As nurses, staffing seems to be a widespread problem, but it's one that we shouldn't have to accept. Lately, I've been trying to come up with ideas to help better staff my own unit.
Today, I explicitly told the DON and schedular that with the growing number of patients and rising acuity, my unit requires 2 nurses and 2 aides at all times. I was given various reasons as to why this was not possible. I expressed understanding but then also pointed out we should not have any Hoyer lift or assist of 2 patients on my unit if not enough staff are available. Again, this didn't go far, and of course there were reasons why these patients couldn't be transferred over to the better staffed unit.
I am at a loss for how to go about resolving this. I am trying to figure out a way to provide better staffing that doesn't involve expecting me to be a manager and a floor nurse at the same time.
A couple of ideas:
1. Document every time a resident puts on their call light. This will demonstrate how frequently residents are requiring staff attention.
2. Document behavior/mood notes every shift on residents that require an excessive amount of attention from staff.
3. Make a list of ALL the tasks needed for each resident. There are over 500 items on the TAR for nurses alone, which is too much for one nurse
Any ideas? Has anyone ever successfully advocated for better staffing with good results?
It is so interesting that some people on the internet are put off when another does not follow their advice.
Some have an overinflated sense of self-importance and believe others should follow their advice merely because they gave it.
Only when one can live another's life should that advice be taken without hesitation.
Well said. There are many reasons why a person doesn't/cannot leave a less-than-perfect job. One thing that keeps me in mine is the thought that my loved ones could end up hospitalized - and if everyone leaves who will take care of them?
Specializes in Psych (25 years), Medical (15 years).
Thank you for your support, Lynden, Orca et al, for it is good thing when members of a community can consensually support one another's interpretation of a perception.
I do not wish to derail the topic of this thread...
On 4/7/2022 at 7:14 PM, SilverBells said:
Any ideas? Has anyone ever successfully advocated for better staffing with good results?
...however, not adhering to the topic is a common practice on forums when a member puts personalities before principles. To take the focus off of the message and put the focus on the messenger is not only derailing the thread, but the act is also a fallacy in reasoning. Chasing a red herring, so to speak.
We can avoid disharmony by utilizing logic, and not emotional feelings, when opposing viewpoints are to be expressed.
Unfortunately it has taken voting in a union to be heard. No contract yet. Meeting next week to discuss staffing concerns. DON wants suggestions/examples of appropriate staffing to come from current national standard recommendations - most of which I've seen do not take acuity into account so seemingly wouldn't help your situation. It's good they are giving us the opportunity to at least discuss, however, I feel the national standards are not always helpful for small hospitals as it still can leave a nurse alone in a unit. Will see how our meeting goes. We, like so many other hospitals, have so many staffing holes they are willing hear us out at least to avoid losing more staff.
Specializes in New Critical care NP, Critical care, Med-surg, LTC.
While this is only my opinion, and will not be backed up by any facts, I think that most people that are giving the advice that SilverBells should find a different job are coming from a place of support. There have been many threads started by SilverBells pointing out the numerous shortcomings of her current place of work. The lack of supportive management, the difficulties with certain staff members, and how she has been treated personally all paint a picture of a difficult work environment. There must be some positive aspects to the job, and as others have pointed out, changing jobs always carries some risks. Perhaps people are encouraging her to move on with the hope that if enough people present it as a viable option, she will find a position in which she is valued commensurate with her work as a nurse. I haven't read the comments encouraging her to leave as coming from a place of superiority or disbelief that a stranger on the internet wouldn't jump to follow the pearls of wisdom from a bunch of strangers behind keyboards, I like to think that members of a support board are doing what they come here for, to try to support another nurse in finding something that will make her happy. Perhaps everyone that repeats "as has been said before, move on" thinks that maybe their words of support will be the ones that give SilverBells the confidence to move on to something more rewarding.
Specializes in Psych (25 years), Medical (15 years).
1 hour ago, JBMmom said:
While this is only my opinion, and will not be backed up by any facts, I think that most people that are giving the advice that SilverBells should find a different job are coming from a place of support. There have been many threads started by SilverBells pointing out the numerous shortcomings of her current place of work.
Au contraire mon frere! Your premise (opinion) was immediately backed by the fact that SilverBells has authored numerous threads on the shortcomings of her current place of work.
However, I am going to argue the point that "people... are coming from a place of support".
In another thread I argued the premise that some of us are here to altruistically support and/or help others. I will reiterate my premise: We are all members on this website for our own benefit, whether that be for entertainment, to feel better about ourselves or our situation.
