Census dreadfully low at our hospital, anyone else???

  1. For about 3 weeks now our census ha been realy low. Not just our floor, but the whole hospital. Nurses are getting called off or sent home mid shift daily. It's frustrating. They have some staffing matrix that they talk bout, but none of the nurses have ever seen it. They call off the CNA's and unit secretary at a certain number. Then of course the nurses have to stay in ratio, so once we get to where there is one too many nurses, they send a nurse home. Yesterday was horrid. We started with 14 patients and discharged 5 then ended up somehow with 20 by the end of the shift (Our floor can take 30) but they literally slammed us. PACU patients started coming up at 2pm and there were only 2 nurses who could really take admits. Me and an RN. The RN got the ER admits (I am an LVN and cant do the admit assessment) and I got 3 PACU patients, within 3 hours of eachother. I was hanging blood/FFP on 2 of my patients that were on the floor already, and as luck would have it, both of their IV's went bad. One before the transfusion of FFP and the other in the middle of the unit of PRBC's. This patient was waiting to go home after his unit. In the midst of all this they decided to send our CNA"s home and our secretary home. So we had only nurses and a charge with PACU patients coming. It was crazy. The manager was on the phone with staffing and talking about how they haven't met their "quota" for the staffing matrix in a while! Geez! What about SAFE patient care!!!
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    About pink2blue1

    Joined: Jul '05; Posts: 299; Likes: 57
    LVN Med Surg; from US
    Specialty: Med-Surg

    24 Comments

  3. by   oramar
    Quote from pink2blue1
    We started with 14 patients and discharged 5 then ended up somehow with 20 by the end of the shift (Our floor can take 30) but they literally slammed us. PACU patients started coming up at 2pm and there were only 2 nurses who could really take admits. Me and an RN. The RN got the ER admits (I am an LVN and cant do the admit assessment) and I got 3 PACU patients, within 3 hours of eachother. I was hanging blood/FFP on 2 of my patients that were on the floor already, and as luck would have it, both of their IV's went bad. One before the transfusion of FFP and the other in the middle of the unit of PRBC's. This patient was waiting to go home after his unit. In the midst of all this they decided to send our CNA"s home and our secretary home. So we had only nurses and a charge with PACU patients coming. It was crazy. The manager was on the phone with staffing and talking about how they haven't met their "quota" for the staffing matrix in a while! Geez! What about SAFE patient care!!!
    I hate when they do that. It is one of the reasons I am not working. They go by the census at certain part of shift, staff to it. When you get slammed with admissions they just shrug their shoulders. One evening they were getting ready to send a nurse home and I got my check book out and said, "how much does it cost to keep her, I will write an check to hospital to cover her wages" I was trying to shame them but hospital administration has no shame. ******:spbox:
  4. by   thinkertdm
    Unfortunately, the hospital is saving tons of money by not having an appropriate number of nurses. And these magical "matrices" to determine the proper ratio of nurses to patients? They were made by an accountant sitting in an office, probably no where near the hospital.
  5. by   NewRN2008
    This is making its rounds all over right now. as evidenced by the numerous posts on this too! that sucks, i know!!
    you know what really sucks, in our little "meeting" times we have during the day, to get info out type of thing- they told us they are redo-ing budget. with this going on, we are in trouble i think. i am pretty upset and confused too i guess- because they just hired 3 new grads. i know we needed it, but i sure as heck hope that they are the first to go!

    trust me, a lot of us are stressed to. i am actually looking for a side- job to supplement d/t using PTO for those lc days!
    Gl to you as well!
    -H-RN
  6. by   locolorenzo22
    The state says we have to use a acuity staffing model...hah! haven't seen hide of that since it was told to us. Doesn't matter if you have a lot of isolation, confused patients, dying ones, and demanding detoxes. You get what you get, and call it good. Do the best we can, and always protect yourself. I have no problem staying over to finish charting if it means my patients get good care.
  7. by   FireStarterRN
    It's been low where I work lately, although I've been getting plenty of shifts even though I'm per diem. I guess people are healthy? I'd be curious if nations with universal healthcare are also experiencing low census.
  8. by   David13
    The hospitals may think they are saving money, but wait until a patient sues because of an error that occurred due to inadequate staffing.

