Question: Choosing a Delivery Care Model and Staffing Pattern You have been hired as the unit supervisor of the new rehabilitation unit at Memorial Hospital. The hospital decentralizes the responsibility for staffing, but you must adhere to the following constraints:

1. All staff must be licensed.

2. The ratio of LVNs/LPNs to RNs is 1:1.

3. An RN must always be on duty.

4. Your budgeted NCH/PPD is 8.2.

5. You are not counted into the NCH/PPD, but ward clerks are counted.

6. Your unit capacity is seven patients, and you anticipate a daily average census of six patients.

7. You may use any mode of patient care organization.

Your patients will be chronic, not acute, but will be admitted for an active 2- to 12-week rehabilitation program. The emphasis will be in returning the patient home with adequate ability to perform activities of daily living. Many other disciplines, including occupational and physical therapy, will be part of the rehabilitation team. A waiting list for the beds is anticipated because this service is needed in your community. You anticipate that most of your patients will have had cerebrovascular accidents, spinal cord injuries, other problems with neurologic deficits, and amputations. You have hired four full-time RNs and two part-time RNs. The part-time RNs would like to have at least 2 days of work in a 2-week pay period; in return for this work guarantee, they have agreed to cover for most sick days and vacations and some holidays for your regular RN full-time staff. You also have hired three full-time LVNs/LPNs and two part-time LVNs/LPNs. However, the part-time LVNs/LPNs would like to work at least 3 days per week. You have decided not to hire a ward clerk but to use the pediatric ward clerk for 4 hours each day to assist with various duties. Therefore, you need to calculate the ward clerk's 4 hours into the total hours worked. You have researched various types of patient care delivery models and staffing patterns. Your newly hired staff is willing to experiment with any type of patient care delivery model and staffing pattern that you select.

ASSIGNMENT: Determine which patient care delivery model and staffing pattern you will use. Explain why and how you made your choice. Next, show a 24-hour and 7-day staffing pattern. Were you able to create a schedule that adhered to the given constraints? Was this a time-consuming process?