A Research Critique

Staffing Patterns of Scheduled Unit Staff Nurses VS Float Pool Nurses

Mr. Jhessie L. Abella, RN, RM, MAN

Life's Lesson No. 1

A little bird was flying south for the winter. It was so cold the bird froze and fell to the ground into a large field. While he was lying there, a cow came by and dropped some dung on him. As the frozen bird lay there in the pile of cow dung, he began to realize how warm he was. The dung was actually thawing him out!

He lay there all warm and happy, and soon began to sing for joy. A passing cat heard the bird singing and came to investigate. Following the sound, the cat discovered the bird under the pile of cow dung, and promptly dug him out and ate him.

Moral of the story: (1) Not everyone who shits on you is your enemy. (2) Not everyone who gets you out of shit is your friend. (3) And when youre in deep shit, its best to keep your mouth shut!

Staffing Patterns of Scheduled Unit Staff Nurses VS Float Pool Nurses

This study pertains to examine the differences in patient assignment between float pool nurses versus the scheduled unit staff nurses. The researcher sought to find out whether the float nurses receives the most difficult assignment compared to the staff nurses.

The hypothesis posted in this study is that;

There is no difference in patient assignments between float pool nurses and scheduled unit staff nurses in a hospital setting.

Methods of Research
The Setting and Sample
The researcher used a comparative study performed in medical surgical, cardiovascular, neurology and orthopedic in patient units at a large quaternary care hospital in the Midwest. The hospital is stratified in communities of service that includes cardiovascular (ICU 16 beds; CCU 16 beds; three progressive care units of 22 beds each), medical surgical (general beds of 40;renal 34 beds; oncology 34 beds; GU/GYN 40 beds), neurology ICU (27 beds), neurology (46 beds), spine (40 beds), and orthopedics (2 units with 20 beds each) Inclusion criteria were the medical surgical, orthopedic, neurology, and cardiovascular inpatient care units. Many of the specialty units within the hospital are considered closed staffed. Exclusion criteria were womens care, mental health, emergency department, and outpatient care units.

Data Collection
The researcher randomly selected three 8 hour shifts and two 12 hour shift occurring from November to December. The hospital utilized the what they called the Acuity System. But during the conduct of the study some units were not using this scene of patient care distribution. The composite level of assignment difficulty was represented with three DEPENDENT Variables: Patient Volume, Patient Flow, and Acuity of Patient Condition.

Acuity
Acuity based on the hospital acuity system Level 1 to 5

Flow
1 patient for each admission, discharge, transfer or surgical patient

Volume
Number of patients cared for throughout the shift

For example if a nurse started with four patients, the volume would be four. If the nurse had one patient discharge and then received a surgical patient, the flow would be two. If the acuity was 16 the difficulty score would be 22 (4 volume+2 flow+16 acuity)

Statistical Analysis
Descriptive statistics were used to describe trends, patterns, and factors of patient assignment of float and unit nurses. The independent variable were the nurses group: float nurse versus non float. T test were used to test the null hypothesis.

Result of the Study

Patient assignments from 217 shifts were analyzed and although there was a tendency for float pool nurses to receive more difficult patient assignment compared to unit staff nurses, this was not statistically significant. The mean patient acuity for float pool nurses was 13.92, while the mean acuity for unit staff nurses was 13.18. The mean of patient flow was 15.13 for the float pool nurses and 14.12 for the staff nurses. In terms of patient volume the mean for float nurses was 12.7 and the mean for unit staff nurses was 11.8.

 The problem is stated plainly because it only deals with the staffing patterns of the Float Nurses and the Staff Nurses. I find this study very superficial because of its focus concerning the staff patterns. There is no specific problem posted in the study that is why it is still unclear to me what the researcher really intended to find out. Is it only the staffing pattern or there could have been a deeper analysis of the staffing pattern concerning the staffs. Because based on the findings of the study it yield no significant difference on the tests performed because of the minimal difference between the means. This study does not clearly showed us that float nurses receives the most difficult assignments compared to staff nurses.

 If the researcher focused on the bigger picture of the staffing pattern there could me more hypothesis to be tested to determine the reliability and the meaning of the this study. If I were to do this research I would focus on the
Quality of Jobs performed by FN and SN or the Quality of Care received by he patient offered by FN and SN

Institutional Benefits of having FN

Floating Nurses Issues of Patient Safety

In this way the findings of the study would have been much helpful for the institution as well as the nursing profession to evaluate the job performed by these nurse and the difference of care rendered for the patient would warrant more importance. With regards to the arrangement of literatures it does not clearly outline the problem of staffing patterns. For me it is just a mere collections of readings and study which does not support the present problem or should I say it does not established a Gap. The researcher could have exhume readings and other materials that could supplement the problem of staffing and the possible outcomes of staffing patterns given to float nurses.

 The research tool utilized 3 variables to measure the Staffing Pattern in the research local. At the time of the data collection NOT all patient care units in the hospital (units who are included as samples) were using the same ACUITY system developed for the organization.

Research instruments serves a measurement tools and are an integral component of any nursing research study. Instrument for research must be VALID which means that it used measure precisely what it intends to measure. In this case how can we measure precisely the acuity of patient given to float nurses if the units included as samples were not utilizing the same patient acuity rating. This would be inconsistent with the other units utilizing the acuity rating. For me this will not measure what it ought to measure in terms of patient classification. How will this established that float nurses receives the most difficult task?......

 Another point in critiquing this study is that the researcher have included the special areas such as the intensive care units which I think have affected the results of the study. Because for a FACT most intensive care units have only one to two patient per nurse. The patient Volume measuring the difference between float nurse and staff nurse is then affected because of the inclusion criteria set by the researcher. Further evaluation of the study reveals to me that inclusion criteria which includes THREE 8 Hours shift, and two 12 Hour shift would have resulted to a non reliable data. Because for example a day shift medical surgical nurse may have three to five patients including new admissions, while on the other hand a night shift nurse may have six patients with NO Patient FLOW at all. Again reliability of the tools is yet again spoiled.

 In this study the researcher have utilized T test to determine the significant difference of two groups the float nurse and the staff nurse. I dont have any problem with the statistical test performed because this is the most appropriate test. The research only pertains to only two categorical variable of the independent variable however due to lack of research tool validity the appropriateness of the statistical tool performed does not clearly provide us with enough evidence there is really a difference in staffing assignment performed by the float and staff nurses.

Thank You!