    I have an idea. How about if that bean counter who came up with the mysterious "matrix" takes a few unpaid days off?
    Last edit by David13 on Jun 9, '09
  9. by   eriksoln
    At my hospital.....yes, census is down a good bit. On my unit, no. I have gotten my 40hrs. per week with no difficulty. They call people off, but NEVER me, not even when I request it. I had overtime twice.

    The general M/S unit is being shut down a lot and its nurses are being floated all over. Some of the nurses from that unit are trying to "put their foot down" and are being difficult about being floated. They have used up all their PTO but request to be called off instead of floated. Then, when they are floated, they spend the day going around looking at everyone's diagnosis and raising heck about "this pt. should have been on our floor, that patient doesnt need to be here, they are a M/S pt.". Laughable really, they way they act, you might get the impression someone was listening to their complaints or that they had a say in any of it. Nothing could be further from the truth though.

    I'll say this though, and I'll probably get laughed at like I do at work, but no one has proved me wrong:

    If you dont want canceled for low census and want to keep your hours, act like you want to go home. Thats what I do. I always say I want to go home (I dont, I am trying to buy a house), tell the supervisor they can send me if need be and make a scene about needing a day off. Sure enough, as reliable as the sun coming up, they play devil's advocate and make me stay. Its how they work, they dont know how else to make decisions other than to always moderate towards whatever it is you are not asking for. Since I say I want to leave, they go out of their way to make me stay. Like I said........never less than my 40hrs and OT twice recently...........while other people have used up their PTO and are being forced to take mandatory call offs. Hospital administration and supervisors are like puppets and you can make them dance any old way you wish if you know how.
  10. by   mochabean
    The same thing has been happening at on my unit, and I guess for the entire hospital. Overtime is slowly being cut back for nursing assistants. That's bad, considering how low we get paid in the first place.
  11. by   eriksoln
    Quote from mochabean
    The same thing has been happening at on my unit, and I guess for the entire hospital. Overtime is slowly being cut back for nursing assistants. That's bad, considering how low we get paid in the first place.
    You should come to my hospital. While they seem pretty well staffed with RNs and a lot of people who did reg. OT are not getting it now, they remain a bit desperate for CNA's for some reason.

    I think when the financial crunch began, they thought a good way to save money would be to cut down on CNA hours. They increased CNA ratios and limited the number of full time positions available. More than a few CNA's moved on, stated they found the new culture of the hospital undesireable.

    Now they are trying to bring people back. Often, we keep an extra RN who works as a float nurse and dont bother trying to staff ourselves with the proper number of CNA's. Hospitals doesnt like it, but the staffing limits/allowances demands it.

    Guess the RNs could learn somethign from the CNA's here. They voted with their feet and now have the hospital seeking ways to keep them happy.
  12. by   cursedandblessed
    no!! no!! no!! i heard one floor is bare(students only having 1-2 patients) but not the one i'm on(i'm learning a lot though about time management). we're packed out i think there was one empty bed on the floor.

    i've had a number of high acuity patients, seems like quite a few are waiting to come in until they're very sick. which is not good in my little idiot student nurse opinion
  13. by   pagandeva2000
    Quote from thinkertdm
    unfortunately, the hospital is saving tons of money by not having an appropriate number of nurses. and these magical "matrices" to determine the proper ratio of nurses to patients? they were made by an accountant sitting in an office, probably no where near the hospital.
    and, not needing care.
  14. by   ElvishDNP
    We tend to hover at 110-115% capacity....so anyone needing hours, I know where to find them.

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