staffing

  1. One would think, in these times of severe nursing shortages, that administrative people would try not to piss off their existing, experienced staff. Makes sense to me, but then, I am not in administration. I work in a small, level 2 trauma er in a big metropolitan poor neighborhood. We have 10 beds. We have, in the past, had 2 rns, 24 hrs a day, with a middle rn working 11a to 11p, and a secretary from 12p - 8p. New CEO has chopped the middle shift to 12p-8p. The person that they put into this new position does not have a us rn license. (They found this out after she had been working as an rn inthe er for about 2 months, go figure . She is now basically working as as intern, until she gets her license in jan. 02. She has already failed the exam once. To make a long whine short, we are getting killed. We get so busy in the late evenings, that we have to close to EMS traffic. We are supposed to triage within a cetain time period when a patient enters the door. We have had people leave after 2-3 hours who have not been triaged, because there is no one to do it. Last week, I was the only person (besides the doc) in the er, because the other rn had to accompany a vent. OD pt. to CT. What, if anything, can we do? We complain, but at a meeting yesterday, our mgr. said we should remember why we got into nursing in the first place. Well, it wasn't to run my a** off while trying to do everything myself (and keep my license). Any suggestions? Are other er's staffed this way? Why do nurses allow themselves to be worked to death? This can't go on much longer.
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  2. 15 Comments

  3. by   klieben
    There is one answer here. Administration is not going to listen to you until they have to. The only way to force them to listen to your concerns is to speak as one voice. We often like to think that administration will see us as the professionals that we are and take our concerns seriously. I've never seen this happen out of the goodness of their hearts. You have to unionize to make them sit down with you and talk about what is happening. Nurses have a certain amount of power right now being in a shortage, it is time to come together and use it!

    United we bargain, divided we beg!
  4. by   deathnurse
    Call your state health department and ask them to drop by. Doesn't sound like they are running a "real" trauma center and may not meet expectations in light of the changes.

    Tell the newspapers, radio, and TV journalists. This may not work if they are receiving advertising money from your hospital, however.

    Tell your customers to do the same. Don't ask them, tell them.

    Remember: No one cares about healthcare until they are waiting for it. And NO ONE is getting adequate return on their insurance dollar. They also need to complain to their insurance companies.

    Forget about your hospitals managers. They have another agenda.
    Last edit by deathnurse on Nov 30, '01
  5. by   canoehead
    I have another question...why is that person who claimed RN status, but was not an RN still working at your hospital? Sounds like she lied on her application.
  6. by   Uptoherern
    I have no idea how the nurse that was "imported" got thru the hiring process with no one realizing that she didn't have a U.S. license. We all wonder... but I don't think she lied about having a license. She is allowed to dishcharge and triage (with a co-signature by a licensed rn), she is allowed to start iv's (non-medicated such as ns or lr) but is not allowed to give any meds. Therefore, all she does is triage or stand around. gack.

    I am wondering about unions. The nurses at St. Joseph's hospital (catholic healthcare which has about 3-4 hospitals in this area) , recently voted on whether or not to unionize. They ended up voting not to unionize. I can not think of any negative reasons NOT to unionize...the nurses would have a stronger voice, and more power to influence decisions in the workplace. The only negative reasons not to unionize that I can think of are from an administrative point of view...

    Why would anyone NOT want to unionize...what are the negative consequences? Does anyone know?
  7. by   canoehead
    God, get that girl to work, she can do vitals, comfort measures, toileting, transporting.

    And get her out of triage, you need an experienced nurse in there to spot all the subtle danger signs.
  8. by   shay
    Heinous, absolutely heinous. And management WONDERS why nurses are fleeing the bedside in record numbers.

    Look, yes, I think the going to the media idea is an especially excellent tactic. And calling the state health dept. or ombudsman (do they even have those for ED's?) or whomever else 'regulatory' that you can get in there to see what a hellhole it is. Nothing prods mgt. to get off their collective a$$es like bad press and the health dept. breathing down their neck. Also, CALL YOUR STATE BOARD OF NURSING. Get them involved. Blow the whistle at every turn you can.

    I don't know what to say about unions. I have never lived where there are unions in existence, and have my own reservations about them. However, they seem to have a very strong presence in the northeast, and it can't hurt to look into it.

    I also agree w/canoehead, get that unlicensed woman out of triage and get her functioning as an NAII. She can do MUCH, MUCH more. Triage is a dangerous place for an unlicensed person who's already failed boards before.

