Why does Nursing put up with short staffing?

Nurses General Nursing

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I am wanting to get a little feedback as to why Nursing (in general) allows short staffing to be an issue? I am on our research committee at work and would like to get an idea of where to take my project. I would like to find an answer to the problem and not just more complaints. Thanks in advance for any insight.

And, remember to blame the hospital for not hiring enough. Magic wands only work in fairy tales.

Why not hire more nurses? Is it because of budget constraints or because there aren't enough qualified applicants to fill empty positions? Some other reason? I'm seriously curious here, because otherwise the assumption is that surely money could be found SOMEWHERE if more nurses were a priority (eg if it's a for-profit hospital that's making money or has several very highly paid administrators with very generous benefits packages). Or perhaps that poor working conditions or non-competitive wages might be keeping nurses from applying to a particular facility.

More likely, the people who complain about unresponsive management DO work with unresponsive management and house supervisors who complain about staff nurses who don't appreciate how difficult it is to staff a facility 24-7 given call outs, vacations, shortages, etc probably DO deserve more appreciation from their staff. We're generally not addressing the people who are reading these boards even if they are in a similar role. We can educate each other about our perspectives and experiences without discrediting others' perspectives and experiences.

Over here the main problem is the lack of funding to fill the jobs, the NHS has put freezes on the jobs so while working for a pittance the current nurses have loads of work! At the same time the consultants are on well over a hundred thousand..its terrible really!

Specializes in Geriatrics/Family Practice.

Today I worked in a LTC facility. Originally I was supposed to have 20 Medicare patients. That in itself is time consuming considering charting, doing vitals, dressing changes, blood sugars, and the unexpected fall first thing in the morning. Well then the DON comes up to me and tells me the nurse who is doing the stable non-Medicare patients with no charting is leaving after morning med pass. First of all I have never passed meds to these patients and secondly how can I take an additional 37 patients on top of my 20 Medicare residents? Well needless to say I muddled through and did my very best. But ultimately who would get into trouble if something went wrong, or if something wasn't charted on or who knows what else? Now to top it off I had to send a resident out to ER because he developed a rash from head to toe and when I asked him to take a deep breath in and blow out he said he felt like he couldn't get air in. So of course I'm sitting here now wondering if I did anything to contribute to this rash. Even though I double check my meds before I give them I couldn't tell you for sure that I didn't make a mistake, especially with that many residents. I've been on the floor by myself for 3 weeks and graduated in June. He's not on any antibiotics or any new meds, so I'm stumped. Also the CNA told me she noticed that rash developing a couple of hours earlier but forgot to tell me. I would think if it was anaphylaxis it would of happened alot quicker. Oh well, welcome to the wonderful world of nursing and working short staffed. I don't actually know how long I'll tolerate it before I get scared and quit. But since I am a LPN my options are very limited here in Illinois.

Specializes in Mixed Level-1 ICU.

"And remember to blame the hospital for not hiring enough. Magic wands only work in fairy tales. Sorry for being "testy". Just spent a weekend trying to cover for multiple call-ins and 2 no shows. Started with a bare minimum (hospital sent a lot of staff to do training for new computer system) and had 12 call-ins, 3 of the 6 scheduled for ICU and 2 of the 5 for L&D. Another viewpoint from a very tired and frustrated house supervisor."

Yes, I do blame the hospital!

Who else sets the standards of care?

Who else sets the salaries? Who else keeps loading more and more work on the laps of the nurses and expect it all to be done in the same period of time and with the same degree of precision, compassion and public-relations worthy dedication?

Watch a hospital provide a truly superior salary and watch the nurses come out of the woodwork. And then have management set the rules...too many illegitimate no shows and you're gone. Too many "sick days" , say goodbye to your salary, they'll be someone waiting in the wings.

Truly pay them for their responsibilities...and they will come.

Provide behavioral parameters..and they will abide.

Allow them the time to practice like they were taught in nursing school--and they will never leave.

But, as long as it's getting done, those steering the ship have no incentive to change things. Until there is a universal hospital acuity tool that will unequivocally show the dollars wasted when over-worked nurses allow the infection rates to increase and AHA standards to be ignored--resulting in extended hospital stays--we are destined to be left re-arranging the deck chairs on the you-know-what.

One of my favorite sayings is: "What gets done (and how fast) is directly related to who is being inconvenienced."

It's NURSES who are being inconvenienced ... inconvenience a "higher up" and watch how fast things change....

Specializes in OR Internship starting in Jan!!.

It's hard to balance leaving your co-workers even more short staffed, and refusing to work in an unsafe situation.

It's hard to balance leaving your co-workers even more short staffed, and refusing to work in an unsafe situation.

**I** am not leaving my coworkers even more short staffed, the hospital is. My coworkers are just as capable of refusing an unsafe assignment as I am. Until we all stick together and refuse unsafe assignments, the hospital has no incentive to quit short staffing us. As long as someone will take the extra 2,3 (or for you LTC folks 20) extra patients, the hospital is saving tons of money! Make them pay someone the big bucks it takes to work an extra shift on a regular basis, and they'll start losing money. Until they're losing money, nothing will change.

