specializes in floor to ICU.

It's hard making assignments. When I was charge nurse I tried to take all things into consideration: acuity, isolation, skill level of the nurse, pending discharges, surgery schedule, number of techs scheduled, continuity of care if the nurse was returning from the previous day and lastly distance he/she had to travel.

Unfortunately, sometimes distance to travel came in last place and I was unable to keep a nurse's group neatly grouped together. I tried not to let it happen but sometimes you have no choice. Of course, the traveling nurse was usually less than thrilled. However, that nurse is only thinking of how the assignment affects them. I had the entire floor to think about.

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We do have Admit Nurses and they are great!! Never thought of using them to help with the Discharges, though. Thanks for your thoughts.

What is a Vocera? We will have phones to carry that let us know when our patients use their call light and we will be able to call other staff with them. And we have switched over to all computerized charting, no need to find a paper chart, just the nearest computer.

Appreciate and understand the perspective of the Charge Nurse making assignments that cover a lot of area. I know you do the best you can. Exercise is good for us--"motion is lotion"--just want to be able to get to the bedside in time to catch the 'jumpers'!!

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