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.
I don't think you were wrong. That's really unsafe for you nurses, as well as those patients. It may look fishy, but with other matters tying their hands, they may not have noticed. I hope you find a safer job! :) Best wishes.
The CNO actually came to work & they were able to wrangle up one agency nurse. They even offered cash bonuses, but no one else was williing to come in. They've never offered cash bonuses. I'm assuming it was because the CNO was desperate because he hasn't worked the floor in forever. So it was again 3 nurses caring for 19 patients. The most sick one being on hep, levo, amio & i how did i forget insulin gtt w/q1 accuchecks.
This was definitely a learning experience. I agree I could've called off sooner. I called to check in with the hopes that the staffing was addressed so that I could come in. I actually wanted to work, just under safe circumstances. When I finally called off, I was honest about the reason. I was told the CNO would be notified of my reason & that I was not being a team player. Hopefully the CNO will get it after working under those conditions. Oh well.
...When I finally called off, I was honest about the reason. I was told the CNO would be notified of my reason & that I was not being a team player. Hopefully the CNO will get it after working under those conditions. Oh well.
Again, thanks for all of your advice!!
This is management's way of saying, "How dare you to consider anything other than our bottom line! Remember, we are important and you are not!"
I was told the CNO would be notified of my reason & that I was not being a team player. Hopefully the CNO will get it after working under those conditions.
Funny how it's "team playing" when they need help but when YOU (the nurse) needs help you can hear the crickets chirping as you wait in vain.
Unfortunately, I'm not sure your CNO will get it after this one experience...things may improve slightly but I'm sure they will try again to get away with using as little staff as possible.
Like I said: there's that target on your back.
I still don't blame you for calling off and hope things improve there for you, but IMO I stand by my earlier advice: start looking elsewhere for something--be it FT/PT/per-diem--just in case your days at this facility are now numbered.
I really dread ending up in a situation like this because I am shy to demand this or that..even if I was not new. Someone replied that you should write it up as an incidence report and keep documenting..also putting that admin never responded to phone calls... So here is my question for those out there already and have dealt with something like this and it might help the OP too... Will reporting this everytime including the fact that admin never responded get you a quick boot out the door? I mean will they target me to quit since I would be a "threat" documenting every little thing just in case something happens? When it comes down to it...they do not care if a nurse loses their credentials because they can save face and fire someone and hire a new one in a couple of hours. So if I were to end up in a situation like this and report it will it pit everyone against me? I know I would need to be looking for another job and all but I wouldn't want to be kicked to the curb in case there wasn't another job I could get? My mom is a DON and I will call her up and ask but she is a DON in a dialysis center and not a hospital..I just want to hear from other nurses before I finish school and get thrown in the pit..what would happen if things are documented like they suggested? I have a MPH with some classes in admin. but they never taught us how to protect ourselves for not doing our own job such as answering phone calls..they just taught us how to protect ourselves in what to say and not to say in cases with law/dealing with the board or firing for someone else not doing their job...I am just pointing out the admin in this case did not do theirs and I have no interest in being an admin. only in being a nurse and how to handle an administration like this in case--what to say/not...etc because I have no experience with this situation yet....: l
nothing ever changes until someone loses a life or there is a serious incident. but the incident has to involve the patient, staff not included. i would have called out too, but you have to learn how to call out. never call ahead of time to get staffing numbers. i think someone said it already. look at the schedule for yourself before leaving your shift. good luck to you. hope everything works out and that this opened some eyes around there.:)
This is why we need national staffing ratios! Too many nurses are being forced to work in unsafe, unfair working conditions and the patients end up being put at risk and most likely end up neglected at the very least. It is very easy for management to claim they can't get staff when they can just work you short and pocket the change!
We need national patient ratios and the ratios described seem way too high to me given the acuity of patients! As long as administration can get away overworking and shortstaffing nurses where is there motivation to improve staffing when they can save money this way? It will take mandated staffing levels to get every healthcare facility to properly staff. In the mean time all we are left to do is vote with our feet and leave bad places to get a reasonable job. Sometimes it seems like finding a decent job is like looking for a needle in a haystack. Too many of us are just hanging in there hoping things don't get worse!
I do not think you were wrong for calling off but it probably will look suspicious that you called several times to check on staffing.
I hate all this nonsense hospitals spew about being a "team player". I'm an employee, not a member of a softball team and I refuse to allow them to take advantage of me. I work 36 hrs/week and that is my only obligation to them. Staffing is not my problem... there are nurses out there looking for work- hire some more and treat the ones you have with respect, lest you lose half your staff within the next few months.
The CNO actually came to work & they were able to wrangle up one agency nurse. They even offered cash bonuses, but no one else was williing to come in. They've never offered cash bonuses. I'm assuming it was because the CNO was desperate because he hasn't worked the floor in forever. So it was again 3 nurses caring for 19 patients. The most sick one being on hep, levo, amio & i how did i forget insulin gtt w/q1 accuchecks.
This was definitely a learning experience. I agree I could've called off sooner. I called to check in with the hopes that the staffing was addressed so that I could come in. I actually wanted to work, just under safe circumstances. When I finally called off, I was honest about the reason. I was told the CNO would be notified of my reason & that I was not being a team player. Hopefully the CNO will get it after working under those conditions. Oh well.
Again, thanks for all of your advice!!
i would love, love, love, lol! :) to see the charting done on those 19 patients. I'm willing to bet they weren't charted properly and it's good the CNO was dragged in and got to see and feel what it was like to work under those conditions.
I worked a bit in a free standing LTAC center and I can attest to nurses there being overworked. It was nothing to see med pass go past 30mins past schedule or seeing nurses take care of 6 pts many of whome were on vents, traches etc.
Personally, I could not work under those conditions and I would immediately begin to look for another job.
here's something for you, never, ever,never ever tell anyone u are calling out or call to check on staffing numbers before you call out. U must be smart about calling out lest u make it obvious.
Never tell staff members that you are looking for a new job.
I am curious to see if they were able to get in one or two, or more, nurses to replace you and the charge nurse? I mean if they weren't really able to get anyone in before what would they do without you and the charge there? Not sayng what you did was wrong or right just curious to see if under preasure they were able to materialize some nurses
The problem is calling in sick is not a realistic answer to an ongoing short staffing issue. I don't believe hospitals can't find staff, it's just a convenient excuse when the real objective is to save money any way they can. Also I don't think it is healthy emotionally or physically to continue to work in such a short staffed high acuity environment. It will do long term damage to our health in the form of anxiety, stress, PTSD, depression as well as HTN, obesity, and even increased risk of cancer and diabetes.
Years ago we used to have LPN's in the staffing mix, but they were phased out as the acuity level increased. I know LPN's have staffed hospitals and ICU's in the past and some still do, but I think it would be better to either change to an all RN staff or have LPN's as task oriented. Nothing against LPN's per se or their ability, but just from an RN standpoint we are responsible for what they do and have to oversee their patients and do what they are not allowed to per each state they work in. Just adds to the RN work load and stress level, where as if each RN had their own assignment they would be responsible for less patients over all and not as overwhelmed or stressed, provided staffing ratio's were fair and safe.
nguyency77, CNA
527 Posts
I don't think you were wrong. That's really unsafe for you nurses, as well as those patients. It may look fishy, but with other matters tying their hands, they may not have noticed. I hope you find a safer job! :) Best wishes.