Closed staffing: a staff nurse strategy.

10-bed cardiovascular thoracic surgical unit, a 12-bed cardiovascular thoracic intermediate unit, a 9-bed coronary care unit, and a 16-bed intensive care unit. Depending on the number of patients and staffing on the critical care units, critical care nurses floated outside their assigned unit to the emergency room and medical-surgical units. When nurses floated outside critical care areas, problems included a lack of familiarity with supplies, unit layout, and staff culture; concerns of competencies, such as care of different populations of patients unique to the medical-surgical units, including oncology, orthopedics, and urology; and the unfamiliar flow of the emergency room. Because of the overall negative morale during times of floating, some concern existed that the amount of sick time used by the critical care nurses might have been related to floating outside the critical care area. The staffing office and nursing supervisors were in charge of staffing, which incorporated a general medicalsurgical float pool that used contract labor and supplemented the pool with critical care nurses. In fiscal year 2002, the TMH critical care units used 9.26 full-time employees worth Noreen Strayer, RN, BSN Ellen M. Daignault-Cerullo, RN, BSN, CCRN Closed Staffing: A Staff Nurse Strategy Management