Short Staffed - Vent

  1. I graduated in May 2006 and worked on a cardiac medical unit for 5 months. I started working on a cardiovascular thoracic recovery unit in November and have been off orientation since the end of January. I need to vent.

    Last night was awful. We were short staffed as well as having 3 fairly new people and an LPN working. We had a patient with an LVAD, patient with CVVHD, and were going to receive a surgery. At 2200 we needed 2 more nurses because 2 nurses leave then. If we wouldn't get 2 nurses then the manager and supervisor would have to take patients. The 3 new people, including me, can't take the LVAD. The LPN can't receive the case.

    Charge nurse takes the LVAD and LPN takes the patient with CVVHD. Newer nurse is receiving. Patient arrives and SURPRISE, has a balloon pump that we did not know about. Luckily the nurse took the balloon pump class last week.

    We find out we will be getting two resource people, one at 2200 and one at midnight. A day nurse that works 10a-10p agrees to stay to midnight. We have 2 teams that are separated and the day of surgery hearts are on one team so we have to shuffle assignments and split the two resource people up. They aren't supposed to take day of surgery hearts but desperate times call for desperate measures.

    The newer nurse with the balloon pump has no resource person on that team to help her out. She has to call the charge nurse on the other team if she needs help.

    Manager comes in the morning and starts drilling her about why her patient isn't extubated, etc. Honestly, she did the best she could, patient was safe overnight. It was her first balloon pump and she had no support staff on that team! She was pissed.

    I can think of two other nights that look as ugly as this. We have job postings but people aren't accepting jobs. Other units as well as other hospitals are offering bonuses except us. Also, they don't even offer bonus to get people to help us out! Other units offer bonus. I would rather pick up OT in ICU since they offer bonus. Everyone on night shift has been picking up OT on my unit and we are tired of it.

    The veteran nurses are getting tired and frustrated. What happened was a lot of the experienced nurses left at the same time. I am starting to get frustrated and I'm the new kid on the block.

    I will hang in there and see how long this lasts. I will have a year of experience as an RN at the end of May. If I switch jobs again it will be job #3 within a short time frame. I hate to look like I'm job hopping but what else is there to do. I love this patient population but the short staffing might throw me over the edge.

    Thanks for reading this long post!
  2. Visit incublissRN profile page

    About incublissRN, BSN

    Joined: Aug '06; Posts: 287; Likes: 51

    10 Comments

  3. by   aa24212
    I have never experienced anything this severe, however, the ICU where I work was having some problems similar to this. One night when it was really severe, a nurse anonymously called JCAHO and also state to let them know what was going on. JCAHO came and did a thorough review and told them either do something or lose accredidation, needless to say, they started getting more workers in with travelers, bonuses, etc.
  4. by   incublissRN
    Does someone have to get hurt before they offer bonuses and get more staff?? It's ridiculous. All night long I had this sick feeling in my stomach.

    I think some experienced nurses are going to approach the manager once they get their thoughts and facts together. I feel like I'm in a weird spot since I'm new.

    They asked me to come in tonight but I couldn't make myself do it. I know they will probably be 2-3 nurses short tonight and I feel bad for the nurses scheduled to work but I'm still angry.
    Last edit by incublissRN on Apr 24, '07 : Reason: added info
  5. by   Agency41
    My old manager left abruptly at 1530 regardless of how bad we were doing with staffing and absolutely refused to get us help i.e., sitters when there were doctors orders, CNA, etc. My husband can't understand why I want to work in a prison but I don't think people are knocking each over to get those jobs or "climb to the top" where it's like that in hospitals. I have 10 yrs. exper. as an RN & the only place I've worked in is a hospital & they're all the same. I'm done for now & am awaiting clearance to work in a prison in IL. Wish me luck. GL to you 2.
  6. by   josoknow
    Get this! Where I work in ICU the nurses are respiratory therapy. The nurses set up and maintain all ventilators with no respiratory backup, the hospital does not see a need for a respiratory department, the nurses can do all that a respiratory therapist does, per my hospital. We also set up and maintain bipap machines. I got online with my nursing board in oklahoma and basically we are practicing beyond our scope of practice.In our ICU there is only 2 RN's and a clerk to 6 patients. No aide to help, not even a lift in the hospital to help lift large patients, which we have a large population of bariatric patients. Nursing always gets dumped on!!
  7. by   clarkheart
    This is so unfortunate--the RT's I work with are invaluable to me in managing my patients. We work together on optimizing care. Come to California--we can always use good critical care nurses! You are right you are practicing out of our scope of practice--that is why RT's have specific certification and we have ours. They are experts in their field and us in ours.
  8. by   josoknow
    Quote from clarkheart
    This is so unfortunate--the RT's I work with are invaluable to me in managing my patients. We work together on optimizing care. Come to California--we can always use good critical care nurses! You are right you are practicing out of our scope of practice--that is why RT's have specific certification and we have ours. They are experts in their field and us in ours.
    Thanks for your support! I just may come to california, I plan to start traveling the first part of october.What really chaps me is that it will take a patient dying before things are changed. I think we are the only hospital in the US that places patients on ventilators and does not have RT to help care for them. If there is anyone else on this planet in my situation I would like to know who. By the way how is it to work in california? Do they really stick to the correct nurse-patient-ratio. I also heard you actually get lunch breaks and get to leave your area, are these just really nice rumors or are they true. I understand california has paved the way for nurses, We need to unite and stand up for our rights the way you have.
  9. by   josoknow
    Does anyone else out there have problems with their house supervisor. I work ICU and our house supervisor thinks we are here to supply the rest of the hospital when they are short. NO RESPECT!!!!!
    When we are pulled she is not even courteous enough to ask us face to face, she calls our clerk and tells him to tell us to go to ER or where ever.Again, NO RESPECT!!!!!
  10. by   clarkheart
    Sorry--been away for awhile--In California there is a state mandated ratio of no more than 2 patients/1 nurse. It's the law -hospitals have no choice but to follow the ratio. We have always had a number of travel nurses from everywhere who end up staying as long as a year or more. The pay is more (and so is the cost of living) but I wouldn't work anywhere else. I work in Northern CA north of San Francisco.
  11. by   incublissRN
    Update:

    I have just accepted a job in PACU. I've worked in cardiac recovery for 2 years now. The short staffing and management issues have continued and I'm tired. I'm ready for something new!
  12. by   incublissRN
    Quote from josoknow
    Get this! Where I work in ICU the nurses are respiratory therapy. The nurses set up and maintain all ventilators with no respiratory backup, the hospital does not see a need for a respiratory department, the nurses can do all that a respiratory therapist does, per my hospital. We also set up and maintain bipap machines. I got online with my nursing board in oklahoma and basically we are practicing beyond our scope of practice.In our ICU there is only 2 RN's and a clerk to 6 patients. No aide to help, not even a lift in the hospital to help lift large patients, which we have a large population of bariatric patients. Nursing always gets dumped on!!
    I can't believe that! Our RTs are worth their weight in gold. I rely on them frequently. I don't see how you get anything done!

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