Specializes in Mixed Level-1 ICU.

"**I** am not leaving my coworkers even more short staffed, the hospital is."

Right on!

It's vital to focus on those who support the inequities and not fall for these lame and tired attempts at guilt transference.

I have worked the gammet of nursing jobs, same BS different facility. The problem with short staffing does indeed boil down to one thing and one thing only MONEY. Yes, we go to nursing school to help others and make a difference and feel better about ourselves, at least some of us do.( For others it's the amount of money you can make in this field. ) Regardless of why we become nurses, this is who we are. The facilities on the other hand are in it because it is a business, bottom line, they are in it to make money. Health care is a multi billion INDUSTRY. Yes, INDUSTRY. They are in it to make money and believe me they are making it hand over fist. So think of it as just that, a business. I am not saying that it is right, but that's the truth of it. Ask any nursing home administrator what their job is, they will tell you (if they're honest) their job is to cut expenses and to save the facility money. At what cost? Yours, mine, and the patient. The corporations that operate these facilities (hospitals included) are in this business because there is money in it. Don't believe the advertisements that say "We care about your loved ones" BULL. What it should say is "We want your money". I know there are places out there though few and far between that put on a good show, but again its all about the money. My solution? I have become an independent provider of nursing service, I am self employed, I work cases I want to work, the hours I agree to work and I get paid nicely. I enjoy what I do, but I have taken on the responsibility of directing my own future. I would not ever consider going back to work for a facility again. I agree that nurses need to join forces and do something to stop the short staffing "ABUSE" that they are subject to, there is strength in numbers, but you have to get hundreds or thousands of women, and men to agree on this and make that change. One more note, I have been in touch with the BON, in Ohio they send out a bimonthly news magazine. If you read it carefully you will see that the BON is set up to protect the patients, NOT the nurses. They are responsible for regulating the practice, the punishments of malpractice etc, but they advocate for the patient, not the nurses. They will hand out punishment if found negligent, but will not help you the nurse out if an employer is negligent. SO, if you are not happy with what you have going on in your work environment, make a change. I am certainly glad I did.:nurse:

I am wanting to get a little feedback as to why Nursing (in general) allows short staffing to be an issue? I am on our research committee at work and would like to get an idea of where to take my project. I would like to find an answer to the problem and not just more complaints. Thanks in advance for any insight.

Hello,

I've been working in the german system for quite a few years now. When I first started here the staffing situation was tolerable, realistic at least. Over the last several years it has turned into the nightmare that we are all experiencing. Why do we put up with it? I think for the most part simply because we have to. I, as one person don't know what to do to change it. Especially when every sane person knows that it's a major problem. It all has to to with money and costs, easy as that. Nursing changed in essence when hospitals and medical care turned into big business. The human issue has transpired into a budget issue. It all has to do with keeping costs down. The answer is easy in my opinion, it's just getting things changed in the right direction what's hard. The big power and decision making is being done way up the ladder.

Take care, Ambil

Most shortages are caused by nurses - sick calls, absences, no shows, and of course, vacations. NOT saying nurses shouldn't call in sick or take vacations (I have no tolerance for no shows - and yes, it happens far too often) but it does stress sometimes limited resources. If you have 7 nurses for one shift and one is on vacation, you have six left. If possible, you get a nurse to cover that vacation shift. Then you have 3 of the 6 or 7 nurses call in sick, where are you supposed to get nurses to replace them?

I am sorry for the stressful situation you are in, but it is not the staff nurses responsibility to staff the unit. Can I as a staff nurse hire? Increase pay/benefits?bring in registry? transfer patients? Authorize OT? Float nurses? Bring in management to work a short staffed unit? Make ER hold patients until the unit is staffed? Send patients out to other hospitals? Management has the authority and ABSOLOUTE responsibility to provide adequat staff. If I take an unsafe assignment the BRN will hold me accountable for adverse outcomes NOT my manager. If the unit is short staffed the only way to hold the manager accountable is to refuse the unsafe assignment.

Specializes in ER, Ortho Surgery.

I was promoted to manager of an ortho ASC 3.5 yrs ago. At the time I had had no management experience and saw the world "through the eyes of a nurse", ie. we have to stand up to administration because "they" will never understand us.

I have learned two things: 1) insurance companies and Medicare drive healthcare. It's not "what's best for the patient". It's the Almighty Dollar. If we're ever going to provide for safe and proper staffing of nurses, nurses as a whole need to become more politically active and create a voice to be heard in legislative arenas -- and begin the near impossible task of taking the control away from the insurance dictatorship. 2) Somehow, in the last 2 months, I have convinced my administator and Board to allow me to function with proper staffing levels. The lesson I learned is this: now that the nurses have enough staff, they have come up with a whole new list to b... about. No kidding! I can't believe it. Why do nurses b... so much?! My point is that constant complaining undermines credibility.

Administration "will never understand us" because of the messages we send. As a whole I would like to see nurses act the professionals that they are!

"Nurses are always shooting themselves in the foot by not working together. I can't stand the infighting within our profession. It gets in the way of promoting our profession and nurse-driven healthcare policy." -- Mother Jones, RN, at Nurse Ratched's Place

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