[psychnurse37]

"Understaffing" will always be a problem because there is a big difference in how you look at staffing, and who is looking. Administration is looking at it from a monitary standpoint. They have to show a profit (even if "nonprofit") in order to pay salaries, buy new equipment, compete with others. The nurse is looking at it for job satisfaction, safety, etc. The patient/family is looking at it from a comfort viewpoint. The "productivity" experts will always say a unit is overstaffed, because that's their job. I think acuity needs to be factored in somehow, because sometimes we can work with less staff and get things done, and other times we need so many more in order to just make it to the end of the shift without an error or death.

As for burnout, the best thing I ever learned was" You have to take care of the caregiver if you are going to keep on giving care." We need to take care of ourselves" practice what we preach: RELAX, take time to do something fun. This might mean a long bath, a hot shower, a walk in the park, a golf/tennis match, reading a great book, playing with the kids, a romatic interlude, a movie, cooking, going out to eat, gettig a good nights sleep, etc. It will be different for different folks. Just unwind, leave your work problems at work and your home/personal problems at home. Take care of yourself, take care of your peers, take pride in what you do, or find something you can do that will make you a better person: get more education, take time off to regroup, become an optimist, look on the bright side, use humor to laugh. Volunteer, work with youth in the community or at church. Visit a nursing home or veterns hospital.

Good luck nurses, do what you can to prevent burnout, we need all the nurses we have and more. You chose nursing for a reason, now fulfill that purpose, make your career something you can be proud of. Take care of yourself! Take care of others!

[RN4NICU]

Originally Posted by spacenurse

From the Journal of the American Medical Association ( attached)
Vol. 288 No. 16, October 23, 2002
Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction


...Conclusions* In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction...

It took them a year and a half of research to figure that out?
A little common sense would have saved them a lot of time.
This isn't something that hasn't been known all along. Perhaps the researchers thought "proving" it would exact change, but that is just not the way health care works. It's all about $$$.

[sister--*]

Staffing on pt. numbers and not acuity. Short-staffing the floor while other depts. are at the nurse's station showing family pictures and sharing community gossip while the floor is drowning. Calling for help to hear, "There's no one here.".....while the Cardizem drips (and others) need two R.N.'s for verifications, is time sensitive, and in need of one-on-one continued assessments. Having to run the block to Pharmacy and the block back to get your STAT meds for your critical patients. Finding that your supplies haven't been stocked and making the mad dash across the facility to Central Supply to get them. Mandatory meetings scheduled during work hours without staff to cover pt. care for these times....this always "dings" the Nurse's employment review. Crazy assignments that over-load one nurse and slides others. Lack of or dishonest communication. Ever-changing paperwork and constantly changing storage places. Being paged to three different pt's rooms at the same time. No breaks in a long work day. Orders not reaching the floor. Inability to get to pt. charts as they're occupied in other departments for hours. Triple documentation. Being repeatedly nominated for Nurse recognition by co-workers and patients to be sent a congratulatory letter on the nomination, but, "Sorry, not everyone is selected."

Best of all: after many consecutive days of running marathons there's not so much as a face to face smile or thank-you. But, when you arrive home in the mail there's a note from your D.O.N. thanking you for all you're doing. I may be ungrateful, however, a smile or acknowledgement during working hours and while in the thick of things would be more meaningful!

I'm developing a pretty tough hide.

[RN130]

Yes there certainly is a s nursing shortage. What we see at our hospital is a greeed driven nursing shortage. Our not for profit hospital has an operating margin of over 10% (read that as profit/and the Hospital Association s own PR says a Hospital needs 5-6% to get the best bond rates and pay for capital improvements....

So we see tighter and tighter planned staffing and no one to replace sick/vacation and people who leave....

We are not "burned out" because of any personal defect--it is ok in hospital management to operate this way--burnout is part of the plan---missing meals and breaks, too many patients and fast turnover---it all makes them more money. Yes it is true that some patient populations are stressful --but we are trained to deal with them---- these thing keep happening afer we have begged for help---that is the burnout...

