The nurse manager of a medical–surgical unit learned that the personnel budget for the medical-surgical unit was lower than the personnel budget for the Intensive Care Unit. The nurse manager wants to know the reason for this difference

Question

Which of the following are the nurse supervisor's best responses? Select all that apply.
1. "The acuity level per client is much higher in the Intensive Care Unit, which results in an increased nurse-to-client ratio."
2. "The Intensive Care Unit has a much lower retention rate than your unit due to higher stress levels."
3. "Your unit was recently remodeled, so money was taken from your personnel budget and moved to your capital budget."
4. "The Intensive Care Unit and this unit have the same number of beds. I've made a mistake with your personnel budget, and will fix it immediately."
5. "The staff members have to be paid for education time to learn how to care for their clients. Your staff members need less education time."

Answer 1

Answer: 1; 2; 5
Rationale:
• "The acuity level per client is much higher in the Intensive Care Unit, which results in an increased nurse-to-client ratio." This information from the nurse supervisor does accurately explain how the personnel budget in the Intensive Care Unit can be higher than the medical–surgical unit's personnel budget. Increased client acuity levels require that more nurses be available for a smaller number of clients.
• "The Intensive Care Unit has a much lower retention rate than your unit due to higher stress levels." This information from the nurse supervisor does accurately explain how the personnel budget in the Intensive Care Unit can be higher than the medical–surgical unit's personnel budget. Units with lower retention rates have to spend extra time and effort training new staff members to care for the clients. Staff members in the Intensive Care Unit require more education and more experience than staff members who are be used to staff a medical–surgical unit.
• "Your unit was recently remodeled, so money was taken from your personnel budget and moved to your capital budget." This is not an appropriate comment from the nursing supervisor. Staff scheduling should be based on client acuity levels, and not only on budgetary restraints.
• "The Intensive Care Unit and this unit have the same number of beds. I've made a mistake with your personnel budget, and will fix it immediately." This is not an appropriate comment. Increased client acuity levels of clients in the Intensive Care Unit require that more nurses be available for a smaller number of clients. The nurses should have appropriate education and experience to care for these special clients in the Intensive Care Unit.
• "The staff members have to be paid for education time to learn how to care for their clients. Your staff members need less education time." This information from the nurse supervisor does accurately explain how the personnel budget in the Intensive Care Unit can be higher than the medical–surgical unit's personnel budget. The staff members in the Intensive Care Unit require extra education to be able to adequately care for the clients in the Intensive Care Unit.