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.
Stats look good for so many nurse/patient ratio - they bring more nurses to the facillity and bring patients....but ancillary help for the staff isn't mentioned in main stats. Also a lot are "intimidated" NOT to fill out those OT papers.
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.
My last stint as a nurse manager ended two years ago, as what little authority and credibility I had been given were constantly being undermined by an administration equal to the one that you have just described.
What was even sadder was the fact that I was increasingly being viewed by my staff as "one of 'THEM'"...despite my efforts to prove otherwise.
It used to be that Managers could halfway rely on adminstration for support. Not anymore. All they want from Managers now is to do their dirty work for them...as they sit around a mahogany conference table and pound out one meaningless Directive after the other.
Justmanda, this happens all over. It happened recently to my previous unit. They cut our unit secretaries, techs, and expected the same outcome. Doctors started complaining because we couldn't properly take care of the patients - it got really bad.
A few of the nurses that had actually worked there for 12-20 years met with management to try to work the problems out.
Nothing happened. There was a mass exodus. At one point, the supervisor had to take a full load of patients and got a taste of what we were experiencing everyday. She couldn't handle it and still.......did nothing.
The unit lost ALL of the original nurses except for two, the nurse supervisor was fired, the NM left and not long afterwards the CNO left also.
Too bad, they should have taken our input regarding our working conditions. I think it's just peachy that people who aren't nurses and who have no clue as to what we do, can dictate what our working conditions are.
The biggest lesson I have learned so far in the nursing world, always keep your resume up to date and always be prepared to give your 2 weeks notice.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
My last stint as a nurse manager ended two years ago, as what little authority and credibility I had been given were constantly being undermined by an administration equal to the one that you have just described.
What was even sadder was the fact that I was increasingly being viewed by my staff as "one of 'THEM'"...despite my efforts to prove otherwise.
It used to be that Managers could halfway rely on adminstration for support. Not anymore. All they want from Managers now is to do their dirty work for them...as they sit around a mahogany conference table and pound out one meaningless Directive after the other.
I understand and sympathize. I do not blame you at all for leaving management. It's thankless and no manager is paid what she or he is worth. It would not be for me. Their authority is without teeth period. No place to be.
Wow. So we were so understaffed last night I literally didn't have time to pee.
#1...Never short yourself on hours. Clock out when you're done and not until then. You don't have to fill out extra paper work to get paid. If they don't pay you, file a complaint with the Labor Dept.
I don't know what to say about short staffing. Our managers won't take acuity into account at all. They short us staff by saying there is no one available. So we run all night, and then I get home and beat myself up all night cause of things I forgot to do, thus getting no sleep.
Last night I forgot to chart a patient's chest tube output. I know the cardiac surgeon is going to go ballistic when he sees it this morning. I was just so busy. So once again I tossed and turned all night.
Patients don't get the care they deserve; nurses feel like crap cause they know the patients aren't getting the care they deserve, and the worst thing is to top it off, it sounds like all hospitals are just as bad, so there's not really any alternative.
This is exactly what hospitals want- nurses so demoralized that they have no time or energy to fight. Exodus out of the hospitals is EXACTLY what hospitals want- they can then scream, "nursing shortage", and petition the feds for more foreign nurses.
As bad as it is, nurses need to dig in their heels and fight this! For once in your nursing lives, band together and DEMAND that changes be made. Keep track of patient incidents, fall, etc, contact the media and the papers, and get in the public's face about what is going on. and how it is affecting patient care and safety. Get ahold of executive salaries and perks, cost of new construction, and point out that each of these could pay for additional nursing staff that would prevent errors. That, by the way, is what teachers do to get what the want. That is why teachers have limits on classroom size, hours worked, etc. Nurses are too socialized to suffer in silence.
