Need ideas arranging staff

[FieryPsychRN, BSN]

I am a fairly new DON and I need guidance from all of you wise ones out there regarding staffing. How do you move nurses around, or change their schedule without dropping the morale and them end up quitting? I need to move an LPN from days to night shift very soon!! Plus I feel like we have too many CNAs at night. Ideas anyone?

[TBlase]

I take this to mean you need one less day nurse, and one more night nurse? If I were DON, I would hold a staff meeting, to tell the staff that you are facing a situation, and why (be frank) , and then ask if any day nurses want to move to nights. Or any 3-11 want to move to nights, and then if any day shift nurse wants to move to 3-11. Or, you might even be suprised at solutions that might be offered up. If nobody jumps, you can then hire a night nurse, while informing your staff that in that event, a day nurse will be laid off- based on seniority, in my opinion. Fair, open, transparent, the way to minimize pain all around. I don't envy you. But I also wouldn't want to see you alienate staff, and cause more pain that must be caused? And even though nurses are a dime a dozen anymore, with no jobs to go around...being frank, honest, appreciative, rather than heavy handed, will do nothing but make your job easier?

[wyogypsy, RN]

@ TBlase - were you being facetious saying nurses were a dime a dozen with no jobs to go around? Wow, that would be the dream of so many places I know who are struggling to find enough nurses to cover shifts, there aren't enough nurses living in those areas to fill the needs.

[SoldierNurse22, BSN, RN]

TBlase is correct... generally speaking, there aren't enough jobs to go around, and it's especially difficult to get hired as a new grad. There are (as always) exceptions to this rule in parts of the country, but the exceptions aren't the norm, that's for sure.

It isn't so much a lack of job availability, it's a lack of funds or lack of willingness ot adequately staff hospitals due to the cost of hiring an RN. It will take time to convince our nation's healthcare system that adequate staffing is important to outcomes and is less expensive in the long run, but it's a worthwhile fight.

OP, I agree with TBlase's idea. Suggest it to your own staff first and see if you get any bites. A lot of people would rather switch than lose their job in this economy.

[TBlase]

@ TBlase - were you being facetious saying nurses were a dime a dozen with no jobs to go around? Wow, that would be the dream of so many places I know who are struggling to find enough nurses to cover shifts, there aren't enough nurses living in those areas to fill the needs.

Everyone reading this forum is waiting for you to disclose these so many places that don't have enough nurses living in them, please:

[HeyHeyitsMaay]

The issue is that most places don't have enough staffing to cover health care needs. We're faced with initiatives like INTERACT that require advanced critical thinking skills of new grads who aren't even taught to make a bed or why it's a critical first line intervention in reduction of facility acquired pressure ulcers. We have shrinking CMS funding and growing censuses with very complicated comorbidities. I've had more than a few nurses who I've hired who quit within weeks because they can't or don't want to handle the level of care and responsibility required of them. We do our absolute best to hold on to nurses and bleed care and concern for their needs as nurses and human beings. It's not enough when we're so heavily regulated that the level of complication of the requirements handed down from DADS and CMS is directly proportionate to the frustrations, lack of sound education inclusive of teaching the reality of how grueling nursing really is, and the millineal generation entering nursing with crazy expectations.

[FieryPsychRN, BSN]

Basically I have a nurse in a position that I don't feel is a good fit for her and I want to hire someone to fill her spot and that would mean I would need to move her. It's a sticky situation but I need to make the change for the better of the facility.

[TBlase]

Ah, the plot thickens. You don't have a staffing issue at all. You have a nurse you don't want or like or trust on day shift, but you need a night nurse, and are wondering if you can push here there, and keep her morale intact, and prevent her from quitting? You have to have a face to face with her, and be honest:"I am not sure you can handle the day shift. But I would like to keep you, because you're a good nurse. Unfortunately, the only other opening I have is on night shift- will you consider taking that?" She may, or she may quit. But since you've already made your mind up, you have to face that. But if the reality is that you want to get rid of her, and are trying to scheme ways to make her quit without you having to fire her, I say you owe it to her, on a professional level, to fire her straight off.

[TBlase]

@ TBlase - were you being facetious saying nurses were a dime a dozen with no jobs to go around? Wow, that would be the dream of so many places I know who are struggling to find enough nurses to cover shifts, there aren't enough nurses living in those areas to fill the needs.

Anybody out there, wyo? My bags are packed, I'm waiting for you to tell me where to go!