Sick of working short

veegeern, BSN, RN · Mar 5, 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

In the state of GA, LPNs can do shift assessements, but cannot do initial (admission) assessments. So, I guess it depends on the state in which you are practicing.

veegeern, BSN, RN · Mar 5, 2006

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

It's a for profit corporation of hospitals. You can look them up online.

jannecdote · Mar 5, 2006

When I worked nights in our LTAC med/surg, we got 8 to 9 patients each with usually one or two RN's. A staff RN demanded safe harbor one night, stating she was unable to provide adequate care under the circumstances. She got laughed at and ridiculed by administration (behind her back, of course--and I am just stating what I heard, by the way). She actually got into trouble over that one because they said if other nurses could handle it so could she and safe harbor was not an option under the circumstances.

SuperFlyRN · Mar 5, 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?

I am always in charge on my shift (7p-7a) which is getting tiring enough on its own with all the arguing and crap that goes on within our units and I, typically, start with a full assignment-no discharges, natch!-to *avoid* me getting an admission, but I usually get one anyway once the admits have come around full circle. I start with four couplets and a laboring (I work LDRP) and get an additional couplet near the end of the night-we work well together so my co-workers help with paperwork, assessments etc but it is still heavy. Coupled with the fact of patient assigments, replacing sick calls, etc, it is just too much sometimes.

Zachary2011 · Mar 5, 2006

First off, you can refuse pts before report is given, however if you refuse after taking report, its pt. abandonment. Even still if you feel its unsafe , while on your shift call safe harbor. This will help protect your liscence and they in turn will follow up with your hospital to look into the working conditions, usually nurses call safe harbor related to unsafe nurse pt. ratios and/or acuity level. Your manager or administration will have no grounds for retaliation if you call safe harbor, its there to protect nurses.

Chuckie · Mar 5, 2006

They will take advantage of you as long as you let them. Just quit they will get some other nurse in there for a short while that will get fed up and quit. Most hospitals are so short of nursing staff that they can't afford to lose you. I quit a couple of jobs like that and they never solved the unsafe problems they just somehow pull through with the few nurses that tolarate the problems. Your a nurse just drive accross town to the next hospital. Seattle has a bandaid hil that has several hospitals all closely located. One hospitals loss is anothers gain. I'm a good nurse infact I usually go above and beyond the call of duty. I never call in sick I work extra if needed I learn as much of the job as humanly possible. In fact I was the only nurse that was able to perform several of the procedures. They took advantage of me, I begged for nearly a year that what they were doing was unsafe for me and the patient. No one bothered to look into the problems I wrote up every occurance that I possibly could. I quit and they had to totally do away with the program that I was doing which was a huge loss for the hospital and they eventually went through three different nurses in the last year and have not solved the problem.

I'm just saying there are better jobs out there and a lot of them you should not have to do what is not safe for you or the patient. Any hospital will take advantage of a nurse for as long as the nurse takes it. The thing is you have the upper hand fight back or quit at least after you quit it may show that wow there really was a problem. I learned that manager will only do the least amount of work to cover the area for the least amount of money. I you are not there to do the job they will do it without you. Some places have already figured this out and are changing the nurse patient ratio some will never figure it out.

