I guess I am starting to wonder why we can't tell the patient that.
I thought I knew- that it was rude- that it equated to saying "I don't have time for you"- "you aren't important" etc.
However, in my garbled mind, I am starting to wonder who, exactly, this omission really protects.
As a nurse, slammed and hurried, rushed and prodded by the latest budget meetings, job stability feeling shaky in her mind... along with the disease processes, the calculations, the mental to do lists, the hourly rounding to be signed on the doors, constant charting- in multiple locations, phone calls, the sounding alarms, the delegation, the collaborative efforts, new orders, lab interpretation, the basic ABC's...
that's a lot going on... and that doesn't even take into consideration the patient...and it's true! We DO have harder times getting into patient's rooms, we do spend less time "actively listening"... hard to do with that work load on your back...
If a patient is attentive, they know that the nurse is overloaded... aside from avoiding a lawsuit, what is the point.
There are ways to say things that do not covey that the patient is not important..
Now- I am not going to say it, and I understand why it's not appropriate, but I just wonder....
I'm curious, for those who are staunch opponents against saying you are short staffed, what do you say when a patient directly asks you if you are short staffed (and the truth is the affirmative?)
However, in my garbled mind, I am starting to wonder who, exactly, this omission really protects.
As a nurse, slammed and hurried, rushed and prodded by the latest budget meetings, job stability feeling shaky in her mind...
While working in LTC, a very frustrated RN told that to a family who was demanding something or other. We were working on the TCU and they had sent one of the nurses home and split the high demand residents between the other two - without even notifying the nurses. He is a great nurse, had been laid off from a local hospital and they were lucky to have him.
Of course, management crapped all over him. He was written up and as punishment was being rotated between the Long Term and Dementia floors for a couple weeks, always rotating to different floors and carts. Due to his competence, he was probably seen as a threat and they would have been happy if he had just quit.
He bit his teeth, did his penance and was eventually hired back by the hospital, thankful to get out of there with his license.
Where I work, we are so short right now that midnights not only does much of thier secretary work, and CENA work, we are now being 'mandated' to stay over or come in early for a total of a 16.5 hour shift. I am exhausted working every weekend, and on call an extra day. I love being a nurse and working with patients, but I feel so inadequate and like the NM is setting us up for trouble. I do not feel safe giving out meds after 14-16 hours, or driving home an hour after being up for 24 hours. I am really grateful to have my job, but also scared because the understaffing and trying to save $$ is leading to very real possibilities of disasterous results, and low pt satisfaction.
I feel confused and sad. Having heard for the last few years about the nursing shortage and job security for RNs, what has happened? My hospital brought in a consultant and now we have staffing grids, to make sure there are no extra RNs or aides based on pt population. Of course, the grid does not take in to account acuity! Meanwhile as the original poster implied we must continue to fulfill all of the current RN responsibilities. If we are busy and understaffed and I don't have time to eat I am getting the feeling I had better not clock out for "no lunch". My hours have been cut and certainly no overtime!! All this stress added, and I shouldn't burden my patient with any indication that the unit is busy!! I don't feel like I am being respected any more as a RN by my employer. I don't feel they understand the important and difficult job we do!
I'm curious, for those who are staunch opponents against saying you are short staffed, what do you say when a patient directly asks you if you are short staffed (and the truth is the affirmative?)
I'm not opposed to saying "we're short staffed". I just don't for fear of what management will do when they find out that I have. We were threatened, without being threatened, if you can understand that, with repercussions if we said those words to pts or families. Since I'm too scared to be honest, I usually tell a lie by omission. I'll say...."the hall is full" "we've gotten alot of admits" "several nurses are on break"....... Half truths that skirt the issue.
Many of my patients figure it out on their own, they'll comment "wow, you sure are busy today, I keep hearing your name paged to this room or that room" and "honey, you need to sit down...I've been seeing you hustle up and down the hall all day!" I appreciate it when they notice that I've been busting my rear, and not off eating bon bons in the break room, and I just laugh and say "yes, I'm quite popular today!". We have spectralink phones, but when I don't answer (cause I'm already ON the phone dealing with one issue or another) my unit will page overhead...most days I'd prefer to be invisible rather than 'popular', lol:rolleyes:
Reminds me of when management was telling us we needed to say the line "I have the time" to patients every time we are in their room. It is very frustrating how they want us to lie to patients to cover their butt and put our own on the line in its place. I simply won't do that. My patients are adults and (usually ) can handle the truth that I have a patient not doing well so I don't have the time to find the channel they want on the tv.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
personally, i'd rather know my nurse was overworked than wonder if she was incompetent or inefficient.
i agree. i'd rather hear "short staffed" than have my request for the bedpan ignored for two hours while the nurse plays solitaire on the computer . . . which has happened to me as a patient. "short staffed" beats don't care any day. and maybe, god willing, if enough press-gainey surveys come back complaining that mamma didn't get her sweet tea immediately upon demand because the unit was short staffed (as opposed to, maybe, because all the nurses were in a code or an insane gunman was holding them all hostage), perhaps the suits would ensure adequate staffing.
When pt's ask if we are short staffed I usually say something like, "Our census is up tonight. Although I have everything undercontrol you might have to be pretty patient tonight. They call it being a "patient" right."
Therefore I have not lied or made myself look bad, but reassured the pt that I will still give good care, but it may be a little slower. Ending in a little joke usually eases the tension.
) can handle the truth that I have a patient not doing well so I don't have the time to find the channel they want on the tv.
PostOpPrincess, BSN, RN
2,211 Posts
Does one really need to say it when the patient inherently figures it out?