Hospitals in Trouble

Nurses General Nursing


....face it! There is no way you can keep up good patient care while you are inadequately staffed! There are limits! That fact that you are asking HOW you can give good care under those circumstances is exactly what the hospital is counting on! As long as we continue to martyr ourselves, the more they'll ask us to do! I don't have any answers for you except to document, document, document your concerns about inadequate staffing, so that if someone is severely injured or dies, you are on record as stating to management/administration that you were working under unsafe conditions. What about your state regulatory board for healthcare insitutions? Do they have standards? What about letting the media know? Your Congressmen? Postings like yours are becoming more frequent unfortunately, and there is some point at which we all need to put our foot down, and that time is rapidly approaching, if not already here in some parts of the country.......Good luck!



We recently had a layoff in our hospital. They laid off 20 employees and talk around town is they might even layoff another 40. Most of the ones that got laid off were our nurses. We are running real short-handed and there is no way we can give good patient care . Our administrator doesn't understand or he doesn't care, not sure which. They even went so far as to close down our surgery floor and added it to our med-surg floor. They said they have no intentions of reopening for awhile. Well now it seems that the nurses that are left after the first layoff are being worked to death. I was called today asking if i could come in and work on my day off, which i have no objections to, but it will be overtime for me. My boss said i was her last resort because there simply was nobody else to cover it. Any suggestions on how the nurses left at the hospital can give good patient care? Any suggestions or ideas will be greatly appreciated.

nurseangel, your administrator doesn't care if you atr shortstaffed. The fewer nurses there are, the more money for him. The healthcare industry has become driven by how much $ can be made by those in charge. They find it cheaper to hire new inexperienced nurses or unlicensed people because it improves the bottom line. This is precisely what managed care has done. In the rush to control healtcare costs, those who make policy have put a dollars and cents value on human life. And Congress proved they don't care when they shot down healthcare insurance for eveyone in the US. Because insurance is becoming so cost prohibitive, there is a growing number of people, not all of them on welfare, a lot working full time trying to feed, clothe, house, and educate children, that the only time they see a Dr. is in the ED because they can't afford any other care. And by that time, their condition may be such that it will cost more to treat them than if the was some form of universal healtcare.


Blues Forever

I really hate to suggest this but it is time to involve the local media.

Get them to see the patients waiting in the hall on gurneys for a bed in a unit that is closed or partly closed because of severe understaffing.

Makes a great 6pm story, but actually creates greater stress among staff for a short period because of the finger pointing that will follow. Get together and be supportive of each other before the big blowout and get the help of the public in this situation.

I hope you resolve this as the community is depending on you...actually for their lives.

There are numerous factors involved here, yourself and your job, the unit you work on, the hospital that you work in, the community that this hospital is supporting and....Why you are a nurse...,Patient advocacy is the bottom line. Stick to this when you make decisions and you will not be wrong...

Good luck


As stated previously by bluesboyj, it comes down to the hospital (and administrator) making more money. Unfortunately, when you are understaffed, errors can and will be made. Hopefully they won't be lifethreatening and career ending for any nurses, but for some reason the hospital administrators have kind of put a price on life and don't seem to care about it.

The hospitals have insurance for malpractice, but I would think settling out of court a couple times for millions could be prevented by having better staffing ratios. Unfortunately with changes in healthcare, it may get worse; hopefully not!


I agree that understaffing is a BIG problem and I do suspect that managed care is the culprit.

However, I don't think that universal health care (run by our government) is the answer. If we think managed care is bad, just imagine what our government would do with health care! Look at how Social Security, Medicare, or ANY other government-funded program in this country is run. How many tax dollars (or insurance premiums in this case) would go to health care and how many would be used on paperwork and a top-heavy team of administrators, etc.?

I've already said on another bulletin board that I don't claim to have the answer to our health care woes, but I wouldn't look to our government to provide health care.

I think, instead, we should ask our state legislators to MANDATE nurse/patient ratios (with REALISTIC acuities) and to fine hospitals that don't comply. I don't wish to have any more government in our lives than necessary, but it seems that understaffing has been a "problem without a resolution" for far too long now, and quite frankly, I don't know where else to turn.

I understand that the Democrats are going to introduce (or "re-introduce") a "Patient's Bill of Rights" this year. The only problem I have with that is that in my experience, it seems that most of what Democrats propose seems to SAY a lot, COST a lot, and DO very little.

