This situation is weighing quite heavily on me so I'd like to get some advice. All responses, no matter how brutally honest, are much appreciated. Sorry for the long post. Here goes....
My evening consisted of 5 patients of my own (2 vents & 1 on 3 critical gtts). I was also responsible for covering the LPN's 3 patients that all required frequent IVP narcotics, IV antibiotics, am labs, and 1 of hers was on a vent. So I'm responsible for 8 patients.
Charge nurse had 7 patients. Several vents/critical gtts. LPN had 7, 3 of which I was essentially responsible for. 1 aide that spent the entire shift in the restroom, breakroom, anywhere but the floor.
Administration was called several times. No one returned our calls.
We barely make it through the night. I check the schedule for the next night & realize that myself, the same charge nurse, and a LPN are on the schedule. No attempts have been made to contact agency even though scheduling has known for 4 weeks we were short on this night. While leaving the charge nurse informs me that she will not be coming in the next night due to the awful night we had just had. So that leaves myself and the LPN tomorrow that would be responsible for the 19 patients.
I call the next day to see what staffing is like. I'm told it's me & the LPN. The charge nurse called off. They left messages for agencies but none have called back. They also left several messages for administration, but they haven't called back either. So I call back 2 hours before shift starts & it's the same situation. So knowing the ridiculously unsafe night ahead of me, I too called off. I've been a nurse for 18 months & the previous night was my worst night. I never let things get to me, but I allowed myself to lose control and cry. I just felt so overwhelmed...I felt I couldn't give my patients the care that they deserve. I couldn't knowingly walk in to the same situation again the next night, especially being a new grad and not having a resource.
Am I wrong for calling off? Am I not a team player? I feel sick stressing about this? Please advise.
Adding to what others have said, here is what I suggest. When you are at work and staffing levels are at a level that is unsafe for the patients or your license, write up an incident report. Include the face that the calls to administration were not returned. I can assure you that not all resources were contacted.
Every hospital has a Director of Nursing, Chief Nursing Officer (what ever it's called there) and that person is a nurse. If that person did not return that phone call, there's trouble. She/he had no way of knowing what the nature of the call was. Just make out an incident, every time, and keep a copy.
Wow! I think the OP on the basis of saftey , protecting her license and getting mgment's attention. The only quibble I would have is that you called in so close to your shift.
What kind of operation is this? I can't believe a hospital would have that level of unsafe staffing. Can you let us know what happened and I would assume that they did not let the LPN work by herself that night, that would be impssible so I'm assuming that additional staffing was called in.
What did your charge nurse have to say the next day? Were any meetings called? You may want to consider xferring to another dept if it's different there or looking for another place of employment if this problem is systemic.
I don't know what I would have done had I been faced with the same situation. I probably would have called off myself but with 6-8hrs notice. The ultimate thing is protecting your licence. Admin rarely stands up for nurses in case of a sentinel event.
Specializes in Oncology; medical specialty website.
I think you shouldn't have called in for the patients' sake. It only makes situation worse. I see it's a danger to be short staffed, but even less staffing doesn't make it better. Being short staffed is bad already, but no staff is the worst, right? LPN is restricted with her scope of practice here, so no nurse to do IV push meds then? Poor patients, I feel sorry for them most.
I think, in this type of cases where we're short staffed, everybody should make attempt to actually come in and help, not run. This makes you a trust-worthy, and dependable employee. This is also a plus when you go for and interview and tell them that you've done it.
I also agree that, it is fishy that you called in after asking staffing. Believe me, they most likely know you called in because of this
Well I hope they find a solution for staffing soon.
When it's a chronic issue, "manning up" and coming in in spite of poor staffing doesn't make you a trusted/valued employee, it makes you a doormat. As far as the LPN, well, she chose to work on that type of unit. I don't feel sorry for her because her practice is restricted. I do feel sorry for her as a fellow nurse for having to put up with understaffing.
However, given the nature of how you called off--calling in to check staffing first--I'd probably start looking for another job. You've definitely put a target on your back, even (especially?) if you forced their hand regarding better staffing. In addition, if these staffing levels are more the norm than the exception, your license is indeed at risk.
Next time, peek at tomorrow's schedule before you leave. Then if you want to call off because you're understaffed, just call off.
I really hope they found staffing for the LPN. Actually, they would have to...legally, an LPN can't be without an RN when there's meds that she would need the RN to check or administer, etc. What kind of floor is this? 1 patient that was on 3 critical drips? Are we talking neo, levo, and some other drip at the same time? And, 4 other patients plus helping with others?
Very unsafe. There's a difference b/w non-ideal short-staffed and unsafe, and that sounds unsafe. You do know that you could have shown up to work, and if they didn't have an acceptable assignment prepared, you could refuse the assignment before receiving report. Or better yet...when you called to work that day, you could have told them that so that they had time to find someone. I would have still gone to work, and asked what my assignment would be. If it were that bad, I would have asked if there was anyone that could stay or if the manager would like to step in to help, that we need the manager to help or some other leadership person if no other nurse is available (NM is still an RN). That way, it shows that you're there to do your job, and you're not just saying "no, won't do it" "no, won't do it as it is, but I'd be happy to call the manager and explain that patient safety is compromised with this staffing level." etc Otherwise, it's too unsafe, and I would tell them I can't accept report. If you tell them you can't accept report, odds are the tables would turn.
I've never had to do anything like that, and I'm not one to ruffle feathers by any means and never complain, but that is definitely something you have to speak up about. You did what you had to do, but rather than calling in sick, it would have been better to confront the problem (more honest), and more likely to arrive at a solution to the problem.
I don't blame you for calling off. Please let us know what happened, and who covered the unit. I'm curious to know how many nurses it took to do the job of two experienced nurses.
Dark humor... LoL! @ the fact she waited till 2 hrs before her shift to say or do anything. LoL!@ the fact it's crazy that as a profession in 2012 we haven't gotten closer to management mandated to treating us better. LoL!@ the fact that it is so Unamusing that it is.... No one would be ok with their family members being taking care of by nurses underneath those staffing conditions.. Y is this even an issue? The nursing profession should be the most powerful entity in healthcare yet we are so weak it's ashame...
DixieRedHead, ASN, RN
638 Posts
Adding to what others have said, here is what I suggest. When you are at work and staffing levels are at a level that is unsafe for the patients or your license, write up an incident report. Include the face that the calls to administration were not returned. I can assure you that not all resources were contacted.
Every hospital has a Director of Nursing, Chief Nursing Officer (what ever it's called there) and that person is a nurse. If that person did not return that phone call, there's trouble. She/he had no way of knowing what the nature of the call was. Just make out an incident, every time, and keep a copy.