One morning in our 29-bed pediatric intensive care unit, we overhead 2 nurses talking about their assignments. Jen was wondering why the same nurses always got the sickest single assignments while she always got the tough double assignment. As unit-based leaders, this was not the first time we had heard this comment. We wondered whether this could be true and made a mental note to look into this problem. At the monthly meeting of charge nurses, we brought up this concern, but the group of charge nurses thought that the concern was not valid. Although they unanimously believed that they made out assignments fairly and without bias, they agreed to keep the potential problem on their radar and to be more mindful of the issue.

Two months after this conversation among the charge nurses, our unit participated in a series of focus...

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