Is staffing always this awful?

[7student7]

It this sort of staffing/census situation common in other hospitals? I'm just not sure where my unit falls - is my hospital particularly bad or am I just not handling it very well? Sorry this is so long...

I'm a night shift (6p-7a) tech at psych hospital on a floor that is supposed to have 15 patients. We'd been having 20 patients so management magically switched our limit to 20 and then they gave us 23!

We're supposed to have 2 nurses for 15 patients, and 3 for 16+. Lately we've been having 2 nurses, even with 20+ patients. Usually only one is an RN and this pretty much guarantees the RN won't get a lunch because there are many things LPNs can't do at our facility.

Typically, we have one tech per 1:1 patient and then an additional tech for on the floor (if we're lucky). Many nights we have no tech on the floor and one of the nurses has to do the tech work.

I am one of the only female techs that works nights, and also one of the few with any experience. Our experienced male techs are often pulled to the Intensive Supervision Unit (violent patient floor), so I am usually the one left alone. I have to do everything by myself and feel awful when I take a lunch because the nurse has to do my work on top of hers for that hour (lots of paperwork every 15 min). Also, due to our close ties with the Intensive Supervision Unit, we usually end up giving breaks and running errands for them.

The nurses help me but they're in the same crappy situation, so it's just all bad. The newer techs are usually placed with the 1:1 patients all night and I'm responsible for giving them lunches, so I that gives me about 2 less hours to get all the floor work done most nights.

And, to top it all off, housekeeping, laundry and dietary completely fail to take our census into account so we are always out of towels, clothes, bedding, snacks besides saltines, coffee filters, laundry soap, even hand soap in the snack room for a while.

I'm terrified someone's going to manage to commit suicide or something because I was running the hospital looking for clothes or cleaner or teaching a new tech how to do something instead of doing my room checks.

Lastly, I'm doubly stressed because day shift gives us terrible reports (they fail to mention important things like MRSA and catheters) and complains about us to the nurse manager for not doing enough work and the manager takes their side because the woman hasn't even met most of us night shift people!

I guess this is more of a rant than a question, but I do wonder if other psych hospitals are ever this awful. Supposedly the summer months are in the worst in my area. Man I hope so, because I can't handle anything worse! I LOVED my job at one point, but this is wearing me out.

[Flipper911]

that is why laws that mandate nurse/patient ratios are important. Hospital administrations will push the envelope more and more to save the all might dollar. Who cares if nurses/staff burnout, you can be replaced.

I originally was licensed in Florida and when the law was being considered to mandate ratios the state nursing association came out opposed to it. Like any of those old hens remember working a floor. I am sorry, unless hospital administrations are held accountable they will take advantage of staff at every turn.

[Zookeeper3]

I don't know if it really matters, because management varies so much with what they do. When I graduated, 15 years ago, I worked for a private psyc. hospital, not state or local. I had complete responsibility for 7 or 8 patients.

We had a med nurse, an LPN, who was the end all and be all and taught me everything. As an Rn I was responsible for the plan of care, taking off orders and chart checking at night. (worked 3-11). During that time I had to build rapport with my patients, enact my plan of care, discuss progress with councelors, the med nurse, do my own assessments and take part of the Q15 minute checks as assigned.

What happens is you end up doing more paper work, more CYA and less interaction as your shift progresses. Less time to teach about meds, compliance, side effects.... someone shows their butt and your whole shift is thrown off due to a take down or intervention and everyone else suffers.

Only you can know, if this is a short term issue (and ask management about that), or if this is an EXPECTATION. If you can't connect, can't teach, can't make a difference, only chart.... you know where you stand.

From there, only you can decide if this is something you can live with as a career. Speak to management, don't listen to the grape vine and determine where the stance is on patient care. You'll know what to do from there.

Psyc, is a very, very sad place to be again lately with all the cut-backs. I left it 14 years ago because I wanted ICU, but still love my psyc. patients. It never leaves you, but if you choose to leave, you maybe can better serve them in a different role if that is your love of nursing. We need more like you. Choose wisely for you personally. You can't make a difference burnt out and hating where you are. HUGS

[SlightlyMental_RN]

Our staffing has been crappy for about a year, too. Many times when we are supposed to have more RNs, we are told to function with less, so staffing grids are ignored. Also, in our facility, LPNs have become glorified aides in many cases, so the RNs have to do things that the LPN could perform, but management says NO. It's all very frustrating. Too many times, the night shift is left with 1 RN and 1 aide or LPN for 20+ patients. Now, granted, about half of the patients are low-impact, with very minimal contact, but the other half has much more intensive needs w/regards to meds and interventions. Plus, even if 10 are low-acuity, you are still required to watch out for them, make sure they aren't sneaking into other rooms for some nooky, or sneaking in drugs, or trying to commit suicide, etc. This is why I have resolved to do no more nights, as I think it's a recipe for problems...I'd rather do AMs/PMs as then there are more staff around to keep an eye on things. Perhaps you could move to another shift? It's still bad (often over-whelming to work short-staffed), but not scary-bad like it is on noc shift.