There are many committees open to staff, such as staffing committees, unit practice advisors, nursing practice advisors, etc. Having direct dialogue with leaders and managers such as clinical managers and directors of nursing provides the opportunity to observe how the staffing grid is developed. At Penrose Hospital in Colorado Springs, Colorado, staffing levels are determined by patient census. Ideally, in the surgery/trauma unit, the RNs will have approximately 4-5 patients, with a post-op nurse arriving at 10 a.m. to care for post-op patients being discharged from the PACU to the floor . The post-op nurse typically sees up to five patients per shift. The CNAs on the unit will have between 7 and 13 patients depending on the staff on site, with the assistance of a unit secretary who moves around the unit and offers assistance as needed. In 2014, the 9th floor unit grid was reorganized with the help of the unit attorney. After speaking with a nurse leader on the 9th floor, the clinical manager met with the unit practice advisor and the unit practice council chair to discuss budget and staffing. After slight changes, there was an increase in employee satisfaction. Staff members felt their voices were heard and were able to make small changes that the entire unit could agree on, while staying within budget. Additionally, with the ability of unit practice council members to visualize what is happening to maintain a budget and get budgets approved, the decisions made were better appreciated. Finally, with the new changes and adjustments, there has been a decrease in the number of unapproved posts.