Understaffed and sick of it!!

[kate1969]

My name is Kate and I'm a Respiratory Therapist, though I am not a nurse and I hope that you don't think I'm intruding in your space here, I just have a problem and I would like to know if Nurses are feeling the same way. I work in an LTAC facility and we are facing what I call outrageous cutbacks in staffing, with RN's, LPN's, CNA's and RT's and we're all pretty sick and tired of this issue. I love my nursing staff, all of them, they're all pretty important to me and I'm just sick to death of all the cutbacks, I think we're all pretty tired of it. Our facility does wound care and ventilator weaning, etc. We were supposed to be staffing per acuity level, granted, I'm new to the healthcare field, I've been an RT for only a couple of years now and this is my first time ever being in an LTAC. I was a nurse aid for a few years way back when in a nursing home, actually a couple of them, but when someone called out sick, the nurses were very helpful, we did all we could for each other, anyways not to get off track, we now are no longer staffing RT's per acuity, the nurses and cna's are still being staffed that way, but they don't do our work at all, we do all the RT work but we help the nurses and cna's a great deal. The nurses on the floor are very upset about this as are the cna's and the RT's obviously, but nothing we say gets through to administration and nothing is changing. We are all very fearful of the "sentinel events" to come from this "short staffing". We are all about ready to take a "leap" . Is this happening every where, or is it just happening to us? They are trying to staff 2 RT's per 30 patients and they still expect us to do admits, discharges, weans, therapies, trach care, run codes when necessary, do abgs etc..., I think the nurses feel lucky having only 4 patients, but most times they have 5 or 6, and the cna's are lucky to have 5 per 30 patients but most times they have 10. I think that's horrible patient care and its very dangerous. Our licenses are on the line, and I'm quite sure that this company wouldn't back us if anything tragic ever happened. I think they would drop us like rocks to avoid liability...and of course to cover their butts...I went to RT school because I don't have the stomach for nursing but I wanted to care for people. I admire nurses, they have to know so much about so much and I think they have enough on their plates. My nurses and cna's know me and they know I'm always willing to help, but the last thing I ever want to do is tell them, "No, I can't help you boost a patient, or clean a patient because I have to get 10 treatments done in the next hour, start 3 trach collar weans, start three cpap weans and do 10 trach care's".....uuuuggggghhhhh

somebody help me...just go ahead, tell me that before I retire I'll be weaning 30 patients, doing 30 trach cares, 30 treatments, running 2 codes at once all by my little old self!!! or instead, maybe you should tell me to just go back to my little desk in Accounts Payables...hehe, I'm trying to find humor...sorry this is so long, but as upset as I am, its actually pretty short...

Thanks for listening

Katie

[indigo girl]

Under-staffing, poor equiptment, lack of equiptment and supplies seem to plague many LTC facilities. Bnding together, enlisting family support, bringing legal/safety concerns to the attention of administrators is just the tip of the problem. I have no concrete answers but I know we need to value our work partners and patients more.

That is true. However, administrators' bonuses are sometimes tied into how much money they can shave off of their budgets. It can really drive how the place functions when all the top brass think that way.

One of the things that is really striking, is that in some LTC's (and actually, I have seen this in a home health agency also) you can observe how well, the owners and comptrollers (I think that is the title), are living. For staff in these bare bones facilities, to see them dressing expensively, driving luxury cars, and taking their 8th vacation of the year, it is such a disconnect.

Here you are, sharing that single pulse ox between 4 units, using second rate equipment, constantly scrounging for supplies, with one nurse covering two units at nite, working short, watching the rush to fill any empty beds, and you wonder. You share a chilly restroom (noticeable in the winter) with all the support staff in a busy hallway, but the administrative offices all have private restrooms. They are air conditioned, but you have a wet towel around your neck to keep from fainting in the summer because your part of the building is not air conditioned (it's an old building, you know, too expensive to upgrade). The bonuses that resulted from all the money that was saved by creating the conditions that you work in every day, were made off of your labor. Sometimes it is so obvious, that staff are just commodities to these people, and the nursing home or the home health agency is just a money making vehicle or investment to the owners far away in that sunbelt state. Meanwhile their representatives are living it up in the Caribbean again. But, you'll know when they return, because they'll be breathing down your neck to do things more economically. Why would you need TB syringes when you can use insulin syringes for just about anything? Need an IM syringe? You better have a really good reason. Catheter kits, throw something together... We need to tighten our belts.

