Short-staffed

Specialties Med-Surg

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What are some experiences you have had when you have been forced to work a shift or are short at least one RN?

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Specializes in LTC,HOSPITAL,HOME CARE,TRAVELING.

We tend to suck it up and pull together to get things done cuz you know and I know no matter how much we gripe it still has to get done and they can't pull nurses outta their butt's as much as we would like them to.You can almost bet though that you will have one patient if not more that has a crisis and need to be transferred to icu or something and usually first thing in the morning when you are trying to go home,lol.You get used to it.Hope n pray you have a good team to work with.

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Agree with wings, you suck it up and get the job done. If unit is consistantly short and no help it in sight, then many vote with their feet regarding the issue.

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Specializes in LTC,HOSPITAL,HOME CARE,TRAVELING.

I agree with gitterbug.If it is consistently short many use their feet,but the grass is no greener anywhere you go.We are all short everywhere.Just a matter of if you have a good team to work with or facility ( mostly team:)).

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What are some experiences you have had when you have been forced to work a shift or are short at least one RN?

what "experiences" have I had? Well, no breaks for starters. Too many patients, with too high an acuity for good or sometimes even safe care. Care techs who use the shortage as an excuse to do even less; they know we're running frazzled and aren't checking on them to see if they did turn that patient, or whatever. Staying too long after shift ends because there was no way to chart on that many patients when I spent the night running meds and doing MAR reconciliations.

But like the others said, it's a fact of life on many units, and nights on med-surg is a prime example.

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Specializes in m/s, icu.

As a new grad, my first night shift ( had done days for 2 m. solo). We had 19 pt (full house for us) 2 RN's: me & a per diem nrs!! I can't remember if we had a nurse's aide on that night or not I was in such a fog. No one died or fell is all I remember!!!

Five years later and we have been told by administration on more than one occassion "we take patients until we are full" and that we nurses "are replaceable" No pity when the acuity is high. :( I have considered writting up incident reports each time we work short for documentation. The hosp has developed an 'acuity form' which has the RN's write in acuity points for each patient, then adds up the whole unit. The number ranges specify how many nurses and aides should be on duty. Many times the numbers add up to be off the chart and we were still told to take admissions. It's easier to take it head on then to fight with shift supervisors over & over again :argue:

(very mentally exhuasting). We all pull together. Someone will start getting a pt history from the electronic chart, another will get care plans ready. When we have no secretary (which happens nightly from 3a-5a) someone else will start throwing a chart together or entering orders. Someone to get IV fluids, pumps, and tubing ready is also huge help.

I am at a cross roads at this facility. It is a rural hosp, the next hosp. isn't for 25miles. My choices are limited. I come home feeling like i've been run over by a truck. I could change units but that won't change the lack of support from the suits upstairs.

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Here's my most recent experience: A fresh post-op (BKA), 2 Murphy gtts, a second day post hip replacement, and a 89 year old post fem-pop that took a sudden turn for the worse and died within 3 hours of the beginning of my shift. Between the frequent assessment and vital signs on the fresh post-op, keeping check on the two murphy gtts, and putting the hip replacement on the bed pan numerous times because our orthopedic surgeon d/c's foley's on the evening of surgery, I had been running non stop when my fem-pop went south. Of course, as soon as I realized she was going bad, everything else took a backseat, but I still wonder if I hadn't been so busy would I have noticed a little sooner and could it have made a difference. I know we aren't suppose to beat ourselves up over a pt. demise, but the reality is, we don't see alot of pt. demise on our floor as opposed to other floors, so it does bother me when it happens to one of my patients, especially when I've been so busy that I can't give the type care and attention I'd like to give. Oh, and this particular day, we didn't have a unit secretary, and we don't employ CNA's/Techs so EVERYBODY was running around crazy. Morale at my facility is in the toilet, and in fact, I know of quite a few nurses who are doing PRN at a competing facility getting a foot in the door so they can move on.

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Specializes in med/surg, telemetry, IV therapy, mgmt.
What are some experiences you have had when you have been forced to work a shift or are short at least one RN?

