If you were paying attention last time, you’ll remember that each nurse was going to have 6 actions per turn. Each patient that they had, however, was going to require the investment of one of those actions just to provide them the basic monitoring and care they would need on a regular basis. So, if the nurse had 6 patients, all of their actions would already be tied up and leave them nothing else to do, right?
More than almost anything else, Nursing is about setting priorities. So in this game, therefore, nurses always have the chance to reallocate their time in a way to focus on the things they feel are more important in a mechanic I’m calling “Shifting Priorities“.
Basically, players can pull action cubes off of patients and use them to do other things. But at the end of the turn, they would have to roll a 6-sided die, and if they roll less than or equal to the number of patients without action cubes, something bad happens. Maybe a patient fell, maybe they just had a complaint that went unanswered, maybe they had a sudden cardiac arrest and died… who knows?
I haven’t decided exactly how to resolve the particular “bad thing” yet. In my early prototypes, I think I’ll just use a table or something, but I’d really like to develop a seperate deck of cards that could be drawn and could potentially serve some of the same functions as the event deck. Regardless of the specific means, I want to make sure that it takes the following into account:
1) The acuity of the patients left unattended – Not checking in on an acuity 1 patient who is ready to go home isn’t really a big deal, so it’d be ridiculous to have them be just as at risk as an acuity 5 patient who is about ready to crash anyway. Therefore, I want “bad things” to have some sort of minimum acuity on them, and if you don’t have an unattended patient at that level or higher, then you’d still be safe.
2) The keywords on the patients – It’d also be ridiculous for a patient who hadn’t had surgery to get a surgical-site infection, so some of the “bad things” would also require an unattended patient with certain keywords.
3) A reasonable balance of risk – Shifting Priorities is going to be a pivotal mechanic in the game, so I don’t want players to be too petrified to use it. But at the same time, I also don’t want them to feel like there is absolutely no risk at all and that they should unilaterally ignore all acuity 1 patients. So I’m going to pay a lot of attention to how this works out through playtesting.
So, to recap, each player will have 6 action points/cubes on each turn, and will be able to perform the following actions:
• Care for Patients: 1 action per patient, but may Shift Priorites to reclaim some of these actions
• Admit a Patient: 3 actions, spent when a new patient is drawn from the Event deck
• Discharge/Transfer to CCU: 2 actions, spent to discard a patient of either Acuity 1 (discharge) or 5 (transfer)
• Improve Acuity: 3 actions to improve the Acuity of one patient by 1
• Improve Quality: 3 actions to improve the Quality score by 1
• Card-based Actions: variable depending on the event card drawn
The way I see it now, New Admissions drawn from the Event Deck will be placed in an “Admission Box” on the main board. At the end of the turn, patients with 3 cubes on them will be moved into an empty bed space on one of the players’ boards. Patients remaining in this space will cause some loss of Quality (to be determined).
Discharge/Transfers will be similar, where the cards will be moved to a “Discharge Box” on the main board along with the 2 action cubes used to complete the action. At the end of the turn, they will be discarded.
Extra cubes used to Improve Acuity will be placed on the patient card itself, and the acuity will be adjusted at the end of the turn.
I figure there will be an “Improve Quality” box on the main board as well, which all players can contribute to as they want. At the end of the round, the Quality score will be improved by 1 point per three cubes placed there (rounded down, of course).
Changes to the Event Deck
Since the last article (and partly based on comments made to it), I think that I’m going to expand the Event Deck some to include Opportunities as well as Events (which I’m now calling “Crisis cards”), New Admissions, and Attachments. Rather than having to spend action cubes to prevent bad things from happening, these cards will give players the chance to earn good things for their actions. In order to have people not totally ignore them (and just consider them a “free draw”), though, I think that I’ll have to make them really good, such as providing the chance to improve Quality or Acuity (or do other things) significantly cheaper than usual. But, of course, that’ll all have to be balanced out through playtesting.
Setting a Goal…
Speaking of playtesting, the next big thing I need to do is to actually put together a freaking prototype! I have some pretty good ideas how to pull off most everything, but the real work I still need to do is to actually design and print the cards. For each player to draw one card in each of 12 turns would be at least 48 (for a 4 players) or 60 (for 5) cards. So, I’m going to set what may be a bit of an optimistic goal to have this done.
I’ll be attending the local MACE gaming convention on November 11-13, and I’m going to try my best to have a somewhat-playable prototype done to take with me. I’ve got some friends who want to try it out (once, you know, it actually exists), and MACE will be the best venue I have to show it to them definitely for the rest of the year. So, if you’ll be there, get with me and take a look at what I’ve got so far in person!
The Boardgame Design Project
The Boardgame Design Project, Part 1: Design Goals
The Boardgame Design Project, Part 2: Brainstorming Mechanics