Fed Up With Understaffing

oramar · Oct 18, 2008

Our hospital has started deliberately understaffing the floors. No secretary. Only one tech for 18 patients. No phlebotomy department. This is not because we don't have enough staff...they actually send techs home all the time because they have redesigned the staffing grid. As a result, the nurses are now the secretaries, the lab, the tech, etc. We usually work one to two hours over our shift.
The management is getting tired of the nurses clocking out late and attached a note to our pay checks that said we must clock out on time. If we don't, we must fill out a form that says "why" we didn't and then have the charge nurse sign it. Of course, the charge nurse has six patients of her own. We are always so swamped, that we are not in the position to help one another. We never take lunch and usually don't even have time to pee. We are encouraged NOT to fill out a missed lunch form because we must also list all the reasons why we did not take lunch. We must also have this "approved" by the charge nurse.
The management thinks we are so dense that we don't realize they are hoping we won't have the time to fill out these forms and, as a result, won't get paid for these extra hours. One manager says she doesn't understand why we can't get our work done.
It took everything in me not to look at her and say, after my 14 hour shift, "You are a horrible human being. How dare you treat your employees this way." I have been a nurse for ten years and I can't believe how bad it has become. I am seriously thinking about a different career. Am I wrong to assume that satisfied employees make satisfied patients? Our management cares NOTHING about the patients. If they did, they would make sure they had enough staff to take care of them.

I left nursing year and a half ago because of conditions like you describe. I feel for you. You are an intellegent productive human being, you deserve better. You are perfectly capable of doing anything you aspire to do. So if you want to go out and get a new career do it. PS I have told managment that they are evil for participating in this sort of thing. It is better to keep silent and just make plans for your escape. PPS It would not hurt to look around and see if their are other nursing careers where you would be appreciated.

CseMgr1, ASN, RN · Oct 18, 2008

The management thinks we are so dense that we don't realize they are hoping we won't have the time to fill out these forms and, as a result, won't get paid for these extra hours. One manager says she doesn't understand why we can't get our work done.
It took everything in me not to look at her and say, after my 14 hour shift, "You are a horrible human being. How dare you treat your employees this way." I have been a nurse for ten years and I can't believe how bad it has become. I am seriously thinking about a different career. Am I wrong to assume that satisfied employees make satisfied patients? Our management cares NOTHING about the patients. If they did, they would make sure they had enough staff to take care of them.

I don't really think "Management" gives a flip about whether or not we or our Clients live or die anymore.

They have made Beggars out of the lot of us.

hikernurse · Oct 18, 2008

Whoa, I'd definitely take the time to fill out the OT slips--mostly because I'd earned them.

Maybe if they are inundated with paperwork from everyone, the grid may end up being changed.

Sounds like a rough work environment right now for you. It's hard to feel supported by other nurses when they are sinking, too. Obviously, management isn't too concerned with being supportive. Sigh.

CseMgr1, ASN, RN · Oct 18, 2008

One manager says she doesn't understand why we can't get our work done.

Amazing.

I am waiting for THE "call", which will enable me to turn over hundreds of files, referrals and admissions to my own Manager, who thinks I should have *NO* problem completing.

Let's see how long it takes for her after she receives my resignation to run to her boss, crying: "I CAN'T DO ALL THIS!" :bluecry1:

Talk is CHEAP, as the saying goes.

glasgow3 · Oct 18, 2008

When I became a nurse manager the very first thing I told my staff was that I would never expect them to do anything that I wouldn't or couldn't do myself.

If this manager is so certain that what she is asking is "doable" then she shouldn't mind taking a couple of weeks personally demonstrating that fact and permitting a staff nurse to shadow and audit her work. Don't hold your breath waiting for an acceptance of such an offer.

What I learned was that some administrations know what they are asking is just not possible. When that became apparent to me I handed their manager job right back to them. In my opinion, any manager with any integrity whatsoever would do the same.

As to all the overtime/lunch documentation. Yes, management can require all the paperwork that they see fit and can fire their employees for any reason (including "excessive" overtime) or no reason at all....BUT they MUST pay you appropriately for ALLl time worked (including overtime if applicable) paperwork or no paperwork, permission or no permission.

My suggestion: 1) Keep track of all hours worked and all lunches missed 2) Find another job and give appropriate notice 3) Complain to your state's Wage and Hour Division about your employer not paying nurses properly and request an audit.

Valerie Salva, BSN, RN · Oct 18, 2008

Great advice on this thread, Manda.

Been there, done that. Hope you find something better.

