Survey: Do you work short staffed on a daily?

prmenrs, RN · Jan 31, 2001

Our hospital has [finally] started trying to solve, or at least deal with temporarily, the problems:

NOT ENOUGH GRADS: All the major hospitals in the area coughed up some large $$$ to the local college to help fund more "slots" in nursing school. By that I mean, more faculty so they can admit more students. They have enough applicants, so that is not a problem, so far.

DAY-TO-DAY STAFFING ISSUES: There is an 'in-house' registry you can just go to the nursing office and sign up for; you get paid separately from your regular paycheck (less taxes), you can sign up for 1 1/2 and 2x pay. Nurses can share a 12-hour shift, usually 6hrs each, works great on days, not so well on nights. Then the charge nurse has several options: per diem, out of house registry, in-house registry. At 0400 and 1600, all of the 'like-area' charge nurses (Adult Critical Care, Maternal-Child Health...) meet, discuss haves and needs, future needs, esp from L&D to NICU, consider floating If all else fails, she gets on the phone and starts begging, goes around to current staff to see if anyone wants to "stay over" 4hrs (the beggee who agrees usually demands that it counts as a "float"! On our large unit, 13-18 nurses per shift, depending on census, the charge nurse gets about $1.50 extra an hour, and [usually] doesn't get an assignment. S/he deserves combat pay. There are usually 3 admit nurses who go to deliveries and transports; they take a relatively light assignment.

NEW GRADS: They should be protected!!!! Preceptorships, new grad programs are vital! Didactic as well as practical are needed to get them up to speed in a healthy fashion! ALL new employees, even non-new grads, DESERVE an orientation, one that is free from "Congratulations! You're "IT" tonight!" Floats and registry nurses DESERVE a staff nurse resource. These new nurses are a resource that cannot, and should not, be abused and wasted!!!

I keep saying this: if we don't nurture these youngsters, us senior citizens are NEVER gonna get to retire!!! Let's focus on solutions!

[This message has been edited by prmenrs (edited January 31, 2001).]

Stargazer · Feb 1, 2001

I quit my hospital nursing job due to short staffing. A typical ICU assignment went from 1:1 or 1:2 to 1:3, even with 2 (or even 3) vents. One nurse had a balloon pump pt (pretty much unstable by definition) and they told her she had to take another pt. IABP's used to ALWAYS be 1:1. They used to ask if I could take another pt in addition to my fresh open heart pt. "Not on my license", was my response. We filled out unsafe staffing forms and called the hospital administrator on-call at home every single shift. (One of them had the nerve to complain about being awakened at 3 AM--and caught a blistering earful from the charge nurse!)It didn't seem to make any difference.

We used to have an in-house agency and OT incentive staffing programs which worked beautifully, but someone decided they were too expensive. Our unit manager disappeared after 5 PM every day and NEVER answered her home phone or pager. She would not give us the authority to hire agency or travelling nurses or offer incentive pay. They tried making us do mandatory OT for a while until someone clued in the state nurses association (our bargaining unit), which informed the hospital that leaving after your scheduled 12-hr shift was NOT abandonment if the hospital failed to properly staff the unit, and to knock it off.

There were also never enough techs to assist with care. I was lucky if I had enough time to throw my meds at my pts, scribble a few VS's, and turn them--maybe twice--in a 12-hour shift. Forget baths, teaching, even changing lines in a timely fashion; and any semblance of TLC. I drove home every night feeling inadequate and depressed that my pts had received far less care than they needed or deserved, and scared for my license.

Every time I talk to one of my former co-workers, or any of my friends currently working bedside care (and judging from many posts on this site), it's gotten worse, not better. I wouldn't even consider going back to hospital nursing as long as conditions remain this bad.

askater · Feb 2, 2001

We worked short on weekends every 2-3 weeks. But the problem was "solved", our matrix was changed. We have to take on more patients.

Even though they changed midnights matrix, they still are short-staffed probably every other weekend. So they're working a cardiac step-down with 7 patients ne nurse. That's why I left midnight shift, it was never staffed to matrix. Plus they usually have no or only one aide.

I must say our nurses work over whenever they can. But most nurses are getting burnt out and not working over as much.

[email protected] · Feb 3, 2001

Today{sat.}our 29 bed unit will be staffed with 2 R.N.'s & 1LPN. It's a med-surg unit,mostly pulmonary/diabetes ie geriatrics,NH pt's .About 75% need assistance with ADL's.We may or may not have 1 nursing assistance. Management feels we are adaquately staffed.But I work there &know better.I sick to death of working like a dog just to give minimal care&frustrated by the lack of options,short of quitting. I really care about these pt.'s & I'm afraid for their safety.The other RN who works weekends with me is totally burned-out but needs the job,reluctant to stand up with me .So here I go once into the trenches,hope I don't cause harm.Wish me luck