One of your nursing units is short-staffed today and several residents are at risk of missed care tasks. What would you do in the next four hours to ensure resident safety and maintain care standards, and what longer-term steps would you take to address staffing reliability?

If a unit is short-staffed I start by triaging acuity and identifying high-risk residents — meds, wounds, falls, and IVs — to make sure nothing critical is missed. In the first hour I’d reassign two cross-trained CNAs from lower-acuity areas, call one on-call LPN to cover medication pass within 90 minutes, and request an agency CNA if needed (target: zero missed med passes). I’d hold a quick huddle with the charge nurse to prioritize tasks and log all changes in the EMR so families and leadership are informed. For longer term I’d run a 6-week staffing trend analysis, create a float pool of four CNAs, introduce a $500 referral bonus and flexible shifts to cut vacancy by 15% in six months, and start weekly staffing huddles to improve reliability.