safe assignment

[martymoose, BSN, RN]

lately we have been short, although it seems that this may actually now be a trend. So everyone is upset and says "this is such an unsafe assignment.

My question is, is this now a new trend? I mean, I know being "understaffed" ( i put that in quotes, because I think that will be the intentions in the long run) happens, but it's more and more. We all dont even want to come into work for fear of such heavy assignments and how "unsafe " they are. This kind of fear is making everyone else leave, thereby making us even shorter staffed, or making the rest of us who have to stay very sick with anxiety and anger at times.

It's no so much the "numbers" its the acuity. Very sick pts, being mixed in with snf placement who are behavioral/delirium/demented and huge fall risks. It's as if those pts are more important than the very sick ones( who belong in the unit, but , alas, "there are no beds") and we spend more time babysitting them so we don' get dinged for a fall.

They've reduced our techs, sometimes we only have 1 or 2 for 28 beds.they do the ekg and blood draws, which take priority over babysitting pts who wont stay put. we've even almost lost ptsthat are demented as they try to sneak out the door!

Is everyone else in acute care experiencing this?

[XNavyCorpsman]

Get a Union.

[Jules A, MSN]

Get a Union.

I wish it were that easy.

OP if this is becoming a pattern and your peers are leaving I would suggest you do so also. It is frustrating and sometimes sad if you enjoyed your job but a no win situation for the nurse, imo.

[proud nurse, BSN, RN]

It's pretty much like this at my job, too. The more we function this way, it's like it proves to management that it can be done. When I complain about our staffing ratios, they don't seem to understand the position we are put in when they don't provide safe staffing based on patient acuity.

[mmc51264, BSN, MSN, RN]

there are supposed to be changes coming at my job. More in middle management that floor nurses, but it's producing a little anxiety.

[Jules A, MSN]

The more we function this way, it's like it proves to management that it can be done.

This pretty much says it all. What are your plans?

[martymoose, BSN, RN]

This pretty much says it all. What are your plans?

I just don't know

[EmergencyRN22]

Pretty sure everywhere is like that. The grass isn't always greener on the other side …and if it is THATS because its **** covered. :) good luck

[Anna Flaxis, BSN, RN]

Rules about staffing vary from state to state. Some states mandate that hospitals have staffing committees responsible for formulating staffing plans. Does your hospital have one?

Are nurses missing breaks? Staying late to chart off the clock? These are issues that can be raised with your state's labor board.

[jadelpn, LPN, EMT-B]

Do you have staff meetings? Perhaps have conversation with your manager and find out if there are plans to increase staff due to acuity issues. A thought would be to have per diem sitters who help with the delirious high risk fall patients. Another thought is to pilot a team nursing concept. Or that 3 nurses take the LTC patients and the rest of you take the acutes (switch off so no one gets burned out) The LTC patients have team nursing--one does x, another y, and then a z. The acute care has a primary nurse, however, there's one "floating" nurse who assists with meds and the like. The CNA's stay as a team. They literally go down the line and work together to get what needs to be done, done.

The Joint Commission has guidelines as well on staffing numbers. That would also be a good reference.

I would think about a union. Any number of union contracts do not address patient load. And they should. Just because it is not done often, doesn't mean it can't. Anything can be negotiated. And what that gives you is another reference to record unsafe staffing levels. This is the information that is then brought forth to management to attempt to make changes.

The trend really is to do more with less. It is a bottom line business. Which is so contradictory to what a nurse feels their goal is, but it is a reality. And it is everywhere.

[HouTx, BSN, MSN, EdD]

Completely agree - conversation with your manager is the place to start. Has there been a change in the staffing plan for your department? If so, you and your co-workers should have been informed. Be sure to do your homework. Does you state have any regulations about nurse staffing? What is the daily staffing plan for your unit? How are staffing variances managed? Are there insufficient PRN nurses to fill the gaps? What is the overall strategy for staffing when you have a call-in? How is vacation time covered?

Discussion of issues at a staff meeting is very appropriate, but I would suggest taking steps to prevent it from turning into a gripe session. For instance, ask for suggestions to improve efficiency and prevent re-work or duplication of effort. If you only have 2 techs, I am sure that they would appreciate some sort of advanced task schedule so they can plan their day a bit better.

BTW, the JC does not actually recommend any staffing numbers. They have standards related to 'staffing effectiveness' that require an organization to allocate, track and measure staffing, but no actual ratios or numbers.

[~PedsRN~, BSN, RN]

We are in the same boat, and it's dreadful. They are offering incentive pay, but no one wants to come in to work extra because it's just such a cluster. I have never ever dreaded work, but lately I have. I am not even sure what the answer is, although I do hope with the warm weather coming things will slow down a bit. I love my job, but I spend so much of my time feeling stressed out and worried about working that it's just - UGH. I see where burnout comes from. This has been a horrible winter for us. Management doesn't even want to hear about it because honestly I do not think that there is much that they can do at this point to fix the situation.