I recently worked at a hospital that doesn’t consider patient acuity when making the schedule.  They told me that they want the nurses to be close to the patients so they put the nurse in consecutive rooms.  They would put the nurse from rooms 35-40 and not consider the type of patients in those rooms.  One day I had seven patients and 6 out of the 7 were high acuity patients.  6 out of 7 were total care patients, diabetics, they had daily dressing changes, and 4 out of the 5 were confused and trying to get out of bed.  I was constantly running.  If I were a charge nurse, I would have split my group between two nurses instead of having one nurse take those patients.  I would rather have patients on two hallways than to have 6 high acuity patients.  I felt like I couldn’t give excellent care because I was so task oriented that day.  Even the charge nurse said that this was the way things have always been.  They want the nurse to be in consecutive rooms so the nurse will be closer to the patients.  The other thing with this hospital is that the permanent nurses work an 8 hour shift and the travelers work 12 hour shifts.  Some travelers work 8 hour shift too but most work 12 hour shifts.  I haven’t been able to keep the patients that I started with.  Sometimes I get a completely new assignment when the evening shift gets there.  The evening nurse wants the patient’s back that they had the other day so the charge nurse gives them back to the other nurse.  When I talk to the permanent nurses, they have also said that the charge nurses don’t consider the patient acuity level.  I asked them why they haven’t said anything and they have said that is just the way things are.  I told them about my experiences at other hospitals and that this is not normal.  Just because things have always been a certain way doesn’t mean they have to stay that way.  Having a patient for 2 days in a row helps not only the nurse but the patient as well.  I would be able to tell the doctor what the patient did yesterday instead of relying on the nurses notes which don’t always tell the whole story of what happened to the patient.  Sometimes the nurse doesn’t chart on the patient.  I can only go by what was given to me in report.  I’m grateful to have worked at this hospital because it taught me a lot.  I think that patient acuity is more important than having the nurse comfortable because the rooms that the nurse has are close together.  I’d rather have to walk a few more steps than to put a patient or my license in danger because the patient acuity wasn’t thought about when making the schedule.