What Is Crisis Staffing In Nursing?

During the pandemic, several institutions had to resort to what is called “crisis staffing.”
This is when facilities find themselves operating under extreme circumstances such as emergencies, disasters or overburdening situations such as pandemics and they are required to change circumstances.

A number of hospitals have experienced examples of crisis staffing including Penn Medicine.

At Penn, when there is a crisis level 1, nurses go from 1:1 or 1:2 to team-based nursing which is, “1 ICU nurse and 2 non-ICU nurses caring for 4 to 6 patients with documentation by non-ICU nurses.”

With crisis level 2, “1 ICU nurse and 2 non-ICU nurses can care for 8 to 12 patients with documentation by non-ICU nurses.” Can you imagine taking care of 8 to 12 ICU patients with 2 non-ICU nurses?

As a medical malpractice attorney and professional licensing defense attorney, this is extremely concerning to me because there needs to be notation of who provided the actual care. If it is not documented, it was not done!

By changing the standards during a crisis is a recipe for poor patient care and outcomes.

Certainly, in a crisis, there needs to be flexibility but who determines when the crisis occurs. Is it just because there isn’t enough staff or is it because of something else? [more information]

During COVID, legislation was passed saying that nursing homes could not be sued. However, the Indiana law was applied retroactively, and nurses were still being reported to the Board. So, even if medical malpractice claims were not allowed, claims against licenses of individual nurses could still be brought forth.

With crisis staffing, the same thing could be true except that there will be malpractice cases and, of course, a nurse can still get reported to the Board.

Does your facility have a policy for crisis staffing and, if so, what are your thoughts about this topic?