Our hospital has [finally] started trying to solve, or at least deal with temporarily, the problems:
NOT ENOUGH GRADS: All the major hospitals in the area coughed up some large $$$ to the local college to help fund more "slots" in nursing school. By that I mean, more faculty so they can admit more students. They have enough applicants, so that is not a problem, so far.
DAY-TO-DAY STAFFING ISSUES: There is an 'in-house' registry you can just go to the nursing office and sign up for; you get paid separately from your regular paycheck (less taxes), you can sign up for 1 1/2 and 2x pay. Nurses can share a 12-hour shift, usually 6hrs each, works great on days, not so well on nights. Then the charge nurse has several options: per diem, out of house registry, in-house registry. At 0400 and 1600, all of the 'like-area' charge nurses (Adult Critical Care, Maternal-Child Health...) meet, discuss haves and needs, future needs, esp from L&D to NICU, consider floating

If all else fails, she gets on the phone and starts begging, goes around to current staff to see if anyone wants to "stay over" 4hrs (the beggee who agrees usually demands that it counts as a "float"!

On our large unit, 13-18 nurses per shift, depending on census, the charge nurse gets about $1.50 extra an hour, and [usually] doesn't get an assignment. S/he deserves combat pay. There are usually 3 admit nurses who go to deliveries and transports; they take a relatively light assignment.
NEW GRADS: They should be protected!!!! Preceptorships, new grad programs are vital! Didactic as well as practical are needed to get them up to speed in a healthy fashion! ALL new employees, even non-new grads, DESERVE an orientation, one that is free from "Congratulations! You're "IT" tonight!" Floats and registry nurses DESERVE a staff nurse resource. These new nurses are a resource that cannot, and should not, be abused and wasted!!!
I keep saying this: if we don't nurture these youngsters, us senior citizens are NEVER gonna get to retire!!! Let's focus on solutions!
[This message has been edited by prmenrs (edited January 31, 2001).]
[This message has been edited by prmenrs (edited January 31, 2001).]
[This message has been edited by prmenrs (edited January 31, 2001).]