[anonymurse]

Hospitals make choices, and so do we. There are two main choices where I live. I hired on with the one that pays less but staffs better.

[TalldiNY]

Chronic under staffing
inability to give good quality nursing care due to the above.
being floated to everywhere but your assigned unit due to the above.
going home feelingdispirited and unfulfilled due to the above

I personally like my 12 hr shifts because the BS takes place when the "suits" (including nurse managers who after all "understand" where you're coming from because they"have been there") are onduty. The weekends Fri-Sun eliminate them pretty much. At my age I am very tired of them. This way I can smile alot and nod.
When forced to join a comittee for something, if the meetings aren't on a Friday I am not there.
I have seen all kinds of "innovative" nursing initiatives. They usually mean I am responsible for making do with less although my responsibility is more.
If I sound bitter I really am not. I am a realist and in order to maintain my own peace of mind I concentrate on being a patient advocate and get my rewards from them, when they say thank you, or I am so glad I have YOU again today!
Di

[lujological]

gerinurse-mangement that has no idea what goes on -on your particular shift,they pull staff ,from your shift to use on other shifts,they have no idea what other things can go on like-alarms you need to check on,phone calls to get maintance in for problems,laundry problems,calls coming in,espically call offs then they have the nerve to exspect me to try and find replacement staff,all while i am trying to do morning medpass.It seems 11-7 is the least understood shift,oh i forgot mandatory inservice during the day when you sleep!!all of these are reasons for burn out.

[passion4parrots]

I work in Springfield MO on a med-surg floor, on the 7 pm to 7am shift. I usually start out with five patients and almost always get another admission by 10 pm. Most of these are high acuity pt's just back from surgeries such as colon resections, Turps (with CBI) and mastectomy/TRAM patients not to mention ETOH WD (which require hourly assessments), We also get a large percentage of very elderly dementia pt's that are pulling out IV's, trying to crawl OOB and such. At the night shift change I pick up two more pt's which brings me up to eight and then usually get another admission during the night (which requires a ton of paperwork and time going over all their past med history and the endless amount of questions we have to ask them, then calling the doc for orders and such). I am a new grad with six months experience (on this floor only). It is very frustrating as I can't get everything done and end up staying at least an hour and a half after every shift just to do all the charting that I didn't have time for during the night. My question is: is this a normal load for these high acuity type pt's on a med-surg floor in most places in the US? It is incredibly stressful and I am already feeling "burnout" at only six months!!

[NumberCruncher]

Originally Posted by anonymurse

Hospitals make choices, and so do we. There are two main choices where I live. I hired on with the one that pays less but staffs better.

Hey, so far this is the best thing I've read. You are right, it all boils down to choices. Hospitals make their own, you make yours. So, why blame the universe for the burn out.

Nice one!

[oramar]

Originally Posted by RNSacht

Just thought I would share my story. If you look at my prior posts (I dont want to be labeled a hypocrit) I have just raved about 12 hour shifts. I have now been a nurse for only a year (on 12 hour shifts) and I feel as if I am exhibiting the Oh so popular burnout symptoms. I have recently accepted a 8 hour position in the ER (cant wait ) and part of my decision was that I feel the 12 hour shifts burned me out quick !! I am sharing my story because these 12 hour nursing shifts are new to SOME facilities and maybe future research will prove that these shifts are burning nurses out, maybe leading to more errors, etc. I just found that the every other weekend 12 hours on Sat and 12 hours on Sunday was too much for me and too much for my family. I will now work a totally different shift that I NEVER said I would work 3-11 four days a week. NEver say never in the world of nursing Hope I have helped with your research. Good Luck

Glad you are being honest about this. I think 12 hour shifts post a host of problems for managment and nursing. They are being promoted at the big panecia for staffing problems. From where I sit they cause as many problems as they solve. It is true they work for some people but not all. Biggest problem from my point of view was call offs. It is soooo hard to find replacements for a 12 hour call off.