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....
Specializes in Psychiatric, Home Health, Geriatrics.
The REAL reason you should NEVER tell a pt. or family that you are "short staffed"? Because it will come back and bite you in the a-- if ANYTHING untoward happens to that pt. You have a responsibility, in all of the 50 states to refuse to take a pt. assignment that you KNOW to be unsafe. Telling a pt. you are "short staffed is an acknowledgement of the situation; and if you have not made a written protest, your but is in a sling if a lawsuit arises. STOP being doormats, nurses, and get yourselves into a union that can help you prevent/defend yourself when this kind of situation happens. YOU DON'T have to put up with these abuses anymore!
EXACTLY!!! I have never hesitated to tell that to a pt. We need to remember, we are PATIENT advocates, not bean counter advocates! The only way it will change is if there are complaints by the pts. - WE are not in a position to do it so why not let those who are in that position do it?
The media needs to level with the public about the problems in healthcare. So many studies support that the nurse/pt ratio has a major effect on the pt outcomes, also less medical errors, If the pt and familes were more informed then they would be the ones asking How many pts does my nurse have? We get the pts and family asking these questions then since we are so customer oriented then we would see changes. However so many local newspapers are more into selling the ads then to hit the real stories, and the local hospitals put a great deal of money into the local media. So they are not going to "bite the hand that feeds them" unless and the shame of it is, it will take some real bad situation before anything will be out in the local media. Until then they can brag to the public about all the new equipment,the new doctors, the new wings open and never touch the nurse/pt ratio issue. I would love to see "Come to "We Give a D___M Hosp. (WGDH) were your nurse has 10pts to take care of you, versus come to WE Really Give a D___ General (WRGDG) where your nurse will have 5 pts. Now I know I am just blowing smoke. But if we had a more educated customer, then we would see changes. But as long as the media and others just go on like nothing is happening we will not see much change. Oh yeah the idea that you have a right to refuse a work load sounds good but if you live in a right to work state, the next day your looking for a job and if by chance you have the Wal-mart healthcare system which buys out all the local hospital and becomes a chain you may then find your self knocking on the doors of the local nursing homes looking for a job, or on the corner with a sign will nurse for food. Unions are a good option, if your living in the right part of the US but trust me there are areas where just the whisper of union can get you in a world of problems. So go on the Med-Scape site and search the the results of nurse/pt ratio and share them with the local media and see. I even tried a local independent so call liberal newspaper and they were not even concern. So hang in there! ?
Specializes in ICU, Telemetry, Neuro, Ortho, Med/Surg.
I never have to say to my patients that we're short-staffed...they see us running around like crazy and TELL me there's not enough staff.
Management knows this too. Still waiting for the staffing miracle to happen...
I have had patients and their families notice as well that I am on a constant go, go, go... They have made comments to me about being short-staffed, "the floor must be full today", and/or "you are really busy". I have never said we were short-staffed because we were told as well not to say that.
And, we are usually not short-staffed and crazy busy due to a call-in or needing to hire another nurse b/c one quit or such. Our hospital/company over hospital allows us certain # of nurses and techs depending on patient census, as with probably everywhere. Ours is not realistic, and it definitely does not take acuity of our floor's patients into consideration.
The media needs to level with the public about the problems in healthcare. So many studies support that the nurse/pt ratio has a major effect on the pt outcomes, also less medical errors, If the pt and familes were more informed then they would be the ones asking How many pts does my nurse have? We get the pts and family asking these questions then since we are so customer oriented then we would see changes. However so many local newspapers are more into selling the ads then to hit the real stories, and the local hospitals put a great deal of money into the local media. So they are not going to "bite the hand that feeds them" unless and the shame of it is, it will take some real bad situation before anything will be out in the local media. Until then they can brag to the public about all the new equipment,the new doctors, the new wings open and never touch the nurse/pt ratio issue. I would love to see "Come to "We Give a D___M Hosp. (WGDH) were your nurse has 10pts to take care of you, versus come to WE Really Give a D___ General (WRGDG) where your nurse will have 5 pts. Now I know I am just blowing smoke. But if we had a more educated customer, then we would see changes. But as long as the media and others just go on like nothing is happening we will not see much change. Oh yeah the idea that you have a right to refuse a work load sounds good but if you live in a right to work state, the next day your looking for a job and if by chance you have the Wal-mart healthcare system which buys out all the local hospital and becomes a chain you may then find your self knocking on the doors of the local nursing homes looking for a job, or on the corner with a sign will nurse for food. Unions are a good option, if your living in the right part of the US but trust me there are areas where just the whisper of union can get you in a world of problems. So go on the Med-Scape site and search the the results of nurse/pt ratio and share them with the local media and see. I even tried a local independent so call liberal newspaper and they were not even concern. So hang in there! ?
