How's the nursing shortage affecting ...

  1. your hospital.

    It's horrible where I work. The hospital has changed the patient:nurse ratio for the worst. (and to top that they can't even find staff to meet the matrix)

    My hospital offers bonuses for overtime. But no one can handle it, when you working short the first 8 hours....everyone's too tired to work another 8 hours....or let alone any extra day's.

    Units that were once staffed well are no longer. Our unit we could always find staff, that were interested in working on our unit. Great retention. No longer. We are working so short.

    I spoke with my manager today regarding my frustration with the lack of staffing. The response I got was surprising. It was more or less find a new job. That's how it is everywhere.

    I am looking for a new job. I'm hopeful to find a new job....with better staffing. I spoke with one lady that works at another unit(different hospital), that's much like the one I'm working on and their staffing matrix was good!! It's "known" to be a great hospital. I'm hoping there's a job out there for me!!!!!!!! Off I go looking!!!!!!
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  2. 19 Comments

  3. by   LPN & EMT-CT
    I think this is everywhere, I was reading the nursing magazine "RN" and it has a good article on page 18 about the nursing shortage. Try these two web sites for info,
    1. www.rwjf.org/special/nursingshortage
    2. www.rnweb.com


    Hope this helps, I know at our hospital and the other around us we are all short staffed.

    David-LPN & EMT-CT -VA
  4. by   Katch22
    I have been in the nursing field long enough to see shortages come and go. I feel this one, too, will eventually blow over. I only wish management would listen to staff with open ears, not just ears which hear what they want. At most hospitals staffing is especially short on the weekend, so what does management do but lower the weekend differential and take away any incentive to get people to work extra on a weekend. How much sense does THAT make?? None whatsoever. It's a shame management doesn't jump in and help take care of the patients!! Boy, that would be the day, wouldn't it!?
  5. by   Jackie N
    Where? What hospital is this happening at? Did your unit all of sudden lose staff or was it a gradual change?
  6. by   RN-PA
    Just speaking about Med/Surg where I work on a 65-bed unit, it's been really bad for night shift for over a year, staffing-wise, and it's now getting bad on the other shifts. The ads the hospital's placed mention willingness to work with peds AND chemo and I think that's frightened potential applicants away. Our floor has every type of patient you can imagine. They recently closed the 18-bed psych unit and are planning to open it as an Orthopedic/CVA unit, staffed only with RN's and a couple of PCT's. (We don't get that many ortho or CVA patients as it is, so I figure it'll end up being an overflow Med/Surg floor.) The thing is, we can't staff the main Med/Surg unit adequately and I don't know from where they expect to hire nurses for the new unit. Also, there are tons of nurses who are either pregnant or are on their 3-month maternity leave at the moment which is eating into staffing. (I'm tellin' ya, there must be something in the water at our hospital-- I never saw such fertility in one place! ) A lot of older, experienced nurses have gone to casual status (or pool) because they're sick of all the nonsense and of working every other weekend. Also, they've been offering unbelievable bonuses for most shifts the past year, ALWAYS calling to beg for staff to pick up time and staffing's been especially bad this summer with vacations.

    The administration's been trying different ways to organize us better on such a large floor by breaking us up into 6 teams rather than just 3, but now I hear they're going back to 3 teams again. :stone They want us to apply for which of 3 teams we want to work on: Oncology, Surgical (and eventually there'll be some monitored beds, I'm told), or Medical-- where the private rooms/isolation patients, prisoners, peds ( yeah, I know), PD, trachs, etc. are placed. But those teams are NEVER that cut and dried with the patient-types-- there's always a mixture of diagnoses. Plus, if you work part-time as I do, you go wherever the holes are for staffing. I've been on two nights in a row and been on two different teams due to full-timers or 12-hour nurses taking my "spot".

    The best thing my NM did was to hire more PCT's. For evening shift, there used to be only 3 PCT's for a potential 65 patients; now we have 6 (most nights) and it's made a big difference. They're now talking about upping the patient:nurse ratio to 6:1. If my patients are mostly partial-cares, that's often doable, but everyone's had shifts where you have only 3 patients but you're running your butt off all night beacuse one of them's going south or because of the acuity of the 3-- or 6.

    There's going to be a big meeting to discuss all the changes that'll happen while I'm away on vacation next week and in a way, it's probably best for me (my sanity). I get too upset and angry over ideas that aren't realistic and with the nurses who sit at these meetings like bumps on a log, saying nothing and then complain to high heavens later. I've stuck my neck out one too many times to voice opinions and it doesn't seem to do much good except to label you as a complainer. I *WILL* still speak up prn, but my new motto is "In acceptance lieth peace." Also, trying to live the quote below. *SIGH*)
    Last edit by RN-PA on Aug 27, '02
  7. by   bestblondRN
    Originally posted by RN-PA
    [B]The administration's been trying different ways to organize us
    diagnoses. Plus, if you work part-time as I do, you go wherever the holes are for staffing. I've been on two nights in a row and been on two different teams due to full-timers or 12-hour nurses
    The best thing my NM did was to hire more PCT's. For evening shift, there used to be only 3 PCT's for a potential 65 patients; now we have 6 (most nights) and it's made a big difference. They're now talking about upping the patient:nurse ratio to 6:1. If my patients are mostly partial-cares, that's often doable, but everyone's had shifts where you have only 3 patients but you're running your butt off all night beacuse one of them's going south or because of the acuity of the 3-- or 6.(B]
    It's unfortunate that most M/S and even tele floors routinely run a 1:6 ratio. I have seen it higher than that on occasion when staffing couldn't be obtained. With a 1:10 ratio of PCTs and a 1:6 ration of RNs, you MIGHT be okay, but you will continue to run your a** off!

