Understaffed and wondering what to do.

[Anagray, BSN]

I am a tech on a telemetry unit. On our floor we have inpatient and outpatient procedures - caths, pacers/aicd, stents, etc. We are one of the largest 2 cardiac hospitals. Our unit (when full) expanded to holding over 40 beds.

The patient per nurse ratio is usually 6:1 on days and evening shift. We have 1 tech. sitting monitors, and we had 4 techs working the floor. Tech's responsibilities include EKGs, phlebotomy, fingersticks q4h, vitals q4h, baths in am, passing trays, feedings, collecting trays, other patient care, etc.

For the last year techs ( and nurses) started to quit because the working conditions became impossible to deal with. As of right now, we usually have only 2 techs per shift - 20 patients a piece.

What this means is that the unfinished tech work ends up piling over on the nurses. People are working without breaks and lunches, patients go without being turned and positioned on schedule, baths and changes are also suffering. Then, we all get reamed out by patients and family members that we don't come quick enough. Not only the physical aspect of care is suffering but some people are scared to death and just want to talk to someone for a minute, to feel that we are here for them and that we are listening.

I tried to find out what is going on and went to my supervisor. She has been very good to me in the past and I sort of expected a truthful answer. She told me she is interviewing and hiring, but not many people are applying.

However, I saw only one posting in HR downstairs for tech position and none for nurse positions. A few people that I know have applied for tech positions, were told that she is "not hiring at the moment."

From what I see there is a certain amount of deceite going on.

I was hoping to join our nursing team after graduation in 2005, but now I am having strong doubts about whether i want to work in such environment.

My questions are: what is it like on your units? How many people of unlisenced personell are working ? what would u do in my situation?

thanks!

[Rapheal]

Anagray I cannot tell you what to do. I can possibly predict the future of your unit as it sounds much like mine. First many techs and nurses leave for better employment. Then the hospital starts to rely more on agency which is more expensive. They then cancel agency when they can in the hope that they can swing the shifts without too many new admits or transfer patients. This seldom happens and more staff nurses leave. Then with the added cost of hiring new staff and using more agency- the unit cuts costs by not ordering enough supplies,

creating hardships and more frustration. I hope your mgmt. sees the light and does not create the work environment that I work in. My unit mgr. had a goal to reduce agency staffing and retain

staff nurses. But because this manager did not staff adaquately, the stage was set for disaster. We have now increased our use of agency nurses to over 50% of our staff. We have lost 8 nurses in 3 months, 2 units secretaries, and 2 tele techs. Some agency nurses refuse assignment and leave, never to come back.

As you have said people will become very overworked. Then in my observation frustration sets in and staff feels that they can't get everything done and start to do the bare minimum. The new staff thinks this is the norm and will believe this is the status quo. You then have a unit that will not be able to meet patient needs and has little incentive to try. It becomes a toxic work environment.

You may stay and try to make change. But if the management just pays lip service and does not hire more staff, your efforts may be futile. Good luck in whatever decision you make.