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*)