    I guess the question I have is: WHAT HAPPENED TO THE IDEA OF PROVIDING SAFE, EXCELLENT QUALITY CARE??????

    That seems to be the last concern of the folks doing staffing these days (and I came from a management role back to the bedside), and unfortunately, is taking its toll in more ways than one. What a sad commentary on healthcare today
  8. by   RN-PA
    Depending on which of the 6 teams we were on, we've had 6 patients if the census was up, so have been working 1:6 for some time now. Add to that the 6 patients I must cover for the LPN. I still have to do their chart checks, give IV push meds, call doctors, etc. for them as well as my own load. Most LPN's I work with are good about asking if they can help me if they're caught up, but there are some nights you really feel like you've got 12 patients.

    It's a shame, bestblond, but it will become a viscious cycle with lower staffing, higher nurse to patient ratios eventually pushing MORE nurses out, leading to worse staffing etc. etc.
  9. by   askater11
    I work at a urban, teaching hospital.

    It occured gradually.

    At first 5 years ago MN.'s was hard to staff. Then it went to change of matrix...units where the matrix was crazy 1:7-8 people left. And other units were still staffed...it was just the units with 1:7-8 staffs that weren't staffed.

    Then they seemed to manipulate with our matrix over the passed 3-4 years.

    Now we are so short staffed. We can't even meet this new, gradual not so good matrix. We are taking on outrageous amount of patients. Everyone's whipped tired. We used to have a listing on our unit with job openings....not any longer....though we do have openings.

    I've heard good things about 2 other hospitals. One's way too far from me. But a family member was talking with a collegue of mine and said she's transfering the patient to another hospital that her mother's been to a lot in the past years. The patient's daugther was outraged with the staffing on the unit (she was on prior to the intensive care) And today the ladies being shipped out to the other hospital. The ladies writing a letter to the CEO regarding our lack of help.

    I'm kind of wondering how it is elsewhere? But it sounds a lot the same everywhere. I hope I can stay in this field...I'm getting burnt out.
  10. by   RN-PA
    Originally posted by askater11
    I'm kind of wondering how it is elsewhere? But it sounds a lot the same everywhere. I hope I can stay in this field...I'm getting burnt out.
    I'm avoiding burn out right now by working part-time and have been happy with my weekly schedule. However, our NM now wants to revamp all of our schedules because they have too many holes.
    SOMEBODY needs to read a manual on "Nursing Retention"... Grrrrrrrr...

    I'm with you though, askater. I know it'd possibly be worse elsewhere. At least we have an IV team in place (for now...) and I know ratios could be worse closer to the city. I like Med/Surg nursing and have no desire to go elsewhere-- if anything, I'd like to work casual status to pick and choose the shifts I'd like to work and quit weekends, but I need the structure of a set schedule at this time in my life; left to my own desires, I'd just work the minimum and I need to make more money than that.
  11. by   fedupnurse
    Our tele staff would kill for a 1:6 ratio! They only get that when there are empty beds which is about....NEVER. Our suits don't even advertise because they say it doesn't work. What the real reason is: They are arrogant enough to think people will flock there because of the specialty services we have and MAGNET. More like MAGGOT. My facility proves this "award" means NOTHING!!!! We have only had people flocking out the door rather than in and the suits couldn't care less. Quality means nothing, profits mean everything!
    Good luck with your job hunt. I hope you find something good out there to go to!
    Last edit by fedupnurse on Aug 27, '02
  12. by   oramar
    It makes me sad to think that shortsightedness in managment is still so pervasive. Imagine telling a person to look for new job when they object to bad practice. This not only happens but is standard practice. There are some places where things are changing but it is a drop in the bucket towards what goes on in most hospitals. I think the nurses south of the Mason Dixon line are going to have to rethink their anti union stance. Your managment is so convinced that they can treat you anyway they want because unions are some sort of "Yankee" thing.
  13. by   Rottie1
    We are begining to see a shortage in the OR at our city, the cardiologist/cardiac surgeons opened a brand new "heart hospita." In order to staff it they offered nurses, and other caregivers from other hospitals all over the city. So now all hospitals are short staffed in all areas, some hospitals closed down their heart surgery.
    I was just speaking to my coworkers and suggested that we were just plain stupid to put up with the low pay, long hours and not to mention the call situation. So a couple of nurse stated that they have already signed up with an agency and are just waiting on a call. Two others stated, "Well, when they leave then we will too."
    We are also wondering what is it that the administration does not understand. They have offered retention bonuses which were just sign on bonuses for those already there, if you signed for 3 years they gave you $5,000, that is before taxes. Okay so now you are just bound to the same lousy place you were working for another 3 years! Nothing gets done about anything.
    We suggested they close a room or two, but oh no they cant do that! That would me they would make less money. We get a measly $3 an hour to be on call and then if we get called in they stop that and just pay us our regular pay for the time we are there! We try to tell them that other hospitals in the same area are paying $5/hr for call, well they can't increase ours cuz then they would have to increase "everyones" - Good Grief! Well, they just don't seem to understand that they will be losing quite a few nurses in just the next six months.
  14. by   renerian
    I left home health as the paperwork and travel time were killing me since we were so short RNs. I would work, no lie, 21 days straight, 10 to 12 hour days and no overtime since we were paid per visit. Don't go to home health thinking it is any better.

    renerian

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