Why does Nursing put up with short staffing? - page 9

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   pickledpepperRN
    Quote from interleukin
    "but what kind of trouble will I be in."

    I'll tell you what we know for sure...when you accept that untenable assigment, and you screw up, you'll be hung out to dry. Be sure to submit a from stating that you are being forced to work unsafely. Otherwise, you'll be on your own in court.

    Documenting that you informed management that staffing is unsafe puts the onus on the facility not the nursing staff.
    Copy the language from one of these forms. Give one the the supervisor ordering you to take too many patients.
    Have all staff who agrees sign it. If you are the only one you will probably suffer retaliation.
    When it is everyone working that unit on that shift what are they to do? You will have your documentation that you did your best under the circumstances.
    Keep a copy and go make copies at Kinkos. One for everyone. It could save your license.
    It is important to be educated and unified. As nurses we have the obligation to do no harm and to not allow harm to our patients.
    Safe staffing saves lives.


    For California - http://www.seiu616.org/docUploads/ADO_form.pdf
    For Maryland - http://www.1199seiu.org/docUploads/a...on%5Fpdf%2Epdf
    Virginia - http://www.virginianurses.com/vna/WP...ion%20Form.rtf -
    http://www.uannurse.org/resources/objectionform.html
    http://www.uannurse.org/resources/ob...rm/ado1prn.pdf
  2. by   oramar
    Quote from Calgon-take.me.away
    okay,,let's take last night for example. Here in PA we have a major snow/ice/sleet/whatever else it can think of storm. We started out with one CNA for the facility. Granted it is a very small (70) bed LTC, but with 2 LPN, 1 RN 1CNA,,not doable or most importantly safe. Roads were terrible, people trying to get there, DON downstairs in her office, Admin in her office, they all left at 3 and okay,,,where we to go for this.
    The "dress up nurses" need to come out of their office, don a set of scrubs and get in there and HELP. Not just deligate, but get some gloves, and get into the thick of things. We did make it thru the night, meals in rooms, ect, but thank goodness no falls or crash and burns. Had some people eventually make it in. But,,,we all pulled together and kept them safe, warm, fed, and clean.
    Three cheers for you for doing your job and adverse conditions. As for managment, used to be they could do the job of the people they supervise. There are still a few that can do that. But most of them want out of the mud and blood and vomit that is why they took that job. They have no intention of getting their hands dirty.
  3. by   obynna
    I live and practice in Nigeria,I think nurses all good in improvising,where there is no equipment to work with,they improvise,where there are shortage of nurses,they also improvise. I wonder.
  4. by   little_lost_bear
    Australia have both private and public hospitals and we often work short, they say that they can't find agency nurses to cover. Pay here in australia is a little better, but still with heavy elderly patients and such people just don't want to do our jobs. We continue to care for the patients the best we can. At least in Australia we are not forced to do overtime unless we want to. We do have nurses unions, but in state where i live we have one of the weakest unions in Australia.
  5. by   Tiwi
    Why does nursing put up with short staffing?
    1. Nurses know that their role is important, that no-one can replace us on the floor, and that ppl still have to be on the floor to care for pts regardless of the amount of staff. So we do our best, even if the situation is dangerous for staff and pts.
    2. I think nurses are also more likely to "put up" with it, due to a mindset that we just 'should'; we've always done it, its part of our history. It needs to change.
    3. Senior staff are either hampered by financial constraints, managerial decisions from "on high", or just the plain lack of nursing staff throughout the industry, so they too must "put up" with it.
    3. Many ppl in the community aren't attracted to nursing, which also decreases the amount of staff available. I understand that the mean age of nurses is increasing, and I think I read somewhere that we are now about 35 - 40yrs of age? Don't quote me on that...Also here in Australia, and I can't imagine that it would be different in the US, violence perpetrated towards nurses is close to that of police officers. Why do we tolerate that?

    Just some thoughts...
  6. by   synesthete
    Quote from TNNurse92
    I haven't read all the replies so forgive me if I repeat information that has already been provided. On January 4th of this year the Safe Registered Nurse Staffing act was introduced into congress. This proposed bill will mandate safe staffing on all shifts and on all units of medicare reimbursed hospitals. The staffing levels will be established by registered nurses in conjuction with the chief nursing officer of said medicare hospitals. This bill also addresses public reporting of staffing, civil monetary penalties for failure to comply and whistlerblower protection It is S. 73.

    Thanks
    Where can I find this law, and how can nurses find out about the hospitals contingency plan? Any information you can give me would be much appreciated.
  7. by   Hoozdo
    Quote from synesthete
    Where can I find this law, and how can nurses find out about the hospitals contingency plan? Any information you can give me would be much appreciated.
    Unfortunately, if you google it, you will see they have been trying to pass this since 2003.
  8. by   laughing weasel
    It is only abandonment after you take report. If the ratio is unsafe you have the right to refuse if the hospital doesn't want to call agency for help they do NOT consider your position necessary so why risk your liscence.
  9. by   BBFRN
    http://thomas.loc.gov/cgi-bin/query/z?c110:S.73.IS:
    Here is the overview of S.73


    http://www.aacn.nche.edu/Government/pdf/Billlist.pdf
    And here is the list of nursing- related proposals currently before the 110th Congress.
  10. by   RNsRWe
    And I just came across someone at my hospital who thinks that by clocking in, we are accepting an assignment, and refusing an excessive number is abandonment. Seems there are alot of fallacies out there about what nurses "have" to do regarding assignments.

