staffing looking back over the shoulder

[oramar]

I want to ask about you about something I experienced in last two jobs I had. This is just what seemed to me to be going on but I am not sure. In each case when I started at the position staffing was fair to good. We worked very hard but we got by. However, each unit experienced a drop in census for about 6 months. The staffing for the unit was then down sized because of the drop in census. Across the board the number of positions for every slot including aids, RNs, LPNs and secrtaries were reduced. No sooner did a lot of people leave not be replaced when the census shot back up. That created a crisis because everyone was working short, always on the edge of disaster. It then got worse because smart people will not put up with that for long and they leave. My last position was complicated by the fact that we had new manager that wanted to clean house of all the older, higher paid nurses and replace them with new grads for financial reasons. The situation played right into her hands because in six months she had all staff she had hand picked. This business of staffing by looking backward over shoulder at previous cencus instead of at unit capacity, what do you think of it? I think tt is bad idea, I personally have experienced it and it is not pretty.

[Zookeeper3]

Our budget is based upon census. We are only allowed to staff, hire or keep hired essentially based upon the last years census and "projections". Paid days off count into this as well, long story short.. those that accumulate the most (senior staff) these banked hours must be accounted for and calculated in.

Now that being said, almost every unit has a lull period. We float staff, give them days off if chosen and cancel them if needed. We have never fired staff because of it.... it usually only lasts 3 weeks for us in spring and early fall.

So we don't practice that way, but we are always short staffed when full. This is a dangerous practice in a "nursing shortage" and it kills morale when lay offs occur and kills morale when working short. To me, there are many alternatives unless your hospital is that small it can't accomodate the extra staff in other units. Perhaps a PRN staff could be started to downsize when down and help staff when full.

[EmmaG, RN]

Been there, done that. Coupled with refusing to staff according to acuity (and known admissions) and it's a recipe for disaster.

When nurses continue to work in these conditions all that does is prove to management that we can. It doesn't matter to them that we may be only one step ahead of harming or even killing someone. Not only is staffing with younger/less experienced nurses cheaper, they are also less likely to raise hell over these conditions.

You hit the nail on the head--- it's the bottom line that counts, and nothing else.

[RN1989]

Oh yeah, nothing new. Usually what happens is that people get cancelled or sent home so much for low census that they have to quit and get other jobs. Then their positions are frozen and although the hospital advertises for the open positions they have no intention of filling the spots. Then census goes up, the hospital waits until the staff are near dead to agree to hire people. By then, the dead tired staff leave, the place is understaffed, they hire new people, census drops again, and the cycle continues. And somehow, I swear this happens at every job when I take a staff nurse position.

[bigsyis]

I agree. It stinks to try to staff that way. We used to work with a set staff day in, and day out, with very little turnover, when I first began Nursing. If, for some reason, it was a light night for you, you helped the other Nurses, and held your breath-you would be the first to get admissions, because your team had empty beds!

[Medic04]

Oh yeah, nothing new. Usually what happens is that people get cancelled or sent home so much for low census that they have to quit and get other jobs. Then their positions are frozen and although the hospital advertises for the open positions they have no intention of filling the spots. Then census goes up, the hospital waits until the staff are near dead to agree to hire people. By then, the dead tired staff leave, the place is understaffed, they hire new people, census drops again, and the cycle continues. And somehow, I swear this happens at every job when I take a staff nurse position.

AMEN, we hear it all the time. "Well the grid says........"or ," we need to do more with less"," we are OVERSTAFFED", or as you said freeze the positions and let people think you are hiring so workers will not complain.

[ginger58, ASN, RN]

"My last position was complicated by the fact that we had new manager that wanted to clean house of all the older, higher paid nurses and replace them with new grads for financial reasons.

Too bad one of them didn't sue for age discrimination.