Adequate Staffing = I Love my Job

[MelBel]

So for some unknown reason, this past week my unit was more OVERstaffed than understaffed. I averaged 5 pts/night this week, and no more than 6. (8-9 is our norm)

Things that happen when we have enough staff:

- My meds are passed on time.

- I don't feel like I have to run out of the room as soon as I finish my assessment.

- I get to have conversations with my patients.

- I get to actually think about my documentation.

- I get to take actual BREAKS.

- If one patient is having problems, only 3 or 4 others need looking in on, not 7 or 8.

I don't know why this happened this week, but I just wanted to share some good! I'm actually smiling after work for once, AND I even worked OT this week. I have a 3 day weekend now, and althouh I'm excited, I'm also not in as much desperate need of it as usual! :lol2:

Hope you all get this sometimes too :)

[UM Review RN, ASN, RN]

I completely agree.

• Report goes faster and I can look in on all my patients and chart as I go, also, instead of skipping one or two charts until later.
  
• I really like being able to take my breaks when I'm ready, not when I'm too exhausted to have a choice.

Yes, it's much, much better when you have time to call the doc and pay attention to all of the patients, isn't it.

[EMTandNurse2B]

I feel the same way about my job. The nights we have enough staff I come home smiling. The nights we are short, I come home crying and work on my resume before bed.

[llg, PhD, RN]

Dear MelBel,

I'm very serious about this request.

Would you be willing to write this in a place where it might be seen by the right people? Not that we here on allnures are not the right people ... but I think it belongs in a few other places. For example: I think it would make a great "Letter to the Editor" of some major nursing journals, such as AJN or the Journal of Nursing Administation or one of the hospital administration journals.

It might do some good if nurses such as yourself would write such positive letters and put them in places where decision-makers are likely to see them. A few readers might start to link nurse satisfaction and decreased turnover with "better staffing."

Most of the time, those folks only see/hear nurses complain about staffing and retention. The letters and conversations about such topics are usually angry and bitter. The administrators tend to become defensive when faced with all that negativity. Perhaps if we all started to highlight the positive occurrances and give some positive reinforcement for good behavior ... it might help the decision-makers start moving in the right direction.

Perhaps we could start a national movement here and now. Reward those hospitals that provide good staffing with positive reinforcement and encourage them to keep up the good work. That might encourage more good work.

It's just a thought -- but it is a strategy we haven't tried.

[MelBel]

The other interesting part of this is that last night I had 4 patients. We only had 1 PCA, but it didn't make too much of a difference because every nurse had few enough patients to do their own total care. 3 of my 4 patients thanked me profusely for being so friendly, and taking the time to listen to them. I try to be friendly and listen every day, but when I'm running out of the room yelling "Need anyth......" I don't think I come accross as that friendly. Those same 3 patients also COMPLAINED about the PCA. Now she is someone I've worked with for almost a year now, and have NEVER had a complaint about her. I do know that she felt overwhelmed being the only PCA (usually we have two).

I'll have to revise my entry a little bit here, but I'll work on sending that out to a few places. :)

[llg, PhD, RN]

I'll have to revise my entry a little bit here, but I'll work on sending that out to a few places. :)

Thanks. It might actually help!

It would also make a nice essay or column. Some publications include those types of things.

[Chaya, ASN, RN]

For me the biggest thing about and "trouble'shoot" my pts. I know how I should do this consistently and I would love to but in reality, I get "tunnel-vision" on those crazy nights when we're just spread too thin. Patient care becomes a series of "check-offs" as I careen from room to room and try to play catch-up after the inevitable distractions of doing a job that can never be totally predictable. To really be pro-active and give excellent care I believe you need to have the extra time built into the system to allow for this. And extra time incurs costs in terms of personnel and money which our society does not recognize the real value of good nursing care enough to commit to.

[Imafloat, BSN, RN]

I agree MelBel. I have also noticed when we are staffed well (only 3 or 4 nurses under vs 6 or 7 under) that I and many of my coworkers are more willing to come in on our days off to work extra.

Another perk to being well staffed is that I don't drive home just knowing I forgot something because I was so busy. I work in a NICU and we are staffed well right now. I love that I have the time to give my patients the care they deserve, the extras like leisurely baths and being held.