Susan is an experienced manager and is aware of several changes that will affect the nursing unit in the next year. More specifically, Dr. Smith, a senior physician who accounted for a large proportion of the unit’s admissions, has just retired. In recent years, Dr. Smith has limited his practice to simpler medical cases, referring more complex cases to specialists who do not admit to the medical unit.

Dr. Jones just started at the hospital; she was recruited to replace Dr. Smith. Dr. Jones is a recent graduate who intends to care for many of the complex patients whom Dr. Smith previously referred to other specialists. Although the hospital projects that the unit’s patient days will not differ from historical patient days, Susan is projecting a change in the mix of patients because of the arrival of Dr. Jones: 500 level 1 patient days, 1,500 level 2 days, 3,000 level 3 days, 2,500 level 4 days, and 1,500 level 5 days. Susan also knows that Dr. Jones plans to do more complex treatments during the day, which will (1) increase the percentage of nursing staff who work days to 57 percent and reduce the percentage who work nights to 43 percent and (2) increase the percentage of nursing staff who are RNs to 78 percent, decrease LPNs to 14 percent, and decrease NAs to 8 percent.

Questions

1. Based on Susan’s projection of patient days, what is the projected total unit workload by patient classification level? What differences do you notice between the projected and the historic total unit workload?

2. Calculate the historical number of FTEs by staff type and by shift. On the basis of Susan’s projection of patient days, calculate the projected number of FTEs by staff type and shift. What differences do you notice between the projected and historic FTEs?