How
sick?

August 5, 2015 -- An issue of perpetual contention in nursing is staffing. How many nurses do we need on staff right now, for the present patient load? Management wants fewer (to save money) and nurses want more (to get all the work done). Where's the science?

One way to make staffing decisions is based on acuity -- how sick are your patients? Today, staffing decisions are based on crude estimates drawn from patient diagnoses. If they're very sick, hire more nurses.

But there is a better way. Degree of sickness is not the best indicator of nursing workload. Instead, I propose a measure of acuity that is the number of minutes of nursing work remaining to be done for each patient. Nurse managers would, in real-time, use a tool that adds up all the durations of the outstanding tasks for each of the patients currently on the unit. A lot of minutes means you need more nurses. How many? Divide the minutes into the duration of a shift. Voila! Accurate nurse staffing!

This measure was developed working with seasoned veteran emergency/charge RN Mark Wandro. We propose a study to confirm that this new measurement of acuity (and the tools that support it) can improve nursing outcomes.

Dear reader: Is your hospital interested? Can you sponsor this study? Please get in touch! Let's make nursing better!

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