People who truly want to altruistically help others do not sit around on their computers and type about it. People who want to selflessly help others are out there in the front trenches.
One might argue the fact that we are-or have been- in the front trenches as nurses. Even that premise is debatable, as paychecks and feelings of self-satisfaction are gained.
There's a concept by Daniel Gilbert who authored "Stumbling on Happiness" he labelled "getting twice the juice from the same orange", where we anticipate an experience and savor the same experience. For example, when we perform a quality act of servitude, we feel good about ourselves. When we post that act on allnurses, we're getting a second helping of juice from that same orange.
To further argue the premise of "support", we all have read posts where SilverBells was viciously attached and criticized because members disagreed with her. Attacking the person and not the premise is not support, it is a person with low self-esteem putting down another in order to feel better about themselves.
There I will end the premise in readiness for a counter-premise.
I am at a loss for how to go about resolving this. I am trying to figure out a way to provide better staffing that doesn't involve expecting me to be a manager and a floor nurse at the same time.
At a loss for answers?So is the entire nursing profession,anything short of a 1-3 day strike is useless.We have made reports at the labor board,filed grievances,they only give lip service, and a cute trinket for Nurses Day.Chronic understaffing is not an emergency for mandating forced floating,overtime and severely penalizing sick time use.
When you know for months that two of your staff will eventually be on maternity leave and you do nothing ,and then expect staff to change their hours and weekend schedules after they are gone on maternity leave.
Sorry there is no answer only patch work measures.
Specializes in New Critical care NP, Critical care, Med-surg, LTC.
2 hours ago, Davey Do said:
Attacking the person and not the premise is not support, it is a person with low self-esteem putting down another in order to feel better about themselves.
I am most definitely not speaking of those that have attacked SilverBells, or any other members, personally, in the course of their responses. There are certainly those that prescribe to the "misery loves company" theory and have made it part of their lives. In almost all of those cases, the negative thoughts they put forth speak more about themselves than they do about the original poster looking for support.
I would, however, still argue that there are people here with the intent of doing good. Maybe not solely doing good, certainly entertainment is a factor in why we come here. (But I don't think we need to be "out there in the world" to be doing good, I've already worked my 12 hours today and other than walking my dogs, by leaving my house I wouldn't do anyone much good) In their research paper: Individual and social benefits of online discussion forums - ScienceDirect, Pendry and Salvatore found that people derive individual benefit from online discussion boards and even foster a stronger feeling of commitment to the social issues put forth online. For nurses, we have a different sort of relationship with our coworkers. For nurses that are feeling insecure about an issue, or are trying to brainstorm an issue that their coworkers do not have expertise in, an anonymous forum is potentially the best place to come for help.
Don't want to derail SilverBells' initial thread, but they have tended to become more divisive than some others. I do think that many nurses have tried to point out that the current difficulties faced with staffing that SilverBells recounts are just another symptom of a workplace that doesn't value the workers or residents as they should. However, these days, are there any hospitals, facilities, or management groups that DO seem to place appropriate value on employees and patients? Not many people share stories of such places. Everyone would love to have a magic answer that would suddenly give nurses the time and resources to do absolutely everything possible for the patients, but that's not the real world.
Specializes in New Critical care NP, Critical care, Med-surg, LTC.
1 hour ago, Leader25 said:
Sorry there is no answer only patch work measures.
One of the most common right now is travelers. My night staff in the ICU should be 14. Right now there are four, including one two weeks off orientation and one with about six months. Other than that it's just travelers. I tried to pick up time for this week and was told no. Then last week I pointed out to my manager that four nights this week they have five travelers on with no one to be in charge. Suddenly they need me to pick up those four days this week. If I hadn't offered ahead of time, they would have had to mandate someone from days or pull a resource nurse from another floor. Short sightedness on the part of management always rolls down to difficulties for the staff, even when it wouldn't take that much time or effort to plan ahead. (I do realize that even small tasks accumulate into large drains on time, but appropriate staffing should be a priority in care environments)
Specializes in Psych (25 years), Medical (15 years).
27 minutes ago, JBMmom said:
I would, however, still argue that there are people here with the intent of doing good. Maybe not solely doing good, certainly entertainment is a factor in why we come here.
Agreed. The vast majority would like to find kindred spirits, experience fellowship with other nurses, be supported in their trials & tribulations, and recognized in their efforts to deliver quality care to those they serve.
Davey Do
10,666 Posts
It is so interesting that some people on the internet are put off when another does not follow their advice.
Some have an overinflated sense of self-importance and believe others should follow their advice merely because they gave it.
Only when one can live another's life should that advice be taken without hesitation.