Before the pandemic, healthcare leaders could easily shuffle nursing staff among any partner hospitals experiencing the greatest need due to staffing shortages. Areas of greatest need were typically identified on a shift-by-shift basis, with appropriate resources being allocated appropriately.
However, the pandemic challenged leader’s usual techniques for dealing with staffing issues. Nurse leaders were required to pivot quickly and find ways to use all healthcare system staff in the most effective way possible. This ultimately allowed staffing resources to become one fluid unit, with one schedule reflective of adequate resources distribution.
A recent article in Nursing Management describes one healthcare system’s approach to solving staffing shortages with strategies based on patient census, acuity, and staff preparation. These approaches helped the system as a whole manage their ever-changing needs with regard to front-line staffing for the care of Covid-19 patients.
Pandemic strategies for optimizing nurse staffing resources
The healthcare system in the article used a variety of strategies to help boost staff nurse numbers in intensive care settings.
Identifying Tier 1 RNs
Former tier 1 critical care nurses were identified and eventually deployed to Covid-19 ICUs system wide. All were appropriately oriented to the ICU environment, ensuring patient safety while care was provided.
Support from perioperative nurses
Many healthcare organizations delayed elective and non-urgent surgeries to help slow the spread of the coronavirus and conserve much-needed personal protective equipment. This created a pool of skilled nurses, many of whom had prior critical care experiences and could be reassigned to ICUs.
The healthcare system identified external nurses in the community who could volunteer to help support Covid-19 patients in acute care. Many of these nurses were retired, previous employees, or friends of current employees. Additionally, the system partnered with local nursing schools to hire students into contingency fast-track nursing assistant positions. These students eventually joined the float pool to accommodate patients in each region of the system.
Team nursing model
Evidence-based examples were used to create team nursing models featuring a lead RN, support RN, and team assistant. This model was designed for the lead and support RNs to take on a full patient assignment with support from the team assistant.
Implementing new nurse staffing models
Using these strategies, nursing leadership implemented a staffing arm to manage overall staffing complexity, the expected influx of ICU patients, and the skill mix of team nurses. This staffing arm was labeled as Staffing on Site (SOS) and managed shift-to-shift staffing allocations for the three hospitals included in the healthcare system.
The development of the SOS model was viewed as a success. Consistency with prescheduled progressive care and acute care RNs was integral to the success of the team nursing model. The SOS model is still in use, and many staff RNs are now considering transfer to ICU nursing. However, the authors of this article stress that working from a consistent plan for system, regional, and individual staffing solutions is of the upmost importance.