Just now, off the top of my head, it occurred to me that, if we had non-profit insurance companies and if we paid insurance premiums the way we do taxes (more income=higher insurance premiums) that this might provide equal health care to ALL, regardless of income. Again, I'm pretty conservative politically, so higher taxes/premiums for people who have worked hard to achieve the "American Dream" doesn't sit well with me----BUT-----since health problems and their costs affect virtually all of us----some more than others---it seems that this approach might be worth a try.

As I said, this idea is off the top of my head, so obviously I haven't had time to think of any long-term merits or negative consequences.

What do all of you think?


I have to agree with barton--government hands in the healthcare would be disastrous! Look at the Medicare now and the new PPS. When they figured out daily payment rates they did not include nursing input. Nor have they disclosed the actual nursing part of the payment plan. It's rumored that nursing is only 20-30% of the daily rate paid out to LTC facilities even though it is nursing at the bedside 24 hours a day and the largest part of any healthcare budget.

I would say that if administration has turned a deaf ear to your pleas, then as a patient advocate it is high time to involve the public. A letter the editor of your local paper will get the public actively involved. I would include a plea from the public to write their legislators,as barton suggested, and the administration of the hospital as well. Once inundated by public outcries...they'll listen.

I've heard that on the east coast hospitals are having the same problems. Some with unions are running informational picket days. Work continues,but on off days, workers are picketing to make the public aware of the unsafe staffing policies.

I wish you luck in your efforts!


Thanks for responding, (and by the way, I live in the Southeast).

Let's ALL write the American Nurses Association and ask if they are doing anything about understaffing and let's ALL write our state legislators and ask the same question of them!

How about this?-----if any of you DO write to the ANA and/or your state legislator, PLEASE post that on this forum.-----and if you receive responses to these letters, how about posting the information you receive?

If we ALL do this, and see the list GROWING on this forum, perhaps we can generate some ENTHUSIASM, knowing that we are working together to improve patient care and our working conditions!

Let's do something positive!

I'll start with me:

February 26, 1999--barton e-mailed the ANA--

[email protected]

Waiting for response.


Hello everybody on the Titanic! Yes, once again the sinking boat analogy. Isn't it hard performing the nursing duties with that life jacket on? Today were had 2 experienced unit RNs and a mediocre float RN (sorry!) to care for 8 pts, 4 of which were on ventilators, an MD doing a swan, another doing a quinton, and waiting for the thoracotomy to arrive from surgery. No stress there! Forget the breaks and meal that are mandated by law, the hospital doesn't care if we don't have 10 min. to recoup ourselves. Of course there was an hour overtime, but I won't see it as time and 1/2 because my institution did away with time and 1/2 after 8 hr in a day, last year. I stayed over 4 hours to help last week and that just put me up to 40 hours in that week, so I won't see andy time and 1/2 for that extra stress I put myself through, and yes, I got ran down and caught a terrible cold, but didn't call in sick because I knew my fellow staff members would be way stressed to be a nurse short. I know you all have similar situations, but ot ventilate helps me to dal with the frustration. I figure the only thing that will shake up administration are lawsuits from pts/families, or the regulatory agencies coming in and inspectiong the situation. Of course in the past when they come for inspections, the books of staffing are doctored in a way to make it look acceptable. Could all our postings be sent to someone that would care or look into the problems? I thought that was a really good suggestion from someone to notify AARP, since they are a strong advocacy group and most of our patients are seniors. Good luck to all!

Barton: I just saw your suggestion on who to notify and I mailed letters to my state assemblyperson, (just call your state capitol, tell them where you live, and they will give you the address of your assemblyperson, and our governer (in Cal.)Gray Davis, State Capitol, Sacramento, Ca.95814. Also, write your state senators, you can get their names the same was as the assemblypersons. It's not that difficult. We could also talk with the NLRB (national labor relations board), ANA,CNA ( in Cal.) Who else?

Nurse Angel, You did not mention what your working conditions are.... What are your nurse/pt ratios and do you have nursing assistants? My facility is making cut backs too, but thankfully no lay off.


I can't tell you how happy I am to see you have taken action by mailing those letters and responding here!

The e-mail address for the American Nurses Association is:

[email protected]

Thank you as well for explaining how to get the addresses of our legislators (that was next on my list---hunting for their addresses)---you saved me a lot of time. PLEASE post any responses you receive (as will I).

NOW---HOW MANY of you out there are going to join Sophie and me??------or are we just going to spend the rest of our lives complaining to each other??!!??



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