Hi. Honesty is always the best policy, but unfortunately, human nature gives us alot of gray areas to contend with. There are certain types of patients or families that you would not want to discuss certain things with or are unable to get your point across with.
As with everything, you have to use your 6th and 7th senses on whether you want to potentially discuss the issue of staffing levels with each and every one of your patients and/or families. It's been my experience that many of our patients/families live in their own little world and nothing you tell them will make a difference in their expectations of you. For instance, in home health, there are times in the winter when we can't physically reach our patients. We plan for those days. However, some of our patients and families are so dependent on us and self-centered, they will request a visit from us when there is 6 feet of ice and snow on the ground. Mind you these are not emergency situations. We try and explain that we can't come because of the danger involved and not to mention we can't get out. We don't have a blue suit with a red, flowing cape. We even ask them whether they have checked the weather. They still don't get it. In other cases, our psychiatric nurses have to use caution in discussing a condition with a patient and/or family. You never know how people will respond.
I look at the discussion of staffing issues as a legal issue. In this day and age, when everyone is being hauled into court, you want to be careful about what is discussed with whom. I do think it is important to make a copy of the schedule and mark the days on it when staffing is short, and confront administration about it, before they come to you. I think the idea about educating the public about safe staffing levels is a great one. I feel that nursing needs to find an ally, in addition. Maybe, we can get support from beleagered primary care physicians who are considered by their peers to be only one or two steps above us. We can forget hospital administrators. Some try to be helpful, but most of them just want to be comfortable in their status.