Double the staff....

[Brian, ASN, RN]

Understaffing a problem for you? Well, AN has the solution: cloned nurses! Now if we can just get the CEOs to buy off on this idea.... In all seriousness, how do YOU deal with understaffing? Is is a chronic or occasional issue?

[MyCall2Nsg]

Under-staffing is a chronic problem and I believe it has to be dealt with from an administrative level.

One of the ways we can get them to hear us or get our attention is through incident reporting.

Each time we experience near misses because of lack of adequate staffing we should write an incident report. These will get their attention especially when too many of them are being done on the same subject. If it's in writing it becomes their problem to solve. If we do not report then they have nothing to prove that this is a problem.

In my current situation as team leader I frequently have to say "no" to additional admissions to our

unit because we are staffed with the bare minimum staffing and when we have met our quota of RN:Patient ratio then we are "Full" even though there may be plenty of beds available.

I try to accommodate the patients that are unique to OB/GYN as much as possible because.

I cannot send these patients to other units in the hospital. On that basis I will communicate to bed control

that due to the number of patients currently in labor (who cannot go to other units postpartum) and any

pending ED admissions with other GYN related issues, I cannot take another patient on the unit.

That usually takes care of the problem for that moment only, but the cycle repeats itself later in the week

or so many times over.

I believe if this is brought to the attention of the administrative body they would look into what can be done to address this problem. After all, everyone is big on patient satisfaction and a patient is not satisfied sitting in the ED waiting for a bed. Equally, a nurse is not satisfied when he/she is made to take on additional assignments beyond what is safe.

Often nurses are "called off because" census is low, other times enough nurses are not schedule because of oversight. I believe it should be a common practice to have at least one nurse on call for areas that are likely to have an increase in census as the shift progresses.

In summary, incident reporting, saying "No" and looking out for the staff so that they are not overwhelmed with a crowded assignment, and advocating for "on call" help as needed is how I choose to deal with this chronic problem.

[amoLucia]

to mycall2nsg - How do you know that your incident reports won't just make it to the shredder/garbage can??

I can understand your other approaches and give you credit for seriously trying to improve the chronicity of inadequate staffing.

[MyCall2Nsg]

Incident reporting at the hospital where I work is through an Event Management System. It is sent to more than one area in the hospital "electronically" Risk management being one of them.

[imintrouble, BSN, RN]

Where I work, incidents are viewed as a failure of the nurse involved.

If an error occurs, it has to be because the nurse wasn't organized.

Took too many breaks. Didn't ask for help. Didn't clarify. It's never because of understaffing. Even when it is.

How do I deal with understaffing? The first thing to go is breaks.

I don't leave the floor. Then the call lights sound longer. Then the niceties don't get done. Pillow fluffing, warm blankets, fan requests, "change my channel", "Call my daughter",......

On a really bad shift, too much stuff gets shoved onto the next nurse, and you get the reputation of being lazy and disorganized.