Fair assignment is fair division of a problem. Proper division of labor.
The following day the Nurse manager decided to change my assignment. She started me with four patients. One decanulated patient(Patient no longer has tracheostomy)two patients with chest tubes, one chest tube to water seal and the other chest tube to suction and one craniotomy patient. So she started me with four patients with room for new admission. It was not a great assignment but better than yesterday. When I asked why two chest tubes. She responded, you are an experienced nurse and you can handle it. Thanks I replied. Good assignment contribute to overall job satisfaction. As the charge nurse ,as you make assignment for your unit, you must keep the following in mind.
( 1)You have to weigh and consider every piece of information when making assignment. Set priorities and think of each assignment and nurse categories. Do not assign easy patients to your friends.And leave others hanging, claiming that they don’t want to work. A new nurse must be able to breathe and not cry.Why should the nurse from Registry, who doesn’t know her bearing in your unit get the worst assignment?.Why should some nurses unable to use the restroom or have fifteen minutes break?.While other nurses are able to take 30minutes break for lunch,play with their cell phone, and take their fifteen minutes break.Is it because some nurses don’t know how to prioritize or because the assignment is very unfair. I will say that most often the assignment is very, very unfair, callousness. I have seen it, and I have witnessed it several times. It is a chronic disease among nurses.
But there are nurses who will complain about everything. They have the easiest assignment they are still complaining. Yes we have those nurses too.They are insatiable and they are known for that.We often wish that they retire or relocate.But get use to them because they are not leaving. They are low in number about 5%.You know them.
(2)Have knowledge of your unit,the patients and the nurses.If the charge nurse don’t know the information it might be very dangerous for the nurses, and the patients.As the charge nurse making the assignment ,be familiar with your unit, hospital policy and procedures manual for unit staffing and assignment guidelines.How was the assignment?.Did the patients receive quality care.Is there enough supporting staff on the floor to assist the nurses?
(3)Every unfair assignment have a very terrible impact on the nurse and the patient. For example if the nurse couldn’t do a good discharge teaching on discharged patient ,and patient return back to the hospital after a week of discharge because the abdominal wound dehiscence needing a new surgery. Who pays for it?.Or a patient was discharged with a leg bag and was not properly taught how to change bag or how to straight catheter on patient having difficulty to void.And patient return to emergency room. Who is responsible for that?.It is very important to ask yourself. What is the patients acuity or workload?.It is also important to put into consideration Isolation patients, Chemotherapy patients, surgical intervention patients, Continuous bladder irrigation patients,dressing changes, total care,psychological support patients, incontinent patients and medications administration.
Together we can do better.
MY LITTLE POEM ON ASSIGNMENT.
Assignment my assignment.
Assignment that is fair.
Assignment that is unfair.
The patient called.
My hands were tied.
The doctor called.
My hands were tied.
I was in Isolation room.
I have two Isolation rooms.
Contact Isolation room.
Airborne Isolation room.
Told the charge nurse to.
Respond on my behalf.
No the doctor wants to talk to you.
Told the resource to take report on my behalf.
I am very busy she shouted.
Took permission from the Isolation patient.
Undressed, woundcare to be continued.
Patient agreed.
Unable to go back until after 90minutes.
It took you 90minutes to get back.
Yes I replied,I am sorry, very sorry.
I need a different nurse .
She was assigned a different nurse.
Her rejection became a mix feeling.
Got a happy ,nice patient .
Charge nurse seized opportunity to make changes.
Yes to amend the assignment.
It was a blessing in disguise.
Same patient later called me to apologize.
I cried like a baby.
She cried like a baby.
She said ,the father of my two kids dumped me.
In nursing some days are good.
And some days not so good.
Nurses You Move Me 