Coping with large patient assignments due to staffing issues

Nurses General Nursing

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Hello nurses!

At my hospital I am the chairperson of the process improvement committee. I haven't been a nurse for very long, but the committee was in need of some help immediately so I offered my time. But I need some help and ideas for running the meetings!!!

The most current issue my hospital is facing right now is staffing issues. Our census dropped so low over the past year that the entire place downsized, including nursing staff. We pretty much we're cut in half. But now that flu season is back we are facing desperate staffing problems. We are caring for more patients with less resources. We are all getting burnt out fast and the overall moral is very low.

unfortunately when talking to some friends at other hospital systems, this problem is not exclusive to where I work. Everyone pretty much has some sort of staffing problem, where the nurses are expected to do more with less.

My question is this: Nurse to patient ratios are not going to get better it seems. So how can we as nurses deal with a larger assignment? What can we do to improve the process for our own work day? What little things can help us do our jobs faster and more efficiently when we are under stress from having too many patients?

Ive be realized at this point complaining will get us nowhere. We have to start helping ourselves and thinking of ways to improve our care and our environment.

Can anyone help us out? We need ideas!!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

What kind of ratio are you talking about?

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Specializes in Gerontology RN-BC and FNP MSN student.

Hire more nurses. Keep a prn pool.

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No quick fix for this one. I would recommend full staffing of CNAs and unit secretaries on all shifts. We can't do our increased workload and spend time answering the phone as well.

How about agency nurses for high census?

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7patients to one nurse, sometimes 8 on a telemetry/PCU floor.

I wish I had the power to hire nurses but that cannot be changed right now. I need ideas for the nurses to help deal with more patients

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I didn't mean staffing cannot be changed, I just meant I have no power or authority in that area.

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Specializes in Oncology.

You're going to have burn out and unhappy nurses and med errors and unhappy patients when you have unsafe ratios like that. No amount of strategizing or team building activities is going to make that staffing seem acceptable.

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Yeah unfortunately there aren't any hidden secrets to making that manageable or safe. I know you are trying to help, but sometimes adding more staff is the major problem. I guess making sure everyone works as a team. I can't see covering for each other for breaks as the patient load would be just too dangerous. Maybe suggesting that they have a nurse just to cover lunches so that everyone gets a break in the day.

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7-8:1 on telemetry/PCU is NOT acceptable, let's get that out of the way right there. At the same, if that's really how it is, while you're looking for a new job I like the idea of making sure that all shifts are FULLY staffed with clerical and NAs. If this means getting PRN CNAs, so be it.

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It sounds like you're on your units UPC. As such, UPCs do not deal with staffing. You are correct--your only option at this point is to change the processes.

With that said, you, as a floor nurse on this unit, know the processes that take the most time. You know the ones that don't make sense, that need to be updated, etc. You also know what needs to remain in place for patient and nurse safety. YOU are on the committee, so you need to talk with your other staff nurses and determine if there is in fact anything that can be done to ease the burden on nursing until more staff is hired.

I empathize; our staffing is also severely reduced, at times to the point that I'm the only RN in my 5-clinic outpatient setting. It's a nightmare. Hang in there, document everything, and if you feel your license is truly in danger, leave!

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You will need to get management involved for this one, but you will need to be strict about what kind of patients can be transferred.

Anybody at all unstable (the ICU needed a bed) isn't a candidate for those kind of ratios.

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Specializes in Critical Care; Cardiac; Professional Development.

7-8:1 on PCU would have me calling safe harbor. I would advise you to host an in service reminding your nurses of this option. Those ratios are unconscionable, which tells me the "normal" ratios are already dangerously high.

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