1. What staffing model is implemented at the facility where you work?  What would you recommend for modifying the staffing model where you work, what is you recommendation based on and how would you implement the change?  (Support your thoughts/ideas with academic literature OR required readings) 

The staffing model the facility where I work is a nursing home. We use a census as our staffing model. On my floor there is a total of 23 rooms and 2 clients per room. Most of the time we are short staffed, and as a result there are only 2 nurses and we each have 23 patients sometimes less if patients get discharged. Per facility each nurse is suppose to have 9 patients. When dividing patients among nurses I think it is important to take into account patient acuity, some patients require more intense care than others. Meaning if the patients are equally divided the workload may not be. I believe that it is important to talk to your coworkers about this concern to prevent placing patients at risk and create a positive environment where the workload is shared. A lot of times coworkers are not willing to change assignments and that is where I think the unit manager should step in. To fix this problem more staff should be hired to keep the 9:1 ratio and the unit nurse should review assignments, before they are given. Most nurses experience substantial fatigue, with high acuity patients having an overall greater impact. We recommend that NPAs shall contain fewer high acuity patients than lower acuity patients. Additionally, The OFER acute fatigue scale (OPER-AF) suggests that assignments should contain no more than five patients to mitigate fatigue (Mollica and Schwerha, 2021).


Mollica, & Schwerha, D. (2021). Exploring the Relationship between Patient Acuity, Patient Assignments and Fatigue among Nurses. Proceedings of the Human Factors and Ergonomics Society Annual Meeting65(1), 1200–1204.