Staffing Shortages in HealthCare

[madwife2002]

I have been a nurse for 22 years and have worked in a variety of hospitals. Now, I manage a dialysis center. I can honestly say that I have never worked anywhere where we had perfect staffing!

With new grads searching for jobs you would think that organizations would take them under their wings and provide training and experience. Its' just mind-boggling how we just sit by and not support new grads.

I remember the day when hospitals stopped training student nurses ... saying they were being used and abused as members of staff.

I was one of those student nurses who complained about working 40 hours a week while having to study, pass assignments, and finals each year.

I was thrilled when students would no longer be used as a pair of hands on the wards, working 10 days in a row.

The rationale was if we send them to become University trained nurses, they will have more academic training and the hands on experience will come. It will also mean that nurses will be classed as professionals.

On the whole, it was a good thing. However, now student nurses struggle to get the hands on training that we got.

Also accelerated training courses mean that less and less practical experience is obtained by students. In the past 3 years, hospital based training was the minimal amount of time to become an RN, and 4 years if you were doing a BSN.

We owe it to our new grads to fight for them to have post grad experience and training in a hospital. So that we have good quality back up for our future and their future.

I do not believe we should have to work under the conditions we work under day in and day out. The stress on staff is horrendous and eventually we all burn out.

New staff members are thrown into the deep end on a daily basis and expected to swim amongst the sharks.

Yes that's how I feel. Overwhelmed. Can you imagine how new grads and inexperienced nurses feel like? Sometimes I feel like I am swimming for my life and the sharks are biting at my ankles and if I stop or slow down ... I will be pulled down into the depths of the ocean - where it will be impossible to come to the surface.

Yet all nurses are held to the same accountability, and it is not an excuse to say you are a new nurse, we are trained to point out that certain circumstances and situations are not safe.

How many nurses actually go the distance and stand up for themselves and others?

How many are brave enough to go to your manager and tell them what is going on?

Is your manager supportive? Does she roll up her sleeves and go work with you side by side? How many nurses feel brave enough to do this?

Not many because nurses are afraid of the consequences of their actions.

It is bred into us that we must never abandon our patients. The charge nurses themselves are over worked and stressed. So, it's no wonder your call for help goes nowhere.

We are all afraid of failure so we struggle on and hope things get easier. Sometimes the experienced nurses appear to be relaxed and less overworked. Yes this is because things do become easier with experience so we don't struggle in the same way and we can prioritize our work, we learn what to panic about and what to not.

I think most nurses are so tired that when we have down time we avoid helping each other because we are just worn out!

I dont think all nurses are able to get to this comfortable stage because their personalities insist that they must always be running and doing something. They stress about their patients because they haven't learnt to read their patient accurately.

They will always run around causing chaos, not taking breaks, charting at the last min and feel very used and abused by their work colleagues.

So how do you get through this chronic staffing crisis ??

Laughter and Fun help enormously, I honestly think the reason I have been able to survive nursing is because I have a good sense of humor and I can laugh at most situations!!

Nurses really do have to be comedians to survive the stress and the negativity.

It might seem sometimes that my blog is full of negativity but I really didnt set out to be negative what my intention is to let nurses know what they are going through is normal!

That all over the country in fact all over the World nurses struggle with day to day issues of short staffing.

I know in my place of work we employ to what our "budget" says we can employ and we are happy but in one week it can turn around and bite you on the nose.

For example last week this is what happened to my staff

1. Full term pregnancy so off work to enjoy her happy event
2. Leg injury so off work for min of 4 weeks
3. Grandparent passed away so on bereavement leave
4. Stomach Flu so a call off
5. Grandparent also passed away

I am left with

1. 2 RN's and I need 3.25
2. 4 Techs and I need 8
3. No float pool and no agency!

What happened? Well, the staff who could work worked - but picked up very little. One tech worked 80 hours straight! The supervisor worked 67 hours straight and as for me the unit manager well I was there for 70 hours.

Results - Exhausted. Fed Up. Resentful Staff.

But how we laughed and joked with each other and our patients. I guess you could call it a sort of Black Humor!

I looked at the clock at one point and wanted to cry I ached and hurt so much and was so tired. I honestly prayed for the night to be over!

Then I looked at my co-workers and we laughed at each other because we were all aching and hurting. We prayed for the night to be over.

One of the patients - a blind lady - sang to us and a couple of the other patients joined in!

I am a manager, I do work side by side with my staff because I know it improves moral, especially when the chips are down.

I do not have. It's not in my job description. I do it because I cannot see my staff struggle without help and support.

I have been that RN who has struggled with trying to manage a heavy caseload and have seen management look the other way.

My upper management look the other way. I know this because I get senseless emails asking me if I have explored every avenue in my search for staff. I really wanna say, "No I thought I would wait and see if they flew in from Heaven to save me." Why would you even ask this question!

The down side is they do expect it now and sometimes I cannot work the floor.

Every place of work has the core staff who will work extra hours, who will not let their colleagues suffer short. They always come in and will always work what ever shift required of them. But one day they say NO! because enough is enough

So look around...

Do you have co-workers who need the support and help?

Has somebody covered for you in the past and may need support today?

Help each other, support your co-worker and don't abuse the willing ones, because one day they may bite back!

[fantasyworld]

"Second, Your staffing shortages are a symptom of our health care system, it's all about the money and bottom line, health care is run as a business now and it shows and until that changes staffing shortages will remain a problem"

And re: the need for hospital cutbacks due to the economy. Sometimes, it's not all about the money. Sometimes it's about letting the hospital staff know that that they are respected, and that their hard work and efforts are greatly appreciated. A validation of all the hours and days when they have worked so hard needs to be given. Sometimes a "thank you", and an acknowledgment of their hardships, and empathy with the staff, make facing deep cuts a tiny bit easier.

quote]

I understand that comment well. I used to come in and work extra shifts all the time. On occasion I would work an entire pay period and never work on the same unit twice or even in the same position the entire 2 weeks. I would fill in as supervisor, preceptor, admission assessment nurse, charge nurse, med nurse and in some instances fill in as a nurses aid. I would volunteer for committees, teach IV classes, do CPR training and do work at home. Do I ever recieve a "thank you" or any other validation of appreciation? On the contrary, I'm expected to do MORE and set a good example for others. It has gone so far as to being denied credit for ideas which I have come up with and someone else up the ladder claiming it was their idea. Now that I'm going through a rough medical problem and specifically informed my managers that I cannot work extra for a while, they make a point to call me EVERY one of my days off to see if I can come in because of the staffing fiasco they are responsible for creating. So much for nursing compassion.

[brandy1017, ASN, RN]

Brandy, while I agree that health care is now run using a corporate model, I disagree with you about training new graduate nurses. I happen to be an Intern Development Specialist. What that means is that our corporation VALUES our new nurses enough to assign one individual at each campus whose only job is following the new nurse, her/his coach, and ensure their progress for 2 full years. We provide additional training when they are first hired (of which we are part of that process) and become involved should something be wrong for any reason. Our goal is retention, competence, and a "corporation free of nurse-to-nurse hostility.

What we look for is: the new nurse a good fit for the unit, is the coach a good fit for the new nurse, and if not we can move the new nurse, from the unit and even campus to campus if necessary. Better yet we don't need HR to become involved.

The result is decreased turnover (running between 3-8%), better run units, and more successful new nurses.

That's great, but I think your training model is pretty rare in healthcare these days!