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staffing model

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On 8/22/2019 at 10:30 PM, parc8000 said:

I work in an ICU that does a 36hr work week.  Currently we do 1 PA on per shift for 24/7 coverage.  Currently there are 5 of us.   Ends up being a fair number of weekends.  I am just wondering what other staffing modes are out there.


We basically staff 1 APP per 5-6 bed during the day and 1 app per 10-12 beds during the night. We work 13.3 hour shifts (basically pay 1.3 hours for sign out and catching up). Full time is 3 shifts per week. We don't allow 24 hour shifts unless in an emergency. We have a few evening shifts for surgical ICUs that get a lot of admissions between 3 and 11. 

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We work alongside residents rotating through the units. We staff 1 person/5-6 patients day, 1 person/7-9 patients night. We work 13 x 12h shifts every four weeks. We work every third weekend, and one major summer and winter holiday each year (we count 3 major holidays each summer and winter). Mixed shifts, it comes out to about 40% nights (fewer people at night, also there are a few who choose to work nights only). 24h shifts are allowed (day+night, but not night+day except in an emergency), if you are sufficiently experienced. 

Our vacation time is fairly generous (4.5 wks/year to start), so that definitely helps make the schedule bearable. You are not allowed to take vacation on your scheduled weekends, however.

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  • 2 months later...

The two ICUs I previously worked in were sometimes staffed by APPs during the day (depending on the availability, otherwise staffed by docs and residents) then always staffed by APPs (and only APPs) overnight. Shifts were 7a-7p, and 7p-7a. The good hospital system I worked for had one PA covering each of the four ICUs (ended up being anywhere from 10-16 beds each). The terrible system I worked for sometimes had two, often times only one APP covering up to 30 ICU beds, plus cardiovascular surgery patients we were consultants for on another floor (another 4-5 beds). You can imagine what that looked like. I still don't know how I made it out alive... and without killing anyone. 

Both facilities said that I could do block scheduling when I signed on. The first really tried to accommodate schedules but could usually get people on for no more than 5 days at a time in order to have the month fully covered.  The second place I worked at, the schedule was a haphazard mess. I am now happily doing locums and one of the biggest benefits, is having a contract laying out the days I will work. Current contract is a strict 7 on 7 off and I feel so much better not having to transition back and forth between nights to days to nights every couple of days. I also get to know my patient's well and I think our patients get better care when  we know them well- especially the very complex ones (that is very difficult to do if you are working haphazard  blocks of 2-3 days at a time IMO- at least it's not really feasible for me).  

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