Staffing can be difficult even under normal circumstances. In fact, we started our AACN staffing initiative two years ago because we heard from you that inappropriate staffing is a barrier to optimal patient care. Now, under pandemic conditions, many of you are asking how to staff for a surge of critically ill patients.
We think the best option is to find new ways as a team to care for patients, recognizing that we are united against a common enemy: the novel coronavirus. Below are a few ideas and resources to help address staffing during the COVID-19 pandemic:
1Let go of “how we always do it.” Traditional staffing models were not consistently effective before this crisis and may be impossible to maintain now. A resource from the Society of Critical Care Medicine offers a model in which physicians, nurses and advanced practice providers with critical care experience lead teams of professionals without that experience. In this way, more patients benefit from the existing expertise, and every team member contributes to patient care.
2Expand the pool of nurses who know how to manage critically ill patients. You may be working with nurses from other areas, or you may need to work in unfamiliar areas, as your hospital increases its capacity to care for patients with COVID-19. For strategies to help nurses who are unaccustomed to critical care develop necessary skills, review Professional Development Nurses Respond to the COVID-19 Crisis
3Know that communication and a clear division of labor are essential to making teams effective. If you are leading a team, identify the work that needs to be done and match that up with the skills of your team members. If you are part of a team, be ready to share your expertise, contribute in new ways and seek help when needed. Team models work best when tailored to the skill mix of those available on each shift.
4Plan for healthcare workers’ exposure to or infection because COVID-19 may impact all staffing plans. The CDC has guidelines related to healthcare workers returning to work after exposure to the virus or diagnosis with COVID-19. These differ significantly from the advice to the public, because the CDC recognizes the need to maximize available staff. This is a crisis, which means standards that may not be ideal are offered. Talk to your clinical leaders about the return to work policies that are best for your unit, and remember the CDC guidance is applicable after other strategies for maximizing staff are implemented.
5Focus on the work that has to be done. The Centers for Medicaid and Medicare, regulatory agencies and many states have issued exceptions to regulations and waivers for others. In addition, hospitals have or are developing policies that define the standards of care in a crisis. Review your hospital’s policies now so you know how to focus priorities when a surge in admissions occurs.
6End each shift with a note of gratitude. Thank a team member who gave you support, recognize the whole team for a job well done or just feel grateful that the shift is over.
Ending this blog with a note of gratitude — we don’t know the words to express how much your contributions mean to all of us at AACN. We are honored to serve you in this crisis.
Do you have advice for staffing during the COVID-19 pandemic? If so, please share it in the comments section.
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