Understaffed and sick of it!!

Specialties Geriatric

Published

My name is Kate and I'm a Respiratory Therapist, though I am not a nurse and I hope that you don't think I'm intruding in your space here, I just have a problem and I would like to know if Nurses are feeling the same way. I work in an LTAC facility and we are facing what I call outrageous cutbacks in staffing, with RN's, LPN's, CNA's and RT's and we're all pretty sick and tired of this issue. I love my nursing staff, all of them, they're all pretty important to me and I'm just sick to death of all the cutbacks, I think we're all pretty tired of it. Our facility does wound care and ventilator weaning, etc. We were supposed to be staffing per acuity level, granted, I'm new to the healthcare field, I've been an RT for only a couple of years now and this is my first time ever being in an LTAC. I was a nurse aid for a few years way back when in a nursing home, actually a couple of them, but when someone called out sick, the nurses were very helpful, we did all we could for each other, anyways not to get off track, we now are no longer staffing RT's per acuity, the nurses and cna's are still being staffed that way, but they don't do our work at all, we do all the RT work but we help the nurses and cna's a great deal. The nurses on the floor are very upset about this as are the cna's and the RT's obviously, but nothing we say gets through to administration and nothing is changing. We are all very fearful of the "sentinel events" to come from this "short staffing". We are all about ready to take a "leap" . Is this happening every where, or is it just happening to us? They are trying to staff 2 RT's per 30 patients and they still expect us to do admits, discharges, weans, therapies, trach care, run codes when necessary, do abgs etc..., I think the nurses feel lucky having only 4 patients, but most times they have 5 or 6, and the cna's are lucky to have 5 per 30 patients but most times they have 10. I think that's horrible patient care and its very dangerous. Our licenses are on the line, and I'm quite sure that this company wouldn't back us if anything tragic ever happened. I think they would drop us like rocks to avoid liability...and of course to cover their butts...I went to RT school because I don't have the stomach for nursing but I wanted to care for people. I admire nurses, they have to know so much about so much and I think they have enough on their plates. My nurses and cna's know me and they know I'm always willing to help, but the last thing I ever want to do is tell them, "No, I can't help you boost a patient, or clean a patient because I have to get 10 treatments done in the next hour, start 3 trach collar weans, start three cpap weans and do 10 trach care's".....uuuuggggghhhhh

somebody help me...just go ahead, tell me that before I retire I'll be weaning 30 patients, doing 30 trach cares, 30 treatments, running 2 codes at once all by my little old self!!! or instead, maybe you should tell me to just go back to my little desk in Accounts Payables...hehe, I'm trying to find humor...sorry this is so long, but as upset as I am, its actually pretty short...

Thanks for listening

Katie

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Specializes in cardiac med-surg.

welcome to allnurses

venting is good for the soul

sorry to hear that work is crazy

hope things improve soon

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working short staffed sucks period. whether it's for a nurse,rt or aide. i just came home from working on a really poorly staffed floor. a physician came on the floor and saw how we were working and immediately called the supervisor. that's the only time you see action. when either something horrible happens or an md complains. hope your situation improves. :smiletea2:

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Specializes in Too many to list.
My name is Kate and I'm a Respiratory Therapist, though I am not a nurse and I hope that you don't think I'm intruding in your space here, I just have a problem and I would like to know if Nurses are feeling the same way. I work in an LTAC facility and we are facing what I call outrageous cutbacks in staffing, with RN's, LPN's, CNA's and RT's and we're all pretty sick and tired of this issue.Katie

The only way the situation could change for the better is if the staff feels so strongly about the cutbacks that they are willing to walk if it does not get better. Safety is a big issue. Really, it is the biggest issue of all. If you and the others agree that your licenses are at risk and the situation is unsafe for your patients, than the staff should request a meeting and lay it on the line. You really must be willing to leave for this to work. Money is what is motivating the cutbacks, but they can not operate without the staff cooperating. I do not believe that they will be willing to find a completely new group of staff members to replace you. Do you?

BTW, I am not advocating for anarchy, but I do believe in safety for patients and for staff.

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No easy answers. You must all band together and fight for safe care levels.

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Specializes in Tele/ICU/MedSurg/Peds/SubAcute/LTC/Alz.