You don't need to put up with that crap. I think mgmt waits for nurses to be so demoralized, that they don't have the strength to look for another job or even complain anymore.

In this short thread, you can see the real reasons for the so-called nursing shortage. It's not any aging baby boomers, or retiring nurses like they would have us believe.

It's this kind of stuff- right here.

madwife2002, BSN, RN · Oct 18, 2008

We have so many problems at work too so I totally understand your frustrations. I havent got any words of wisdom to share with you at the moment but hold on in there, I firmly believe this situation you are describing is becoming more and more common.

Pudnluv, ASN, RN · Oct 18, 2008

I joined this community to get a bird's eye view of what is going on in nursing thru out the country, because I couldn't believe that it was just my facility that was so bad. I've learned that the same problems that are affecting us are affecting everybody. So it makes me wonder, who is really to blame for the crisis that are seeming to affect healthcare everywhere.

Staffing is probably the biggest issue affecting my facility at the present. Our staffing grids are a joke and we are forced to work short staffed or minimum staffing at best. Add that to shoddy equipment, not enough equipment or supplies and the increase of paperwork and you have a recipe for disaster. Med errors occur and patient falls on my unit are at a record high. Nurses are burned out and angry and patient satisfaction is low. We do the best we can with the little that we have and it is still not enough.

So who is to blame? Our NM is responsible for everything that occurs on the floor. Anything that happens is a reflection on her. She advocates for our staff and is there every early every morning. She is on the floor and rounds on every patient every day. Yet her hands are tied also. She has to answer to someone higher up. She does the best she can with the little she has.

Then there is the VP of Nursing. Ours has a reputation thru out the community and quite frankly is why our staffing is so poor. We have had a mass exodus of nurses since her arrival (13 nurses have left one unit in the past couple of months). She has come in with a lot of good ideas and I truly believe she is trying to do what is best to improve patient care. Her delivery and people skills are terrible though. But she is also limited due to budget constraints and so forth. But the reputation of the hospital and in particular nursing care are a direct reflection on her.

So how about the CEO or the hospital board? They are given a budget to run an entire facility and must stay within it or lose money. The entire facility is their responsiblity, not just nursing care, but maintenance, housekeeping, food service, ancillary services, etc. Where do they cut and where do they save? Hard decisions all around.

So who is to blame? Goverment cutbacks to medicare, tightned restriction on reimbursments from insurance companies, the rising costs of insurance and pharmaceuticals? Responsible budget decisions from management, realistic goverment awareness of the issues facing hospital care today and public support are needed. Until then, I don't think change will happen.

Just something to think about.

CseMgr1, ASN, RN · Oct 18, 2008

I think mgmt waits for nurses to be so demoralized, that they don't have the strength to look for another job or even complain anymore.

You've hit the nail on the head, Valerie.

A co-worker and I were talking about this same issue just the other day. They want us blindly follow orders and to keep our mouths shut. I have kept mine shut for too long, and I have almost reached the point where I really don't care if they fire me or not.

SmilingBluEyes · Oct 18, 2008

I feel for nurse managers these days, and would not personally become one. They really are trapped between a "rock and hard place" between their employees and the administration that is so out of touch with nursing issues, that they can make such dangerous decisions.

I have a feeling a lot of these problems are not of your manager's making, but rather, from "on high". It's happening all over. I think this is just the beginning as our health care crisis continues to unravel.

Just keep filing the appropriate paperwork, including OT and incident reports as well as accepting unsafe assignments "under duress". And as I said to someone else here, consider whether continuing to work there is really worth it to you.

I am so sorry. The frustration you feel is being suffered all over. And our patients are really suffering, too.

CseMgr1, ASN, RN · Oct 18, 2008

So how about the CEO or the hospital board? They are given a budget to run an entire facility and must stay within it or lose money. The entire facility is their responsiblity, not just nursing care, but maintenance, housekeeping, food service, ancillary services, etc. Where do they cut and where do they save? Hard decisions all around.
So who is to blame? Goverment cutbacks to medicare, tightned restriction on reimbursments from insurance companies, the rising costs of insurance and pharmaceuticals? Responsible budget decisions from management, realistic goverment awareness of the issues facing hospital care today and public support are needed. Until then, I don't think change will happen. Just something to think about.

You've made some valid points. My frustration lies with the CEO's who reap multi-million- dollar salaries and bonuses in the process of selling their employees and patients down the river along with like-minded individuals in our government, insurance and pharmaceutical companies. I once worked for an HMO whose CEO received 32 million dollars from a merger....and I don't have access to health benefits with this

same company because of a "pre-existing condition"?? Please!