Alpha Nurse

Beta Nurse

Omega Nurse

Member Nurses

List roles & workload

Delegate clear roles

Establish goals that can be met

The Bamboo Sked - Fixed but flexible work shifts

Day & Night Shift. Week 1:

Pack A - M T F Sun

Pack B - W Th Sat

Day & Night Shift. Week 2:

Pack A - M T Sat

Pack B - W Th F Sun

Day & Night Shift. Week 3:

Pack A - M T F Sun

Pack B - W Th Sat

Day & Night Shift. Week 4:

Pack A - M T Sat

Pack B - W Th F Sun

Distribute workload evenly prior to every shift.

Utilize the acuity tool + the pack sheet.

Patient acuity tool on a medical-surgical unit

April 11, 2018

Author(s): Andrea Ingram, BSN, RN-BC, and Jennifer Powell, BSN, RN

Each patient is scored on a 1-to-4 scale (1, stable patient; 2, moderate-risk patient; 3, complex patient; 4, high-risk patient) based on the clinical patient characteristics and the care involved (workload.) Each nurse scores his or her patients, based on acuity, for the upcoming shift and relays this information to the charge nurse, who then assigns patients before the shift change. The handoff report between RNs allows each to validate patients’ current acuity and care needs. (See Patient acuity tool.)

Andrea Ingram is a medical-surgical certified nurse at the VA Health Care System in Durham, North Carolina. Jennifer Powell is a neonatal intensive care unit nurse at Novant Health Hemby Children’s Hospital in Charlotte, North Carolina.

Editor’s note: The authors grant permission for using the tool in the article provided they are credited as the source.

Plan and map physical locations based on patient acuity and members of the pack. (See Patient acuity tool)

Maximum Load = Minimum Safety and Efficiency

>Maximum Load = <Minimum Safety and Efficiency

Hourly VS Salary

Stipend & Incentive

Budget & Staff Friendly

Win-Win Situation