Understaffed and sick of it!!

  1. 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" <nursing, cna's and rt's>. 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
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  2. 16 Comments

  3. by   muffie
    welcome to allnurses

    venting is good for the soul

    sorry to hear that work is crazy

    hope things improve soon
  4. by   cappuccino
    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. :spin: :smiletea2:
  5. by   indigo girl
    Quote from 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.Katie
    The only way the situation could change for the better is if the staff feels so strongly about the cutbacks that they are willing to walk if it does not get better. Safety is a big issue. Really, it is the biggest issue of all. If you and the others agree that your licenses are at risk and the situation is unsafe for your patients, than the staff should request a meeting and lay it on the line. You really must be willing to leave for this to work. Money is what is motivating the cutbacks, but they can not operate without the staff cooperating. I do not believe that they will be willing to find a completely new group of staff members to replace you. Do you?

    BTW, I am not advocating for anarchy, but I do believe in safety for patients and for staff.
  6. by   TrudyRN
    No easy answers. You must all band together and fight for safe care levels.
  7. by   st4wb3rr33sh0rtc4k3
    This is exactly what happens at the facility I use to work at. It was my first nursing job, and because the work load was beginning to burn me out I left. It was brought up several time to administrators, but they never did anything about it. I had up to 60 patients, depending on what shift I worked on. It was way too much. And if the aids were short there patient load would increase from 10 to 12.

    Dangerous, it is true. That is why I didn't want to stay I felt it was unsafe practice.
  8. by   linzz
    I wonder when the media writes about a nursing shortage, do they include the jobs where the facilities are so understaffed that staff is burnt out in months and each day the nurse wonders if she/he will have a licence at the end of day.
  9. by   indigo girl
    Quote from linzz
    I wonder when the media writes about a nursing shortage, do they include the jobs where the facilities are so understaffed that staff is burnt out in months and each day the nurse wonders if she/he will have a licence at the end of day.
    No, I don't seem to recall any mention of that.

    Tonight, I am working at a facility that saves money by having one nurse work two units. The other two units have one nurse each. I will probably have the double unit as I am the agency nurse. How my night will fly by!

    This is also the place that does not have TB syringes so if I have to give morphine SQ, it will be with a 1cc insulin syringe.
  10. by   withasmilelpn
    What do you think of a trach/vent unit with 12 patients, 1 nurse 1 RT (who also does trach care for the rest of the building and checks those on bipap at hs and o2 and the crash carts are stocked. Also assists with assessments and codes. Also (maybe) 1 CNA? Used to have 2nurses and 1 RT (no cna).
  11. by   RRTM2
    ]Honestly, I think you might want to think about moving on.
    ]Are there are other places to work now that you have some experience to back you? Have you considered acute care instead of a sub-acute/rehab type facility?
    ]I can see the value of a group meeting with administration but I think you're fighting the corporate monster there.

    ]I'm an RT too... just for a few years now too. I work in a faith-based Trauma Level ll hospital, and I won't say the loads are cake but they aren't dangerous either. Floors are 12-15 Pts with Txs; ICU is 5-7 vents with maybe a BiPAP, HHN, or a trauma Pt added during the shift. There is usually time to do your job thoroughly and also deal with the things that come up... be that a Rapid Response, a trauma, a Code, a trip to CT, extra ABGs/EKGs, or helping out with a Pt. The tasks that equal good Pt care, not just good time management.

    ]I realize you probably care about your Pts, especially long term vent dependant ones, and worry about their care if you weren't there. Leaving them would naturally evoke some guilty feelings on your part. But honestly, they will likely find another RT just out of school again who will be conscientious but unaware of the employment options who will pick up where you left off.

    ]I love being in ICU, keeping my Pts clean, the vents stable, helping out with basic Pt care. I know it's only assisting compared to what the RNs do, and the knowledge they use (not kissing a$$ here... I really do know and appreciate the skills. If I was younger I'd probably get my RN) but I feel like I'm contributing to someone's well-being, plus helping my coworkers. It's job satisfaction compared to honed time management skills.

    ]Another benefit is that I'm always adding to my knowledge of acute care. I had a vent last night... ICB, shift to the right, a Swan-Ganz, ventriculostomy, an IV pole that looked like a bunch of grapes. I only had the vent... the RN had all of that to manage. But it is sooooo much more interesting.

    ]Feel free to PM if you like. I read this site all the time because I learn so much... but I do feel like I'm butting in where I don't belong so I don't post much.

    ]Good Luck whatever you decide!
  12. by   gitterbug
    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.
  13. by   bassplayerrob
    I am also an RRT/RPFT and have worked as a Respiratory Care Practitioner for over 16 years and graduate RN school this May. I agree that healthcare in general with it's cutbacks causes facilities to be understaffed. Where I work, it is nothing for a therapist on night shift to go out to do 15-20 HHN txs and between the 2 of them cover ER, CCU, OB/nursery, ABGs, EKGs, ICGs, etc. During the day, I have done 3 rounds on a floor with 8-10 HHN txs and then 4 PFTs that day all in about 10 hours. Nursing is just as understaffed. It;s nothing 2 or 3 ER nurses (1 of the nurses doesn't work that often) to cover a very busy ER with 2 doctors working during the busiest part of the day. America needs help!
  14. by   indigo girl
    Quote from gitterbug
    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.
    Last edit by indigo girl on Mar 13, '07

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