Question: How Will You Plan This Busy Morning? You are a staff nurse who functions as a modular leader on a general medical-surgical unit. The group for which you are responsible is assigned patients in Rooms 401 through 409, with a maximum capacity of 13 patients. In your unit, a modular type of patient care organization is employed, using a combination of licensed and unlicensed staff. Each module consists of one RN, one LVN/LPN, and one NAP. The LVN/LPN is IV certified and can maintain and start IVs but cannot hang piggybacks or give IV push medications. The LVN/LPN may give all other medications except IV medications. The RN gives all IV medications. The NAP, with the assistance of his or her modular team members, generally bathes and feeds patients and provides other care that does not require a license. The RN, as modular leader, divides up the workload at the beginning of the shift between the three modular team members. In addition, he or she acts as a teacher and resource person for the other members of the module. Today is Wednesday. You have one LVN/LPN and one NAP assigned to work with you-LVN Franklin and NAP Martinez. LVN Franklin is 26 years old and the mother of four preschool children. Her husband is a city bus driver. NAP Martinez is 53 years old and a grandmother with no children living at home. Her husband died 2 years ago. She says that work keeps her "happy." The patient roster this morning is as follows:
Additional information about patients:
? Mr. Niles is depressed because he believes that his football career is over.
? There have been problems with Mr. Ford's IV and his nasogastric tube. Both will need to be replaced today.
? Mrs. Worley requires frequent changes (every 2-3 hours) of the dressings at the laparoscopy site owing to a high volume of serous drainage.
? Mrs. Jones will need instructions regarding her postoperative activities and has begun to talk about her prognosis.
? Mrs. Land began to talk with you yesterday about her husband's recent death.
? The preparation for the barium enema will result in Mrs. Land's having frequent toileting needs today.
? Mrs. Smith requires assistance with feeding at mealtime.
? Mr. Arthur is no longer able to turn himself in bed.
? Mr. Vines states that being in the same room with a critically ill patient upsets him, and he has asked to be moved to a new room.
ASSIGNMENT: How will you make out your assignments this morning? Assign these patients to the LVN/LPN, NAP, and yourself. Be sure to include assessments, procedures, and basic care needs. What will you do if a patient is admitted to your team? Explain the rationale for all your patient assignments. Refer to the sample acuity levels provided to assist in determining patient needs and staffing.