    Set her straight on that one: clocking in means I am WILLING to accept an assignment, not that I have ALREADY accepted an unmanageable one, sight unseen! If I see that the census has me slated to take ten or more patients, I don't care WHAT the acuity is, I'm not even thinking about taking report until the supervisor has assured me that we have an additional nurse coming in. And when I see that additional nurse, and know what MY number will be, then fine.

    Actually, I can't swear to it, but I don't know that even taking report is "accepting" an assignment: how can you legally be accepting responsibility for a patient load if you don't know what those patients are (what their acuity is, what their needs are)? Seems to me, if I'm taking report on nine patients and at the end of the assignment I see that it's not do-able for me, I should be able to tell charge nurse (who won't want to hear it) or call supervisor and say "not happening".

    I'm tired of hearing "that's just how it is on this unit" and "So and So did 12 patients last week". Don't care. I know how many I can safely work with, and since So and So KNEW it wasn't safe for her to take that load but she was willing to do it because "everyone does it sometimes" (not because it was safe, mind you), then that's her license she's about to lose. Not mine.

    That's why there's unsafe ratios. Nurses who allow the pressure tactics and bogus threats to force them to do the insane. Can't you just see the lawsuit bred out of a nurse being fired for NOT accepting an unsafe assignment? I can't, because I can't imagine the hospital that would open themselves up to that. They'd rather cow you into believing that you have no choice in the matter. Hogwash.
  11. by   Gennaver
    Quote from elfinM
    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 project. I would like to find an answer to the problem and not just more complaints. Thanks in advance for any insight.
    I have nothing to contribute to your question but, more questions to add.

    Why do nurses put up with shift and weekend diff and overtime and so on rather than to ask for an outright Salary? Just give me a salary, either a straight hourly one that is decent or a yearly one then do not throw nickles and dimes at me for ot or shift diff.

    Gen
  12. by   RNsRWe
    Quote from Gennaver
    I have nothing to contribute to your question but, more questions to add.

    Why do nurses put up with shift and weekend diff and overtime and so on rather than to ask for an outright Salary? Just give me a salary, either a straight hourly one that is decent or a yearly one then do not throw nickles and dimes at me for ot or shift diff.

    Gen
    Because there will always be harder shifts to get coverage for, and facilities are willing to pay more for those shifts than they are for easy to fill ones. At my facility, lots of nurses want day shift. They get a base rate of pay. Nights, however, require far more baiting, and therefore we get extra $$ per hour. Do I "put up with it"? No....I want and expect it!

    Why do I want hourly pay (not salary) plus differentials? Because I want to be paid for every single minute I work, as I do now, and because I AM willing to work hard-to-fill shifts, I will take the extra cash, thank you. Definitely not "nickels and dimes" where I am!
  13. by   Sheri257
    Quote from RNsRWe
    And I just came across someone at my hospital who thinks that by clocking in, we are accepting an assignment, and refusing an excessive number is abandonment. Seems there are alot of fallacies out there about what nurses "have" to do regarding assignments.

    Set her straight on that one: clocking in means I am WILLING to accept an assignment, not that I have ALREADY accepted an unmanageable one, sight unseen! If I see that the census has me slated to take ten or more patients, I don't care WHAT the acuity is, I'm not even thinking about taking report until the supervisor has assured me that we have an additional nurse coming in. And when I see that additional nurse, and know what MY number will be, then fine.

    Actually, I can't swear to it, but I don't know that even taking report is "accepting" an assignment: how can you legally be accepting responsibility for a patient load if you don't know what those patients are (what their acuity is, what their needs are)? Seems to me, if I'm taking report on nine patients and at the end of the assignment I see that it's not do-able for me, I should be able to tell charge nurse (who won't want to hear it) or call supervisor and say "not happening".

    I'm tired of hearing "that's just how it is on this unit" and "So and So did 12 patients last week". Don't care. I know how many I can safely work with, and since So and So KNEW it wasn't safe for her to take that load but she was willing to do it because "everyone does it sometimes" (not because it was safe, mind you), then that's her license she's about to lose. Not mine.

    That's why there's unsafe ratios. Nurses who allow the pressure tactics and bogus threats to force them to do the insane. Can't you just see the lawsuit bred out of a nurse being fired for NOT accepting an unsafe assignment? I can't, because I can't imagine the hospital that would open themselves up to that. They'd rather cow you into believing that you have no choice in the matter. Hogwash.
    Obviously this can vary by which state you're in but, this is what the California BRN says about patient abandonment, just as an example:

    http://www.rn.ca.gov/practice/pdf/npr-b-01.pdf

    For patient abandonment to occur, the nurse must first accept the assignment thus, establishing a nurse-patient relationship. Then the nurse must severe the nurse-patient relationship without giving adequate notice to the supervisor so that nursing care can be provided by others. In my nursing program, we were taught that four hours is reasonable notice.

    Not showing up for work or refusing the assignment is not considered patient abandonment. However, while you wouldn't be charged with patient abandonment, this doesn't necessarily prevent the employer from firing you (especially if you don't show up for work), which the BRN doesn't have jurisdiction over.

    In my California nursing program, we were taught to do the following if we ran into an unsafe assignment. Give them the four hours notice to find somebody else or bring in help and, simultaneously ... file an incident report stating that the assignment is unsafe. This puts the liability on the hospital, not you, if something goes wrong.

    This way ... you're protesting the assignment, protecting yourself and giving them adequate notice while simultaneously not giving them any cause to fire you.

    Again, I don't know how this would work in other states, especially "at-will" states because in California, once you get past probation, you can't be fired without cause.

    But this is what we were taught to avoid problems both with employment issues and the BRN.

    :typing
    Last edit by Sheri257 on Mar 5, '07

close