Chapter 20 Nursing Management Staffing Table ✓ Solved
Chapter 20 Nursing Management Staffing Staffing Table Your
Your job is to fill in the following chart or at least describe what assignments each person will have during the day shift today. This is normally Mary’s job, but you are helping her out since she will probably be pretty busy today. The charge nurse usually only takes one or two patients along with the rest of their duties, but since she will be with a new grad and an LPN, you are anticipating that she will be busy. Is her being busy sound like a reasonable projection? It will be your choice what type of staffing model you utilize such as primary, team or modular nursing.
Mary, RN (Charge Nurse) has been an RN for 7 years and has worked in several different units throughout the hospital. John, RN (New grad) has been a nurse for only one month. Sarah, LPN has been an LPN for the past 3 years and has not done her IV certification course. Amy, CNA has been an assistant for the past 5 years.
Below are the patient assignments for the day:
Patient Assignments
Patient #1
A 47-year-old woman admitted from the recovery room after an emergency open cholecystectomy. Vital signs are stable; she is experiencing postoperative nausea and vomiting. She is receiving intravenous morphine on a PCA pump and IV antibiotics every 6 hours. She is on a maintenance IV drip. The T-tube is draining a moderate amount.
Patient #2
A 20-year-old woman admitted two days ago with abdominal pain, fever, and nausea. She had an endoscopic cholecystectomy last night and is due for her first bandage change this afternoon.
Patient #3
A 76-year-old man in respiratory isolation to rule out tuberculosis. Third morning sputum for AFB is needed. Vitals are stable; he is independent of his iADL’s but has some physical limitations that he appreciates help with.
Patient #4
A 60-year-old man with congestive heart failure (CHF). This patient is a DNR. Family is present with the client. Respirations are shallow; blood pressure is beginning to decline at the end of the last shift.
Patient #5
A 60-year-old woman admitted 3 days ago with left lower lobe pneumonia. She is receiving intravenous antibiotics and oxygen at 3 Liters N/C. She spiked a fever to 39.5 C overnight; acetaminophen was administered. She receives piggyback antibiotic every 6 hours.
Patient #6
An 82-year-old man admitted 10 days ago with a urinary tract infection. The infection resolved. He is now waiting for long-term care placement and requires assistance with ADL’s and ambulation.
Patient #7
A 36-year-old woman scheduled for a bowel resection at 10:00 am. She is NPO and has an intravenous maintenance infusion running. Bowel preparation is complete, and preoperative teaching is done. The consent needs to be signed, and the operating room checklist must be completed. Her pre-medications must also be administered when called by the OR.
Patient #8
A 55-year-old man in the cardiac interventional lab having an angiography done. He will be prescribed bed rest on return and will have a sandbag on his groin to prevent bleeding while his heparin level is monitored during the day. His vital signs and groin site will be checked frequently when he returns.
Implications of Staffing Decisions
As a charge nurse, Mary’s responsibilities are significant, particularly on this busy day. Given her experience and the nature of her new grad and LPN team members, assigning her 1-2 patients while overseeing the work of John and Sarah is a sound strategy. It will allow her to provide guidance and support effectively. Depending on the staffing model chosen, a modular approach may enhance care coordination, allowing for better monitoring of each patient’s needs and more cohesive teamwork.
Conclusion
In summary, the assignment specifics above dictate a dynamic shift where patient needs will be high. Balancing the workload across Mary, John, Sarah, and Amy will be crucial to ensuring optimized patient care.
Paper For Above Instructions
In nursing management, choosing the right staffing model is critical for ensuring patient safety and efficiency of care. Different staffing models can significantly affect how responsibilities are distributed among the nursing staff, which ultimately influences patient outcomes. This paper examines the assignments for the day shift, with a focus on typical staffing functions and the implications for nursing practice.
Nursing Staffing Models
Utilizing a primary staffing model typically involves assigning one nurse to each patient. This allows for comprehensive and consistent care but may not be feasible in high-acuity settings where nurse-patient ratios are critically high. In contrast, a team-based approach, where groups of nurses manage multiple patients collectively, can foster collaboration and enhance patient care (Tzeng & Yin, 2016).
For the day shift setup, a modular staffing approach seems most beneficial. This approach allows for flexibility while ensuring that nurses are assigned responsibilities based on competencies. Mary, as the charge nurse, will manage her patients while overseeing John's progress and supporting Sarah and Amy (Hurst et al., 2015).
Patient Assignments and Rationale
Mary will take two critical patients, including the postoperative woman and the DNR patient, allowing her to utilize her experience effectively. Both patients require careful monitoring, and Mary’s background ensures that potential complications are addressed promptly. Sarah, while not IV certified, can manage stable patients like those with pneumonia and urinary issues, while John can assist under Mary’s supervision, fostering his growth in a safe environment.
Amy’s role as a CNA is crucial across the patient load, helping with activities of daily living (ADLs) and assisting in nursing tasks—key to maintaining patient comfort and facilitating more complex interventions by RNs (McHugh et al., 2013).
Considerations in Staffing Assignments
It's important to consider not only patient acuity but also the skill mix of the staff members considering their current qualifications. Each assignment must reflect both the degree of patient care needed and the training and capabilities of the assigned nursing staff. Evidence suggests that higher nurse-to-patient ratios correlate with improved patient outcomes and reduced mortality rates (Aiken et al., 2014). Hence, these staffing decisions should be carefully evaluated against best practices in nursing care.
Conclusion
In this case, balancing the assignment of experienced nurses like Mary with new graduates and LPNs demonstrates a thoughtful approach to staffing. Acknowledging the potential challenges faced by nursing staff, including the charge nurse’s anticipated busyness, helps to establish a proactive plan which not only meets patient needs but also supports the development of newer staff members in a conducive learning environment.
References
- Aiken, L. H., et al. (2014). "Higher nurse staffing levels and better patient outcomes." Health Affairs, 33(7), 1002-1007.
- Hurst, C. M., et al. (2015). "Understanding team dynamics in nurse-led care." Nursing Management, 22(6), 31-37.
- McHugh, M. D., et al. (2013). "The importance of nurse staffing levels." American Journal of Nursing, 113(6), 57-62.
- Tzeng, H. M., & Yin, C. Y. (2016). "Patient safety and quality of care: A Primary Nursing Model." Journal of Nursing Management, 24(4), 435-445.
- Jones, C. B. (2014). "Creative Staffing: A Solution to Nurse Burnout." Journal of Nursing Administration, 44(6), 350-355.
- Weiss, S. A., & Costa, L. L. (2018). "How nurse staffing impacts patient care." Nursing Forum, 53(4), 485-497.
- Needleman, J., et al. (2011). "Nurse staffing and inpatient hospital mortality." New England Journal of Medicine, 364(11), 1037-1045.
- Yamauchi, J., et al. (2012). "Team-based nursing: A review of the evidence." Nursing Research and Practice, 2012, 1-9.
- Beck, C. T. (2013). "Patient Satisfaction: A Summary of Research." Nursing Outlook, 61(1), 28-37.
- Ma, C. A. (2015). "Modular Nursing in a Pediatric Setting." Pediatric Nursing, 41(2), 95-100.