Handling Acuity vs. Intensity

By Jenny Palmgren, BSN, RN, Clinical Nurse Manager, MSSI

It can be frustrating when your manager tells you that your patient doesn’t have high acuity and you feel otherwise. We, as professionals, tend to get offended, but this is where the lack of understanding comes into play.

In nursing, many terms have been used for a patient that is “busy”. However, there are many misconceptions around them. I know many caregivers can think of their patients as having a high acuity, when in fact this may not be the truth. Just because a patient is busy does not mean they have high acuity. A patient may have high intensity/high acuity, but on the other hand, they could have high intensity/low acuity – not requiring highly specialized interventions by a skilled nurse.

The differences are spelled out below.

Acuity: The measure of a patient’s complexity which requires licensed personnel (i.e. an RN) to complete interventions for them.  An example would include an ICU patient that may need more interventions to assist in life saving measures. Those measures may include tasks such as titrating pressor drips, ventilation, etc.

Intensity: A reflection of the workload of a patient. Examples may include frequent blood sugars or vital signs, turning, ambulation, etc. These tasks are busy but can be done by assistive personnel. Some of these tasks can include frequent nursing interventions as well, but don’t necessarily require them to be more highly specialized.

The next time you become frustrated when the charge nurse assigns patients and it seems unfair, remember these definitions before stating the unfairness as it may not necessarily be true. Assignment making should be fluid and change through the shift. There are many factors that occur that can change what one’s assignment is simply due to the ins and out of patient placement.

If the assignment still seems unfair, then use this knowledge to help educate others on the difference. Be the advocate for yourself and your patients!

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