Sick of working short

DusktilDawn · Mar 2, 2006

Then what is the answer? Are nurses just supposed to accept unsafe assignments all the time just to keep their job, or do you protect the license that you worked so hard for, and keep bouncing around from job to job? Talk about a no win situation! I have just applied to nursing school, and I tell you what, it's crap like this that really makes me think that becoming an rn is a mistake! Dusktildawn, is it just as bad in Canada too?

Definately there are staffing issues in Canada and definately there are facilities that try to understaff. The facility I last worked at in Canada was uniionized which meant that my employer had to go through a process in order to fire me. There was also a form we could fill out if we felt an assignment was unsafe that basically documented that fact. It also covered our butts in those situations where our licensing was concerned. I don't know if "Safe Harbor" is similar. The best advice I would give to any new nurse is:

1. Know the laws and legislature in your state that governs your practice. For instance is "Safe Harbor" an option in your state. When you state with certainty what your state has to say about certain practices, you have told your supervisor/employer a few things:

a) You are not some uninformed dimwit.

b) You are very aware of what the law says about your practice.

c) You know when you have grounds to report them to THEIR governing bodies.

2. Know your states Nurse Practice Act, or in the case of Michigan the Public Health Act as it pertains to nurses.

3. Know your SBONs regulations and position as it pertains to nursing issues. For instance most if not all take the position if you accept an assignment, you've accepted the responsibility.

4. Know your facilities policies and procedures. It's surprising how many facilities will try and violate their own policies. Know your chain of command. Know who to report to when it comes to staffing issues. Always keep a copy for yourself.

5. Educate yourself on the Labor legislation in your state.

6. If you have a question that pertains to your practice, DON'T stop asking until you get an answer. DON'T stop looking for the answer until you find it.

One thing that has always appalled me about the education nurses receive is that they are woefully underinformed when it come to the legislature and laws governing their practice, and what their rights are as an employee. These things should be a standard part of education and not just glossed over.

suebird3 · Mar 2, 2006

I just briefly read through the posts, so forgive me. I work LTC, and the app's we DO get expect higher wages then what we pay. Many of our rezzies are Public Aid. Yes, working short is a pain; Meown has heard me beller and peep about that alot. I have 60 patients while on 3-11, all 120 when on 11-7. HOWEVER....we have no Medicare beds, and not everyone gets meds at all med passes. I wish we had more nurses, also; I personally think my pay is ok, but many want more $$.

Suebird

tree trunk · Mar 2, 2006

I work on a med/surg floor on the 7p shift, the charge nurse takes as many as the other R.N. takes that means up to 10 or more patients a piece, does this happen to anyone else? :idea:

military spouse · Mar 2, 2006

Wait a second. I need a clarification here. You're saying that 1 RN and 2 LPN's had 8 patients each? Did the lone RN take responsibility for assessing all the patients? If this is a hospital, I must be missing something. LPN's can't assess, at least under Washington state law, and I would assume it's pretty similar elsewhere. If I did what I think you're saying is happening, I'd be operating WAAAY outside of scope. Someone please tell me I've misread.
Lee

Hi,

Just moved from AZ, where LPNs could assess, but an RN had to perform assessments once every 24 hours. So, basically, an LPN could have that pt for a shift then we automatically switched to an RN for the next shift. Made doing the assignments a nightmare. LPNs also couldn't do IV pushes, hang TPN or hang blood. I have a friend in TX who is an LPN and she could give IV pushes. Don't know if that is hospital policy or a state policy.

jenni82104 · Mar 2, 2006

Thanks for the great advice, dusktildawan. Being informed is your best protection!

kristi-lpn2 · Mar 3, 2006

I do work in a hospital the RN's take turns with the assessments for ex 7-3 shift does total assessments on the middle part of the floor the 3-11 shift does the bottom half and the 11-7 shift RN does the top part of the assessments. We do have to do "Focus charting" on every shift unless the Rn does the assessment on one of out patients. We split the floor so that the RN takes care of the patients they do the assessments on. The other nurses do all other care including meds and I do assessments on my patients anyway (makes me feel a little better).

kristi-lpn2 · Mar 3, 2006

What union? I have been searching before commiting to anything and I have no idea what union is right. I am an LPN and most of the unions I have researched are for RN's only.

fakemusician · Mar 3, 2006

please someone tell me, what's a HCA hosptial?

kristi-lpn2 · Mar 3, 2006

RN's only have to assessments on the patinets every 24 hours but as an LPN I do the complete assessment on all of my patients and chart under my nurses noted. LPN II which is what I am can give IV pushes and hang blood and TPN anything an RN can do we can do!!! Except of course the 24 hour assessment

JKDON · Mar 3, 2006

It sounds like the original poster is fed up but committed enough to want to stay and make it better. That is tough. I see that in my facility as our agency numbers climb and the lack of "qualified aps" dwindles. (I mean those who are not limping when they arrive, have no criminal history, problems with their licensure, worked their 30 day notice and showed up to work at their last 10 jobs) These people are hard to find, and my staff as short as we are feel they'd rather have someone worthy to train than someone to fill a hole who will be gone as soon as the place down the road offers 50 cents more. We don't get near enough applications so we used agency. Not the best scenario but our residents mean that much to us. No matter how many staff we have on hand, we feel these people are worthy of our care, the best we can offer with what we have. I admire all of us who are working short and making it work, but it is tiring and scary. I would not be allowed to keep anyone who "refused" an assignment but that's in a nursing home and I do have to go in from time to time to help. Of course our census and acuity do not change like the hospital.

I would

JKDON · Mar 3, 2006

Sorry I must have clicked reply already. Here's the rest.

I would suggest that a couple of nurses try to form a group who will be willing to meet with your administration on a solution. Honestly look for solutions, not just complain. Bring some of your own solutions to the table. Perhaps get other professionals involved, docs, lab, etc who may have insight. Would you get more aps if people knew the place was run better, and staffed better? It takes time. I'm surprised that the census hasn't dwindled as well as the public surely knows your staff feel this way by now.

Otherwise, if you've lost faith in your facility, yes by all means move on as it will be reallly hard to stay objective and be a part of the solution. It takes positive attitudes by all involved to change that culture and get nurses to come and stay. I wouldn't want to apply if I knew all the staff were unhappy.

Good luck.

marycg · Mar 5, 2006

:angryfire I am also in the same situation..We had 27 patients, 1Rn, 2LPN, 2Techs

and we have a fast turnover(surg)we dc 10 pt a day and get 10 and the

other 17 are medical..The RN has to assess and give all IV's MEds..Surgery

pts get lots of IV meds..It is not a good situation..But is seem its like this

every where..What is the answer??????I see lots of med errors that don't

get reported..It's scary and I am sooooo tired......I HATE 12 hours shifts

under these circumstances!!!What about it???