Staffing Coordinator Small Explained for Students (Easy Guide)

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Original Question

You are the staffing coordinator for a small community hospital. It is now 12:30 p.m. and your staffing plan for the 3 p.m. to 11 p.m. shift must be completed no later than 1 p.m. (The union contract stipulates that any “call offs” that must be done for low census must be done at least two hours before the shift begins; otherwise, employees will receive a minimum of four hours of pay.) You do, however, have the prerogative to call off staff for only half a shift (4 hours). If they are needed for the last half of the shift (7 p.m. to 11 p.m.), you must notify them by 5 p.m. tonight. A local outside registry is available for supplemental staff; however, their cost is two and a half times that of your regular staff, so you must use this resource sparingly. Mandatory overtime is also used but only as a last resort. The current hospital census is 52 patients, although the emergency department (ED) is very busy and has 4 possible patient admissions. There are also 2 patients with confirmed discharge orders and 3 additional potential discharges on the 3 p.m. to 11 p.m. shift. All units have just submitted their PCS calculations for that shift. You have five units to staff: ICU, pediatrics, obstetrics (includes labor, delivery, and postpartum), medical, and surgical departments. The ICU must be staffed with a minimum of a 1:2 nurse-patient ratio. The pediatric unit is generally staffed at a 1:4 nurse-patient ratio, and the medical and surgical departments at a 1:6 ratio is used in postpartum. On reviewing the staffing, you note the following: ICU Census = 6. Unit capacity = 8. The PCS shows a current patient acuity level requiring 3.2 staff. One of the potential admissions in the ED is a patient who will need cardiac monitoring. One patient, however, will likely be transferred to the medical unit on the 3 p.m. to 11p.m. shift. Four RNs are assigned for that shift. Pediatrics Census = 8. Unit capacity = 10. The PCS shows a current acuity level requiring 2.4 staff. There are two RNs and one CNA assigned for the 3 p.m. to 11 p.m. shift. There are no anticipated discharges or transfers. Obstetrics Census = 6. Unit capacity = 8. Three women are in active labor, and three women are in the postpartum unit with their babies. Two RNs are assigned to the obstetrics department for the 3 p.m. to 11 p.m. shift. There are no in-house staff on that shift that have been cross-trained for this unit. Medical Floor Census = 19. Unit capacity = 24. The PCS shows a current acuity level requiring 4.4 staff. There are two RNs, one LPN, and two CNAs assigned for the 3 p.m. to 11 p.m. shift. Three of the potential ED admissions will come to this floor. Two of the potential patient discharges are on this unit. Surgical Floor Census = 13. Unit capacity = 18. The PCS shows a current acuity level requiring 3.6 staff. Because of sick calls, you have only one RN and two CNAs assigned for the 3 p.m. to 11p.m. shift. Both confirmed patient discharges as well as one of the potential discharges are from this unit. Answer the following questions: Which units are overstaffed, and which are understaffed?

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