I've never been "forced" to work any shift. Coming in to work is always a decision on my part. I can always say "no". Unless they sent Guido to my door, I wasn't going in to work when they called and told me I had to come in. Just to make them understand, over the years I developed a little orificenal of surefire reasons. The best one is "I've been drinking and I'm in no shape to work or drive." You might want to write that one down. Another is "I'm babysitting for XXX and I can't just leave these kids."

As for working short a nurse (or two)--that's when you have to determine your priorities. The first thing that I crossed off my ToDo list was a lot of the routine stuff that didn't absolutely need to be done. That included a lot of ice and water passing, cleaning up of the rooms, bed changes and baths. Basically, it was do meds and treatments. If any of those were getting behind, antibiotics and pain medication got priority. I also would call the supervisor who was on duty and ask if he/she would help out and I would give them specific tasks that needed done. If you tell a supervisor or someone who has come to help out "I need help" a lot of times they won't respond as well as if you give them specific tasks. Tell them that you would really appreciate it if they would do the dressing on the patients in Room 2 and 6 or restart the IV in Room 10. That, they can deal with. Then, when there is any time when you are freed up (ha! ha!) you pick up the slack with the things you have put off.

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Sorry but water is important to me, so I try to fill pitchers for my patients once a shift if no CNA. If the orders are done, then putting the chart together is no big deal, meds, IV's, dressings, assessments, and chart checks for missing orders are big with me. I tend to chart in depth, so I have issues with 2 lines on a critical patient. I like to work with another nurse who will buddy with me, we help each other turn patients prn, cover lights, share VS, and double check some orders. Those days are getting fewer and fewer, but it is nice to have trust worthy team-mates. I do not gossip at work, so I tend to have a different focus than some of the other nurses. I just do not care who is dating the married doc in the ER, who is gay, who is meeting in the parking building for a "quickie", or such . I will freak out if the narcotic count is off, and no one better leave until it is correct. Supervisors give me a rash, I never get one when I need one, and when she comes generally have handled the crisis. I had one tell me I should have cleared calling the doctor with her, I asked her what she would have done if her patient was having a BP of 210/110, confused, rt pupil blown and face drooping. She said call the doctor of course, I said we agree, so I did not waste the 20 minutes it would have taken you to answer, got orders for the ER doc to evaluate the patient, a ICU bed, an emergency MRI, labs, and emergency meds. She did not like me, but she respected me. More importantly, the patient was cared for. Nursing, love it and hate it, but never think it is dull or boring.

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Specializes in Cardiac, Med-Surg, now in ED.

At my previous job, working short staffed was the norm, not the exception. Having a good team is great, but our admin loved to figure out who worked well together, then split that team up to strengthen the other crews. You just have to pull together, and get the job done. I agree that some of the less importnat things got overlooked, but by morning (it was a 12hr night shift), most everything was done. Yea, you leave feeling like roadkill, but the pts always came first. My darlin daughter came up with a line that I continue to use, "if nobody dies, its a good nite". That came from her hearing my DH ask how my nite went and me answering "nobody died". Sad but true, sometimes thats the best you can hope for.

I now work in a different facility in the ED, great team and great teamwork

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I left med-surg almost 2 years ago thinking that the grass on OB was much greener :chuckle Had me fooled! 10 patients and being in charge is not my idea of a good night. Then my manager tends to roll all the little duties that everyone thinks is a good idea to do, but noone wants to do it, onto the charge nurse checklist for night shift. Understaffing is also the rule and not the exception on my unit. One morning after having a bad night I complained to my manager that I was tired of having 7-10 patients along with being in charge and fighting with bed management about trying to send us a closed head injury pt because the progressive unit was full (hello, this is a postpartum unit here). When she finished checking her emails and voicemails while pretending to hear me and bobbing her head with a pathetic attempt at looking sympathetic, she says to me.....Oh it will get better and just shoooshed me out of her office. *****! Better? yeah, just as soon as I leave bedside nursing.

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i work at a ltc facility in nyc , nite tour..most of the time 1 nurse lpn.60 residents..3 cnas...

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