Our units acuity is at an all time high.

grandpaj · Aug 21, 2015

We've had the same problem over the last few months. High census, high acuity, low staff. It's been a rough summer.

calivianya, BSN, RN · Aug 21, 2015

Is it low staffing because people are out or because the hospitals will not pay to hire enough staff? Just curious.

Just laid off all our LPNs, who were supposed to be resources but were actually taking assignments, and then the hospital went on a hiring freeze. So, not only were we short before we laid off people, which made us extra short - now we're not hiring any more. There are multiple shifts on the next six week schedule where we are short nine nurses. Short NINE nurses for the shift. There's only one day we're only short one person. We don't have adequate staffing for a single shift for the entire next six weeks.

I don't know how the heck those days are going to shake down. We have a float pool at my hospital, but they can only usually give us up to four or five at a time. I don't think they can cover us with nine floats, especially since the float pool department is also short staffed.

TheNGTKingRN · Aug 22, 2015

Summer also means new batch of residents. Which can mean more work for the RN as orders change every 20 minutes. Also more work as you walk these residents through the basics. Also more time because you have to KEEP reminding residents of things that are common sense... like placing an NPO patient on a higher rate of IVF... like ordering the labs to be AM labs NOT random labs at 9AM when I'm passing medications and doing assessments. I totally understand random labs/BMPs etc... but I am so over "I forgot to put it as QAM" UGH.

And I'm tired of the ones that ACTUALLY think I'm going to take a PIV on a patient going home the next day just because it's been "three days already" ... um excuse me... the pt is a hard stick... you wanna start an IJ? I'll get the supplies.

And my biggest pet peeve... being interrupted during report to get them supplies...

Please PLEASE put an order to have 4Ã—4/Saline at bedside. Please do not interrupt our report... I don't interrupt when you give report.

Sorry... long shift. Had to vent.

cardiacfreak, ADN · Aug 22, 2015

Hang in there, guys.

If I hear this from my manager (who doesn't come out of her office to help) one more time I may just punch her in the throat! Looks like this problem is country wide not just my hospital.

i keep telling myself and my coworkers, "It will get better."' But I'm not really so sure, it might be time to start looking for other options.

cracklingkraken, ASN, RN · Aug 22, 2015

If I hear this from my manager (who doesn't come out of her office to help) one more time I may just punch her in the throat!

I laughed out loud. This sounds like something I would say. I like your style

n.igmatic1 · Aug 22, 2015

It's oddly comforting to see that this is happening all over, and not just in my unit. I feel a tad guilty because I am jumping ship to the OR in 2 glorious weeks, but if I don't look out for my best interests no one will.

0.adamantite · Aug 22, 2015

Same story here. Short staffed constantly, beds overflowing with patients. Very ill patients, too. We can barely keep up, some nights most area hospitals are full and we are sending patients to the next city!

ixchel · Aug 22, 2015

We've been seeing the staffing issues, but not as much of the acuity issues. It is a stepdown unit, though, so we're used to the acuity we're usually at. I say that with caution, though. Our worst time with acuity is typically January.

I'll second the sepsis observation. Dopamine drips, too. Surgery has decided our ICU is their personal daycare, so we've been keeping more people needing pressors.

CT Pixie, BSN, RN · Aug 22, 2015

Count me in!

Constant full census...can't think of a day I've worked in the last few months that if it wasn't full when I walked in (2300-0700) it quickly filled with admissions within the first few hours of the shift.

We are a specialty floor but we also get medical overflow b/c we are tele as well. So we get pts who really belong on another floor but aren't there b/c that floor isn't set up for tele.

High acutity patients that are teetering on heading off to the units..and when they do, we get new admissions quicker than you can blink your eyes, who are basically a carbon copy of the one we just sent to the units, just teetering on needing to go to the unit themself.

constantly changing orders b/c the new docs are on the floors...nice enough bunch i've noticed (very polite to everyone, tries not to bother the nurses during report, sincerely want our input and actually LISTEN to what we say and act on it..its been nice.), low staffing due to vacations, short anyway b/c we have a few holes in our staffing.

Nurse tobe · Aug 22, 2015

While I am not a nurse yet, I have seen first hand what you ladies and gents are going through. My hubs had to have a procedure done and bless this nurses heart, she was the only one there at the time. She had a lot of other patients needing things as well. We understood and tried to help her out as best as we possibly could. She was very sweet. So I understand. I wish AN had a 'hug' button.. I would hug the ever living daylights out of you guys!! (more if I could). You are all awesome!

linda535 · Aug 22, 2015

Not just in hospitals. High and increasing acuity, no "summer slump" and no staffing increases. (But thank God, no drops in staff!)

"Flu season" all year round now.

I think the higher acuity is partly related to insurance. Pay-for-insurance people wait longer to be seen because it's so expensive and "free" insurance people just keep coming in.

imintrouble, BSN, RN · Aug 22, 2015

Is your acuity the really sick people? Or the heavy lifting, confused, high maintenance crowd?

Two different patient populations.

When I spend a shift running after personal alarms, or turning every 1 hr because the patient demands it, I prefer the really sick ones.

Then when I have a shift where 3 out of the six are full codes checking out, I'd rather have the confused ones.