Why does Nursing put up with short staffing? - page 4

I am wanting to get a little feedback as to why Nursing (in general) allows short staffing to be an issue? I am on our research committee at work and would like to get an idea of where to take my... Read More

  1. by   June55Baby
    Quote from barbyann
    I don't understand why the "White Coat Nurses" are not asked to work when we are short staffed. We have lots of RN's who never touch a patient and have fancy titles. QA, ID, NM, IV, CI (you get the point). When I am told the supervisor called "everyone" and no one can come in I question it. I ask about these licensed professionals and if they were called in to work. All I get is a blank stare. Why can't these nurses help out in a crunch? Are they too good to do bedside care?

    I guess I am one of those "White Coat Nurses" you are referring to even though I never wear a white coat. As far as being "too good" to do bedside care - I paid my dues with 20+ years of clinical nursing and have been in Quality Management for 10 years due my health.

    In the past year, during a crunch, I have been seen at the bedside admitting new patients, completing discharge papers, wheeling out discharges, completing patient education and doing whatever I could to assist. The issue comes up when after assisting on the units for 8 or even 4 hours my job is left undone and then I am behind in my work taking at times days to get caught up. And do I ever get a simple "thanks" from those I help? Nope!

    Especially now with Medicare's Pay for Performance Program those of us who are "White Coat Nurses" are important partners in healthcare too!
  2. by   grannyNan
    A few weeks ago I was sick. I was supposed to cover for a coworker so she could go to an appointment with her husband. Not only was I sick but 2 other nurses were sick. The hospital was busy for us 15 or so patients on the floor (including OB) and a rip roaring emergency room. We normally staff 3 nurses (RN/LPN) for the floor and OB and 1 RN for the emergency room with a paramedic/tech to assist. YOU know what ususally happens in this instance? The director of Nursing and the Social service/discharge nurse worked in our places. I know this sounds unreal for many of you but at our hospital that is how it goes. It doesn't happen often but it does happen. The reasons for short staffing are many. I happen to believe that in today's culture people feel entitled to certain things. Like just because you don't feel like putting in a day's work you can call in and push off the burden onto others. If you are sick fine, if your house burns down and you are having a rough time trying to find your sanity, call in. If you just can't go to work because your hair won't curl right or you forgot to get gas for your car, then you need to seriously rethink your goals in life. I have tried to cover shifts for people who I later see shopping at the local mall. I have worked many hours over because someone could not find anyone to give them a ride to work when they let their child take the car to whereever. I cover for people on short notice because part of it is my job and part of it is because I would like to believe that if the tables were turned they would do it for me. I hate it when the floor nursing blames management and the management blames the floor nurses. The reason for working short is because someone has fallen for whatever the reason and it is everyone's job to pick up the pieces and go on the best we can. My job? I am the Infection control Nurse and Staff development coordinator and when I fill in for a sick nurse it puts me that much farther behind in my work.
  3. by   santhony44
    Quote from June55Baby
    I guess I am one of those "White Coat Nurses" you are referring to even though I never wear a white coat. As far as being "too good" to do bedside care - I paid my dues with 20+ years of clinical nursing and have been in Quality Management for 10 years due my health.

    In the past year, during a crunch, I have been seen at the bedside admitting new patients, completing discharge papers, wheeling out discharges, completing patient education and doing whatever I could to assist. The issue comes up when after assisting on the units for 8 or even 4 hours my job is left undone and then I am behind in my work taking at times days to get caught up. And do I ever get a simple "thanks" from those I help? Nope!

    I've wondered how the floor staff would really react to someone who has been away from the bedside a while trying to help.

    I'm a NP. I've been away from the bedside for over 10 years, and away from med-surg longer than that. I can do a gyn exam in my sleep but there is no way I could take a full load of hospital patients.

    I could answer call lights, do vitals, make beds, and so forth but I'm not up on all the technology nor even all the meds used in the hospital right now.

    Would the floor staff really want someone like me helping out or would the attitude be "if you can't take a full load don't bother?"
  4. by   grannyNan
    They'll likely have to pay extra which they won't want to do. But there is SOMEBODY that can take those patients, even if it has to be the DON that does it. Someone with a nursing license is available, they just won't do it for the paltry sum the hospital is willing to pay if they can bully YOU into doing it instead.
    I don't want my patients or my family members taken care of by "someone with a nursing license" I want them taken care of by someone who knows what they are doing. Just because someone has a nursing license does not make them a safe nurse. As they say any trained monkey can give you a pill but does the monkey know why they are giving you the pill?
  5. by   annmariern
    Quote from TazziRN
    I understand your feelings but how does this help the short-staffing problem? This would make it even more dangerous for the few nurses who are already working that shift.
    I disagree, it means the supervisor will have to grow a set, call an agency, get a bonus approved, and get the patients covered somehow.It puts the ball back where it should be, managements. Every time nurses accept a dangerous assignment, problem solved, too bad about your day, too bad for the patients and fingers crossed you don't kill anyone. Your licence not there's. Next time they're short, the attitude seems to be, we'll they did it last week. I see this all the time and it's often know a week in advance there is a day really short to begin with, forget sick calls. We once had a bonus program for RN's $250 for an additional 12 hrs shift. People were more than happy to work extra shifts. It can be done, but when they can get away will it why bother?
  6. by   k3immigrant
    i think it is more of nurses allowing it. i typically precept new nurses & i would always end up getting an extra patient because i let the management take advantage of me. after one incident that i was left in a unit w/ 6 pts, 4 step down & 2 med-tele w/ only one new tele tech, i learned my lesson & started saying, " no". since then i stood my ground that if the union contract says it, i follow it to the letter because it is my license in line not the management's. our management does not exert effort to get agency nurses if they can squeeze extra patients to nurses & in turn the management will give us a 10-15 dollar ticket for some goodies after they saved $500 for not calling in another nurse.
  7. by   crb613
    Quote from earle58
    i don't believe for one moment, that hospitals will not survive if they don't take shortcuts elsewhere (which of course, is the nsg dept)....have you ever seen the salaries of the ceo's and other bigwigs?
    no, most hospitals are doing quite well and it's plain, old-fashioned greed and disrespect that creates the shoddy decisions they make.
    imo, if nurses did indeed, refuse to take this b.s. and walk out, the hosp would be in for a rude awakening.
    and the paradox is, once they started treating nurses w/the respect that is so lacking (w/safe staffing, pay hikes, autonomy, support and much more appreciation), they'd likely get a bigger return on their investments-meeting or exceeding their fiscal goals quite nicely, thank you.
    to me, it's good, old common sense.
    but that's me.
    what do i know?
    i'm only a nurse.