This does not begin to address the reality of how well you can provide care to the residents and patients, you are responsible for. Do I sound bitter?

Well, this is reality. I do not have the power to change everything, but I can advocate for better working conditions, and the tools to take care of the patients in the best way possible. Never feel sorry for banding together and demanding safer ratios.

[linzz]

No Indigo girl, you are not souding bitter, just realistic and justified. I am a new nurse and I am already fed up with all the cutbacks on supplies and being in charge of double units all because the need to increase profits. I vote that the fat cats live in one of their facilities for the summer, esp. the wing with no a/c. :angryfire

[VegRN]

working short staffed sucks period. whether it's for a nurse,rt or aide. i just came home from working on a really poorly staffed floor. a physician came on the floor and saw how we were working and immediately called the supervisor. that's the only time you see action. when either something horrible happens or an md complains. hope your situation improves. :smiletea2:

wow, that was awesome that the md advocated for the nurses instead of taking it out on the nurses. sad that it took an md to complain about it for things to happen though.

back to the op issue. i would agree with some of the other posters and say that sometimes you have to force change. if you go to another job, make sure this employer knows exactly why you are leaving. write a formal letter to the director, the owner of the facility etc and detail incidents and let them know what can happen and has already happened. won't change things overnight but may make them think a little bit and who knows....

it is your license that you worked for. don't risk it.

and thanks for all your kind words about nurses:)

[kate1969]

You all are sooooo Awsome!!! I want to thank you all for your responses, I'm so happy to know that I'm not alone, not only in what I'm seeing/experiencing but in how I feel as well. 1 issue I would really like to address first and foremost was the "Consider leaving and going elsewhere" issue. I have to say, I didn't have time to really get a lengthy education, I got a great education don't get me wrong but I needed an education and needed it fast, but it was good and one of the best parts about it was the time spent in Clinicals, but when you do clinicals as you all know, not only do you get to browse in your prospective field, you also get to eliminate all the "not so great" places to work. I live in a large city, I don't really want to post where for fear the "higher ups" are "watching" but for this large of a city, I've seen some bad places in clinicals, like so bad that if they were the last hospitals standing, I still wouldn't work for them, and there are a couple of hospitals that are 1st rate, but they don't pay well and there are a couple that only employ RRT's...I'm waiting for my check to be cashed by the NBRC and then I will be Registry eligible and I'm studying for the exam diligently so that I can expand my opportunities.... however, I walked into this LTC a couple of years ago right after they opened and it was wonderful, I didn't think they would hire me because I was so green, but to my surprise, that's exactly how they wanted me! I was so greatful, my first job was horrible, I worked there just under a year and I did more there in clinicals than I ever did as an employee, I never got to touch a ventilator and I can honestly tell you that I am a pro at giving neb treatments...hehe

isn't that sad!! Anyways, the pay here is so depressing even at the top hospitals and I still have a 14 year old at home which takes me out of the possibility of becoming a travelling therapist, at least for 4 more years....

How come they don't tell you all this IMPORTANT information in school? Hey, all you nurses to be, rt's to be, cna's to be, did you know that when you get out there on the job, you'll be short staffed, running your a@# off, lose 40 lbs in less than 6 months, never get breaks, put your hard-earned license on the line, all for a couple of pennies a day because the bulk of your new salary will go to taxes and outrageously expensive insurance with prescription coverage eating away your food money and you have to go in every day, never call off sick, cause if you do you'll be written up, work every one of your off days, and every six weeks your schedule will change, you'll work nights, days, weekends, EVERY HOLIDAY, and instead of getting double time for your holidays worked, you'll only get time and a half....

HAPPY JOB HUNTING GRADS!!!

Oh Dear Lord up in Heaven, Please Bless me and The patient's I don't kill today....

Thank you all for listening/reading my rampaging ramblings...

I sincerely appreciate you all!!

I'm almost 40 years old, I've raised 4 daughters, I have 1 grandchild and believe it or not, I've lead quite the sheltered life!!!

I have so much to learn....

uggggghhhh, life is so exhausting...

thanks again, you have all made me feel so much better....

[kate1969]

I think that's what they're trying to turn my place into.... :)