I absolutely agree that this situation should be placed before the public, including the studies that show appropriate nursing care can affect patient outcomes. But your local newspaper's reporters are dealing with workloads as ugly as yours. Newspapers have slashed their payrolls mercilessly, and the heck with decent coverage. It's awfully hard to do an in-depth story like the one you're proposing when you're one of three or four people left on a desk of what used to be nine reporters. You're being told to shoot your own photos and help read copy to step in for the copy editors that were let go (but don't you dare go over 40 hours!), in addition to producing the same number of stories that nine reporters together used to generate with the four that still remain, all while making a wage that would shame Scrooge. You want to get mad that the situation isn't being covered by your local paper? Go yell at the upper management types who've run the local papers into the ground but still take trips to Aspen every few weeks when the skiing's good.
OUCH: Sorry not up to date on the newspaper and media staffing problems. But don't you think it also has to do with the fact that at least here where I live I see ad about how great the hospitals are daily in the newspaper and TV comercials. In fact they actually sponsor the news sometimes. I think that would keep the heat off of some of the stories?
EXACTLY!!! I have never hesitated to tell that to a pt. We need to remember, we are PATIENT advocates, not bean counter advocates! The only way it will change is if there are complaints by the pts. - WE are not in a position to do it so why not let those who are in that position do it?
And this is why the 7th time being short on my floor in the past 2 months I finally thought that If the patients were aware of the situation, they would stop throwing the CNA's under the bus, for not doing their job. I was trying to protect MY floor, MY PATIENTS, MY CNA's! Administration NEVER listens to me when I say you cannot leave me on a floor with 60 residents 1 LPN, and 4 CNA's for the 3rd day in a row when every other floor with the same census has FULL STAFF! Think about a CNA who has 10 hoyers! I am the fool because I continue to allow them to do it. I am so sick of it. Hence I am looking for another job... as I type this. ( Nurses know how to multitask )
I have also worked for a facility that did not want us to use the phrase "sorry, we are short staffed tonight"....Found a few ways around it. If patient is alert/orientated I use objective data. Such as "I am so sorry your dinner is 10 minutes late, there are 35 of you, and two of us here working to take care of all of your needs" I personally do not feel that this is unprofessional. It lets patients understand the dynamics of the floor, and the staffing issue. Why should staff take the brunt of the abuse when they are running around giving 150%...but can't keep up due to short staffing? I have had many of these patients then discuss THEIR concerns with management related to staffing, which I feel is totally appropriate!
OUCH: Sorry not up to date on the newspaper and media staffing problems. But don't you think it also has to do with the fact that at least here where I live I see ad about how great the hospitals are daily in the newspaper and TV comercials. In fact they actually sponsor the news sometimes. I think that would keep the heat off of some of the stories?
Oh, the lack of stories could definitely be due to ad revenues from the hospital, or because someone from the paper's upper ranks sits on the hospital's board, etc. I have no clue about your local paper, as I don't know where you live! It just depends on the type of crew you have running your paper. There are some places that take in loads of ad revenue from big hospitals but whose editors don't give a hoot and protect their reporters from that sort of pressure. There are some places where the ad revenue considerations have invaded the newsroom. But there are a lot of newsrooms where the pressure comes from how few reporters are still left rather than from what place buys what ads. The reporters there are still fighting the good fight, but have little time for in-depth stories.
It's a lot like nursing in those places - your workload increases every day, you're expected to do your own work and that of the people who were laid off last month, and you're prioritizing on the fly while managers and the general public continually harangue you with complaints you aren't allowed or don't have the ability to do anything about. And by all that's holy, you'd better not mention to the public that half your staff has been laid off when people complain about your work!
Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.
The hospital I work at actually posts our staffing at the front desk of each unit for everyone to see, including what our nurse to patient ratios are for that shift compared to what they should be based on special staffing and other variables. It hasn't caused any problems so far. I think more problems get caused by not clearly communicating to the patient what they can expect in the way of a nurses time.
WOW! What part of the country are you working. That sounds like a sensational place to work. So rather than deny your conditions of work they actually admit the problems and address it. That really sounds to me to be a progressive idea of thinking outside of the box. kudos to you and your unit for the honesty
EXACTLY!!! I have never hesitated to tell that to a pt. We need to remember, we are PATIENT advocates, not bean counter advocates! The only way it will change is if there are complaints by the pts. - WE are not in a position to do it so why not let those who are in that position do it?
Apparently, you missed the entire point in my post, as you quoted it. I said that you should NEVER tell a pt. or family member that the unit is short staffed, because if there were a serious event that happened, YOU would be liable for accepting an unsafe assignment. Your State BORN has strict policies about this, it is called the STATEe NURSE PRACTICE ACT. Get familiar with this, it overides anything your facility would like you to believe. And to another poster, you have the right to refuse an assignment at any time until report is over, and than can refuse new admissions, transfers etc., based on your professional judgement. All you have to do is document it, with copies sent appropriately to manager, DON, and hell, I'd probably send one to the Board of Directors if you do not belong to a nurses union. let 'em try to fire you; I bet they will back off after your first interview with the media (which is the third place I would go to after being fired for such an act, the first being an employment attorney; the second being the National Nurses United, who can help you understand your rights and options.
Meriwhen, ASN, BSN, MSN, RN
4 Articles; 7,907 Posts
I never have to say to my patients that we're short-staffed...they see us running around like crazy and TELL me there's not enough staff.
Management knows this too. Still waiting for the staffing miracle to happen...