This is exactly what happens at the facility I use to work at. It was my first nursing job, and because the work load was beginning to burn me out I left. It was brought up several time to administrators, but they never did anything about it. I had up to 60 patients, depending on what shift I worked on. It was way too much. And if the aids were short there patient load would increase from 10 to 12.

Dangerous, it is true. That is why I didn't want to stay I felt it was unsafe practice.

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Specializes in Geriatrics, Med-Surg..

I wonder when the media writes about a nursing shortage, do they include the jobs where the facilities are so understaffed that staff is burnt out in months and each day the nurse wonders if she/he will have a licence at the end of day.

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Specializes in Too many to list.
I wonder when the media writes about a nursing shortage, do they include the jobs where the facilities are so understaffed that staff is burnt out in months and each day the nurse wonders if she/he will have a licence at the end of day.

No, I don't seem to recall any mention of that.

Tonight, I am working at a facility that saves money by having one nurse work two units. The other two units have one nurse each. I will probably have the double unit as I am the agency nurse. How my night will fly by!

This is also the place that does not have TB syringes so if I have to give morphine SQ, it will be with a 1cc insulin syringe.

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Specializes in Rehab, LTC, Peds, Hospice.

What do you think of a trach/vent unit with 12 patients, 1 nurse 1 RT (who also does trach care for the rest of the building and checks those on bipap at hs and o2 and the crash carts are stocked. Also assists with assessments and codes. Also (maybe) 1 CNA? Used to have 2nurses and 1 RT (no cna).

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]Honestly, I think you might want to think about moving on.

]Are there are other places to work now that you have some experience to back you? Have you considered acute care instead of a sub-acute/rehab type facility?

]I can see the value of a group meeting with administration but I think you're fighting the corporate monster there.

]I'm an RT too... just for a few years now too. I work in a faith-based Trauma Level ll hospital, and I won't say the loads are cake but they aren't dangerous either. Floors are 12-15 Pts with Txs; ICU is 5-7 vents with maybe a BiPAP, HHN, or a trauma Pt added during the shift. There is usually time to do your job thoroughly and also deal with the things that come up... be that a Rapid Response, a trauma, a Code, a trip to CT, extra ABGs/EKGs, or helping out with a Pt. The tasks that equal good Pt care, not just good time management.

]I realize you probably care about your Pts, especially long term vent dependant ones, and worry about their care if you weren't there. Leaving them would naturally evoke some guilty feelings on your part. But honestly, they will likely find another RT just out of school again who will be conscientious but unaware of the employment options who will pick up where you left off.

]I love being in ICU, keeping my Pts clean, the vents stable, helping out with basic Pt care. I know it's only assisting compared to what the RNs do, and the knowledge they use (not kissing a$$ here... I really do know and appreciate the skills. If I was younger I'd probably get my RN) but I feel like I'm contributing to someone's well-being, plus helping my coworkers. It's job satisfaction compared to honed time management skills.

]Another benefit is that I'm always adding to my knowledge of acute care. I had a vent last night... ICB, shift to the right, a Swan-Ganz, ventriculostomy, an IV pole that looked like a bunch of grapes. I only had the vent... the RN had all of that to manage. But it is sooooo much more interesting.

]Feel free to PM if you like. I read this site all the time because I learn so much... but I do feel like I'm butting in where I don't belong so I don't post much.

]Good Luck whatever you decide!

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Under-staffing, poor equiptment, lack of equiptment and supplies seem to plague many LTC facilities. Bnding together, enlisting family support, bringing legal/safety concerns to the attention of administrators is just the tip of the problem. I have no concrete answers but I know we need to value our work partners and patients more.

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Specializes in Geriatric, Rehab, and Pulmonary.

I am also an RRT/RPFT and have worked as a Respiratory Care Practitioner for over 16 years and graduate RN school this May. I agree that healthcare in general with it's cutbacks causes facilities to be understaffed. Where I work, it is nothing for a therapist on night shift to go out to do 15-20 HHN txs and between the 2 of them cover ER, CCU, OB/nursery, ABGs, EKGs, ICGs, etc. During the day, I have done 3 rounds on a floor with 8-10 HHN txs and then 4 PFTs that day all in about 10 hours. Nursing is just as understaffed. It;s nothing 2 or 3 ER nurses (1 of the nurses doesn't work that often) to cover a very busy ER with 2 doctors working during the busiest part of the day. America needs help!

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