    Finally, I work in a hellhole, too. Our management has her head permanently grafted to her anus, and probably wouldn't even BLINK if the whole unit were to go up in flames. Our nurses are leaving in DROVES (I'm one of 'em). Our docs are FURIOUS. Furious to the point that the CEO and DON have recently been FLOODED with letters from our docs. Last night yet another doc found out that me and another nurse will be leaving very soon, and said, 'Well, then, I suppose it's time for Mr. [CEO] to get a letter from me...tell me what it needs to say so we can stop this.' GET YOUR DOCS INVOLVED. Docs don't like giving crappy care, either. They don't like losing good, experienced nurses that they're used to working with. GET THEM INVOLVED. When a lot of docs start *****ing, higher-ups tend to listen. Angry docs usually get their way, ONE WAY OR ANOTHER.

    If nothing changes, GET OUT. Protect your license and GET OUT. You can't afford to work in a place that puts your license AND SAFETY at risk on such a regular basis. No sense in making yourself a martyr for the sake of 'the cause' if 'the cause' is going nowhere.
  9. by   LynniNurse
    Nurses are leaving in droves from our unit, as well. We use agency nurses to cover at least 50% of our staffing needs. But still our management continues to needle the remaining staff with the most pettiest of things. Our director won't even say a pleasant "hello" when she shows her face. The only time I've talked with her in the last 4 months since she took over was the three times she's called me in to discuss my attitude towards management. Well, my attitude would be greatly improved if we weren't understaffed, if we weren't treated like children, if we were ever given a pat on the back, if we were ever shown any appreciation of any kind. Morale is in the pits and I, like so many others, am about to bail! When will nursing management remember what it's like to work in the trenches and give the bedside nurses some respect? I just wish I could work for a human being with a heart instead of a budget conscious idiot that doesn't know a damn thing about the type of nursing we do on our unit. Management's lack of understanding, lack of people skills and cut throat mentality is why nurses are running. When will they get a clue???
  10. by   shay
    Originally posted by LynniNurse
    Nurses are leaving in droves from our unit, as well. We use agency nurses to cover at least 50% of our staffing needs. But still our management continues to needle the remaining staff with the most pettiest of things. Our director won't even say a pleasant "hello" when she shows her face. The only time I've talked with her in the last 4 months since she took over was the three times she's called me in to discuss my attitude towards management.
    Typical, how typical!!! My manager demon from hades is the exact same way. She's only *fake* nice to you if she wants something. None of us trust her any farther than we can throw her. Has she even BOTHERED to ask any of us why we're leaving? NOPE. I tell ya, more than money, more than location, more than job perks and benefits, nothing will bring in nurses like good management that shows respect and caring for their nurses. It just floors me the way so many managers just s*** all over their staff and then wonder why no one wants to work there. Just makes me ill.
  11. by   Uptoherern
    I think that most administrators have their collective heads buried in the sand. They attend meetings to discuss what their next meetings should be about.

    I have suggested that the middle shift be "shifted" to at least 3p to 11p, since this is when we are busiest. Asking that the entire 11a to 11p shift be returned did me no good. Suggestions from the nurses, though, seem to fall on deaf ears.

    I will also talk to the nurse-with-no-license, (again), and suggest charting vitals, checking patients, etc. She is willing to do what we ask, but has NO initiative. ( I also have a hard time understanding her).

    Lord, it IS nice to ***** and whine to someone!
  12. by   Ivy Purdom
    It is no better in England, I work on a 30 bedded care of the elderly ward for acute medicine and palliative care, there are 2 staff on duty, myself & a nurses aide, we work for 11 hours without a break, have tried talking to management to no avail. The unions have been ineffective to say the least, would love to hear of solutions.
  13. by   outbackannie
    Well, our crew took a stand today! I work on a Med-Surg floor.
    The local nursing home had already turfed 7 of their total-cares to us. When we got a call from ER that they had another, my colleages and I said "No. It is not safe to take another patient."
    So, they called the CNO. He called and wanted to know what was going on. When we told him, he said he'd back us up on our decision and he would come do the admission papers aand orders if ER would hold the patient until change of shift which was better staffed.
  14. by   MoghraRN
    I have recently started a job at a "unionized" hospital (about 4 months ago). I was worried at first about the union and the sometimes negative tune that word has but now I am absolutely in favor of unions. The staff at my hospital talks of the better pay, better nurse/pt ratios, and the ability of the charge nurse to say no to an admission because the floor is drowning as GOOD things that came from the union. And best yet, everything is written in the contract and not even management came break the contract!

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staffing