I'll also spend a fair amount of time talking with families, particularly if there has been a death. We also need to evaluate frequently whether to call in a social worker or deal with a family issue ourselves. Then, I'll get some sense of how busy the emergency department is before going out on the units, visiting every one. I'll try to get a feel of whether they're going to need more staff for the next shift. I also give them a feel for how busy the rest of the house is, whether we can float in help or if they'll have to call in staff on overtime if they need more personnel.
Early planning is important.
If at 5 p.m. the units expect to be busy, they can call in an extra nurse for the shift that starts at 7 p.m. The units that receive patients from the ED are very interested to know if the ED is busy and might be sending patients their way. I go to every unit, meanwhile answering pages. Most of the pages are units requesting help from the crisis staff. Other pages come from admitting telling me they can't find an appropriate bed.