Make copies of the articles, that are on this listserve, about staffing and patient mortality and morbitity. Have a rally in a very public place, with lots of foot traffic, and invite the press and news stations. That is the only way this is going to stop. get oot and be a revolutionary! JMHO, and my NY $0,02.
subject: new pbs special examines the nursing shortage
on october 24, 2008, the emmy award-winning newsmagazine now on pbs will examine the root causes of the nursing shortage and innovative efforts to reverse the trend. "a nursing shortage paints a frightening scenario for the recipients of their care - all of us," says executive producer john siceloff. "it's vitally important to understand the depth of this problem, but also to recognize models of success that can help us avert a serious disaster." hosted by award-winning veteran journalist david brancaccio, the nursing shortage and the crisis in healthcare is supported in part by a grant from the barbara & donald jonas family fund and the jonas center for nursing excellence. for details, see http://www.jonascenter.org.
i was one of the charge nurses for 14 bed icu, with cabg and crrt that was to be one on one patients and they are now 3:1, on some nights i would be charge and have 4 patients. too risky and way to scarry. i left in august and took a teaching position at a community college. i love teaching. there was actually a mass exit and now have travel nurses training new staff and new grads.
I just received an e-mail from management the other day that say that even though we are understaffed our patients should never know it and how we should never let on to them how understaffed we are. I never verbally say anything to my patients but they aren't dumb. We have these locators we have to wear that tels the front desk where we are and then if they need us they call us on the intercom in the patients room. So while I'm in with pt A the secretary will call me and tell me pt B needs to use the commode then 2 minutes later will call me again to tell me that pt B is still waiting, mind you I am trying to help pt A the entire time. How do they think this makes the pt feel? I had one pt comment to his wife that I must be the only person on the floor because they called me every 5 minutes. I literally cried the other day because I was 2 hours behind in vital signs and my morning med pass and I couldn't keep up with demands of my patients. I'm trying to hold on until my years up so I can transfer but I'm not sure I'll make it or not. I'm tired of being expected to be the nurse to 5 pts most ICU step downs without any assistance.
I feel your pain. We're unionized with a 1 to 4 nurse/patient ratio, and still those shifts are all too frequent. It's because acuity is not taken into account. When you have one on TPN and an insulin gtt receiving tube feeding, another coming back from the cath lab with an introducer sheath in, another on a PCA and a diltiazem gtt, even just three patients is too much. I filled out a "Staffing Request" form that night, which goes straight to the union. The more of these things we fill out, the more pressure we can exert through our union. That's the theory anyway. I haven't seen anything change. Things will be good for a while, but then they always go back to the way they were before. It's a constant battle that does not end. This is what has me thinking I want out. I want out before someone dies on my watch because I was overwhelmed, because you know darn well the facility will not be blamed. The nurse is where the buck stops.
Many facilities have made it so that practicing nursing id downright dangerous. Too much of a workload and mistakes are bound to happen. i wouldn't put my nursing license in jeopardy so that some CEO could put a few extra $$s in his/her pocket. There are jobs out there that are willing to treat their workers with dignity and recognition, but it does take a little time and effort to find the right fit for you.
This is exactly what hospitals want- nurses so demoralized that they have no time or energy to fight. Exodus out of the hospitals is EXACTLY what hospitals want- they can then scream, "nursing shortage", and petition the feds for more foreign nurses.
As bad as it is, nurses need to dig in their heels and fight this! For once in your nursing lives, band together and DEMAND that changes be made. Keep track of patient incidents, fall, etc, contact the media and the papers, and get in the public's face about what is going on. and how it is affecting patient care and safety. Get ahold of executive salaries and perks, cost of new construction, and point out that each of these could pay for additional nursing staff that would prevent errors. That, by the way, is what teachers do to get what the want. That is why teachers have limits on classroom size, hours worked, etc. Nurses are too socialized to suffer in silence.
Make copies of the articles, that are on this listserve, about staffing and patient mortality and morbitity. Have a rally in a very public place, with lots of foot traffic, and invite the press and news stations. That is the only way this is going to stop. get oot and be a revolutionary! JMHO, and my NY $0,02.
Lindarn, Rn, BSN, CCRN
Spokane, Washington
I totally agree with you. Until all nurses say no I will not work like this anymore the powers that be will continue to take advantage of us. Maybe one day nurses will stand together and tell the powers that be no more, I will not do this anymore. Until we stand together nothing will change. I hope that I can last long enough in this profession for that to happen.
Straydandelion
630 Posts
Stats look good for so many nurse/patient ratio - they bring more nurses to the facillity and bring patients....but ancillary help for the staff isn't mentioned in main stats. Also a lot are "intimidated" NOT to fill out those OT papers.