    leslie
    I so agree w/you! BUT...what do we do??? Whine,cry & go back in the next shift for more! How much more are we going to tolerate? :trout:
    Who's fault is it?.....ours because we allow it to continue.
    Last edit by crb613 on Jan 24, '07
  8. by   wjf00
    Quote from TazziRN
    I understand your feelings but how does this help the short-staffing problem? This would make it even more dangerous for the few nurses who are already working that shift.
    Refusing an unsafe asignment, is the least I can do as a patient advocate. This forces management to deal with the issue. Let's face it management has many options to deal with short staffing. Options include paying overtime, floating, working the floor themselves, paying registry, transfering patients to other floors, closing the unit or essential care policies. Failure to staff is a management caused problem. They need to be proactive in fixing it. By accepting an unsafe assignment I assume all the responsibility. By refusing, management is on notice that their license is on the line if something bad happens.
  9. by   wjf00
    Quote from nurse_clown
    So, what do you do? How do you refuse the assignment? I've been left short-staffed many times. It's starting to really wear me down. What if one day I come to work and find out that I'm short staffed again and I can't handle it? I mean, I'm not perfect. Sometimes, it's hard handling the assignment I already have.
    If I get an unsafe assignment (very very rare) I tell the manager or house supervisor I will accept what is SAFE, say 4 of 5 patients. I will not accept more than what is safe. It is not abandonment if you refuse an assignment. Abandonment (in the state of California) can only occur AFTER accepting an assignment.
  10. by   OC_An Khe
    The long term culture of Nursing has been to be submissive to authority, both medical and administrative authorities. Those in authority have not been reticent to use this cultural aspect of nursing to their advantage. Thus the less then optimal working conditions in many patient care facilities and the low professional respect some MD's give to RNs. This submissive part of the nursing culture is slowly changing within nursing itself. Those that take advantage of this aspect of nursing culture are really fighting, delaying this change and trying at times to "de-profressionalize" nursing as an independent profession.
    In many ways the nursing profession, being mainly female, still is being treated by many, as women in general, were treated by society as if we were still in the early 1900's. The societal changes that have given women a more equal place in society, over the last quarter of a century as a whole, have still not fully taken place within the nursing profession and by those that have control over nursing employment.
  11. by   RNsRWe
    I'm still kinda new on my unit, but after having been "forced" a few times to take ten patients on med/surge on nights (trust me, a ridiculous number), I have now decided to refuse. Flat out.

    Recently we had a super-surge in admissions and we were not only full, but over-full (stuffing beds into rooms slated for day-use only). And we were staffed for three nurses for 32 patients.

    I told the oncoming charge I wouldn't do it. She said SHE wouldn't do it. The outgoing charge said "they've been trying to get someone all day", as if that made a bit of difference. Supervisor shrugged and said "don't have anyone".

    Umm..ok. I told outgoing charge that I would just refuse the assignment, I would keep the half dozen patients that I had until the end of the shift, turn in my badge and then go home. She thought I was nuts, and claimed I would be charged with patient abandonment. Informed her that NOT accepting an unsafe load was NOT abandonment; how could I "abandon" patients not yet in my care?? And make no mistake: I would not jeapordize my license yet again by taking that kind of assignment (again). I'd quit first.

    Well, long story short: a fourth nurse materialized as a float from another unit, miraculously. Hmmm. Sometimes when TPTB hear that you really, actually, honestly are going to walk out the door and REFUSE, perhaps that's what's needed. People say you can't change staffing, but sometimes I think you can change it for a bit, for when you need it most, by just standing by your guns.

    We all had eight heavy patients apiece for that shift, and 1-2 techs. Not the easiest night, but manageable amongst all of us. And I didn't have to quit
  12. by   anonymurse
    Quote from casbeezgirlrn
    i don't know what you mean by "allow it". if there's no one to work, there's no one to work.
    nearly 1 out of 5 rns are not working as rns. conditions and pay are most commonly cited by these rns as reasons for leaving nursing.

    imagine, if you will, if conditions and pay were satisfactory. then staffing levels would rise. outcomes would improve dramatically, but the cost of care per patient would rise.

    if you can figure out how to make the government, insurance companies, and health care corporations happy with higher costs, why then you'll make us all happy.

    but don't try to use better outcomes as a sales pitch. you think they don't already know the best way to improve patient outcomes? you already know their decision on that one.
  13. by   muffie
    Quote from June55Baby
    The issue comes up when after assisting on the units for 8 or even 4 hours my job is left undone and then I am behind in my work taking at times days to get caught up. And do I ever get a simple "thanks" from those I help? Nope!
    thanks on their behalf

    those poor nurses probably were focused on the 3000 things they had to do, couldn't eat/pee/breath if they wanted to, and probably stayed after work 1-2 hours catching up on charting etc.

    tell me if i am wrong

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