worldtraveler · Mar 5, 2006

I went to work this weekend. I work weekend doubles. On 7-3 we had 23 patients on a medsurg floor. 1RN and 2LPN 1CNA and 1US. We had 8 patients a piece to take care of. Am I just a wus or is this a bunch of crap. We have been told we cannot refuse patients. Can we get fired for rufusing to take report when we know we cannot give the care these patients need? I remeber in nursing school my instructor said we have the right to refuse is this s*** or is the nursing supervisor that said this full of crap? Can we be held responsible for patients not getting their meds on time if I document we have to take care of to many patients per nurse? The staff is sick of this tx and more and more people are quitting every day. I dont know what to do or say. I dont know if I should tell my patients they didnt get their meds on time because I have to take care of my 7 other patients and the ones that are the worst get my care first. The bosses are trying know that so many people have quit. Lpn's are getting 50cent raise and RN get 75cent raise they are trying to bring in traveling nurses but it is hard to even get them to stay. The first worked 2 days and quit she said it was the hardest patient/nurse care hospital and the worst hospital she has ever worked at. People are starting to talk about Unions. I would like to look into one but I dont know where to begin we have to do something or there is not going to be any nurses left. No RN's have put their applications in for more than 6 months so we have been told a bunch of crap because a friend of mine says many of her friends that are RN's have put in their applications and they have never been called. what the h***. I am fed up. I cannot simply find another job b/c of the shift I am working I need to stay on weekends. I work 32 and get paid for 40. I have been looking around but have found nothing yet. I am an LPN have been at this facility for 6 years I dont want to quit but am getting to the point of not caring what happens. I am doing the best that I can. Please give me some advice someone on what to do. If we can get a union to make things better or is it like this everywhere? Every shift we work at least 2-4 people short and this is getting worse every time I go to work. Thanks for listening I had to get this out. By the way I work in a hospital and we have around 120 beds. It is not just my floor working short it is everywhere in the hospital. What should we do?

With a post like this on short dangerous staffing, its hard to beleive that some Nurses are still against Unionization that could rectify these dangerous work conditions and possibly save their Licneses. Unbeleivable, if you think these Institutions are ever going to resolve the Problem you mention(OP) out of the goodness of their Heart, I have some Dry Florida Swampland I will sell to you on the cheap! LOL

MultipurposeRN · Mar 5, 2006

It's a tough call when you can be held liable for accepting an unsafe assignment, but fired or disciplined by your employer for doing the same thing. Doesn't seem like there's an easy answer unless mandatory staffing ratios come about. And that won't happen easily. Not to mention that schools would have to hire more instructors and take on more students, etc. And pay instructors more. It's a vicious circle.

kitten77 · Mar 5, 2006

My heart goes out to you. I just want to mention a few things. Some states have patient to nurse ratios (I respect the fact this won't help you just this minute) these rules set by the state are good to know about. Like someone mentioned I, too, would look for another job pronto. Just too much stress and risking my conscience and license..........It just can't be worth it. FYI I work in outpatient so I don't have to deal with this type of nightmare. My sincere best wishes.

MNlpn · Mar 5, 2006

We work short now and again at our hospital too. However, we are unionized. In the RN's contract, they have to ability to close the unit to admissions if they are not properly staffed. I think it can stay closed to admits for up to 4 hours. This gives them time to hopefully catch up on work, and maybe give time to find nurses to come in to work. We also have unsafe staffing reports that we can fill out if it's that bad. Sad to say, but it doesn't look like the staffing situation is getting any better no matter where you go:o

kokopelli · Mar 5, 2006

I'm afraid this problem is only going to get worse. Remember the nursing shortage? I spent all my time last week trying to get enough staff for the weekend. In the last year I have gone from spending a few hours a week on staffing, to almost all my time. I don't get other things done such as following up on incident reports and planning new improvements. I work in middle management and am ready to quit. There just are not enough nurses out there. The nurses we are interviewing are getting worse and worse, is it better to put any warm body in a position, or hold out for someone good? A bad hire just demoralizes the staff more. I was glad to hear that some nurses still try to mentor new staff and keep them coming back.

perfectbluebuildings, BSN, RN · Mar 5, 2006

We are working somewhat short right now w/all kinds of admissions, it is very tiring I agree. I have a question- more like a frustration. How can you refuse a pt assignment BEFORE you get report but not AFTER- you don't know what's going on with the pt till you get a report, most of the time- sure you can look at the chart but that does not tell the whole up-to-the-minute story!!! (This is pretty much just a rhetorical question of something I don't quite understand.)