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Survey: Do you work short staffed on a daily?

Specializes in CCU, Geriatrics, Critical Care, Tele. Has 26 years experience.

This months survey Question...

Do you work short staffed on a daily basis?

FYI: Here are the results from this survey question, when asked on allnurses.com last month:

Yes81.91 %

No18.09 %

We encourage your comments and discussion on this question. I'm sure many of you will have some lively comments on this topic.

To post your comments, just click on the "Post Reply" button.


Brian Short


It's how nurses surf the web!

[This message has been edited by bshort (edited February 15, 2001).]

Every once in a while a floor will have to go short if our census is high, but for the most part the floors get what they call for. My hospital has instituted a "bonus" of $75 for coming in extra for 8 hours. This has helped tremendously, but won't work for a lot longer since nurses and NA's are getting tired burned out. The furture looks very scarey, for sure.

I just quit my position as a staff LVN at a rehab hospital due to the lack of staffing.

I have been burned twice by this facility. When I say burned, I mean that I have came to work and accepted a patient load that was too excessive. In my case on 12-25-00 I was hit with 12 patients and one admit to follow up on.

Today I came to work and they said that 4 nurses called in and that I had to accept my load of 12.

I flat out refused and quit.

It seems that the facility that employed me does not value patient care nor does it seem to have a commitment to its employees. They tend to try to deal w/ nurse shortages by simply strecthing the over worked nurse with more and more pts.

This will only serve to wear out nurses and comprimise the safety and care that the pts. are entitled too.

I find it very sad that this hospital does not have the brains to call a PRN Agency and get some help on the floor so the pts. can get the care that they need and that the nurses will not feel as if they are being abandoned.

However, they value $$$ rather than pt care. And I value my license more than I do a paycheck, so I quit!

I can always get another job; but I can't get another license.

And any time you, me or anyone else for that matter accepts care for more pts than they can safely manage, they ARE LIABLE FOR ANYTHING AND EVERYTHING THAT MAY HAPPEN OR NOT HAPPEN TO THOSE PATIENTS!!!

Yes, we worked everyday short staffed in LTC. I no longer do it because I was also afraid of losing my license. I have posted here before with my complaining and I realize now what great therapy this is for me. I tried to block or forget some of my nightmares working in LTC, but it's good to talk about things, right? Let me describe a typical day of short staffing, no, I will talk about NO staffing. I was the 7-3 RN with 3 CNA's with 40 patients. At 3pm, the CNA's leave (flee) and I am the responsible RN waiting for my 3-11 nurse and any CNA to show up. So, it's me and 40 patients. While I am frantically trying to reach someone in administration for help, I see Mr. A has fallen again and sitting on floor. Mrs. B has a puddle of urine around her wheelchair, 4 to 5 wandering, confused residents are trying to go out exit door and setting off alarm, Mrs. C has another skin tear on arm which is bleeding on floor, Mrs. D has taken her shirt off again and singing loudly and Mrs. E is yelling for her to shut up and 4 room bells have been ringing for about 20 minutes. My relief nurse and 1 CNA finally show up. I stay to help because I love these residents. But, I've missed another of my son's soccer games, and my teen daughter was getting into more trouble. (I have talked to many other nurses in LTC. They say they have the same problem with short staffing and turnover.)

Too many have lowered their standards so give the "bare minimum" all the time. Who still does complete teaching? Backrubs? Collaboration with the "team" ie MD, dietitian, RT, LVN etc? We used to help each other with advice.

Now patients have to wait while we find someone to help pull them up in bed, go get the missing supplies, deal with emergencies, etcetera. Many shifts are one emergency after the other. Not even minimal care. A friend said she cannot give meds on time and answer call lights too. NEVER!

This is just plain wrong!

What about the patient quietly suffering because the others keep us too busy?

If you can do this without wanting to work on the problem you are suffering from "cardiosclera"= hard-hearted. Too bad for you and your patients.

I work in small rural public health department that serves two counties. We cover ~ 970sq miles and serve a population of about 64,000. We have three "fixed" clinic sites, two "semi permanent" clinic sites and also travel to all of the schools, and head starts in the area, plus some of the larger daycare centers. Our programs are not just the core public health programs, but Family Case management, KidCare (medicaid), Breast and Cervical CA, Family Planning etc. We do this with 4 RN's and 2 LPN's. I need to note that 1 LPN is currently working as receptionist only due to a stroke, and one of the RN's only does Health Education and the Tobacco grant. Another RN is also the DON. We are stretched about as tight as we can, and have to plan to be sick or it can cause a clinic to be canceled. I am grateful however that I don't have to deal with staffing issues that the other posters have presented. Let me add that we are unionized, but our wage scale is low. CNA's in local nursing homes are sometimes making more than we RN's are.

Originally posted by bshort:

This months survey Question...

Do you work short staffed on a daily basis?

not any more. We negotiated safe staffing ratios into our latest contract. The hospital is legally bound to comply.


Specializes in Hospice, Critical Care. Has 17 years experience.

We are also given the "we cannot staff for what-if" line. Of course, "what-if" nearly always happens.

I worked 7P-7A last night. I had 3 ICU patients. Most of the other nurses did too. One RN only had TWO patients but that was because one of her patients was a one-on-one patient--55yrs old on triple pressors, on the vent on assist-control @100% w/15 PEEP, insulin drip and God knows what else (there were 7 IV pumps in the room)--so she only had two patients. There was a call-off for daylight. Everyone is too exhausted to keep coming in for extra shifts. Not an extra pair of hands to be found. Several of the daylight RNs were assigned FOUR ICU patients...and we had to fight to keep the RN with the "one-to-one" patient to only have two patients.


When we have a vented patient, we are at a 1:1 ratio here. I can't imagine how you could adequately care for a tubed patientPLUS another. How saFe is that anyway? Is that the norm for icu"s. WOW!! We may have a patient who is clinically dead, we are waiting for family to come and say their goodbyes, then in that situation we might have a vent,and another non-tubed patient., but only in those rare circumstances.


In California we also have a state law that mandates only 2 patients per specialty unit RN. However we have a smaller 150-bed hospital, and frequently we are staffed at the bare minimum. Several nights we have had 3 patients (on an 8-bed unit) staffed with 2 RNs, with one of those patients a critically-ill 1:1. So no room for any in-house codes! Also with only 2 nurses, there's little resources for turning, bathing, etc. When i talk to the supervisors, i get the standard, "We can't staff for what-if, we can only staff for what is!" Makes me want to gag.....Let's us know exactly what the administration thinks of us, that's for sure!

Spacenurse, I hope you weren't specifically talking to me on your response. If so, please read again. I NO longer do LTC nursing. At the end, I said I was staying over to help with my residents. No overtime pay, I was staying to help but in the meantime neglecting my own kids who were in trouble and needing me. I have written to CEO's, I have complained to administrators, I have written up and requested the termination of CNA's that I personally saw abusing a resident/patient and nothing happens. I am tired. I am thankful I have a nursing job. I am reviewing LTC medical charts for an attorney friend. I hate it. I would rather be a real nurse taking good care of people, esp., the elderly, but I have to pay my bills, and it's just too dangerous these days.

NO! As of 1-1-01, I refuse to work short staffed. I worked short staffed almost everyday for 6 years and I'm not gonna take it anymore. I went o nursing school to take care of patients and at the hospital I was at, I was unable to take care of patients and felt horrible when I wasn't able to get pain meds to a patient in time or talk to a patient who was concerned and scared. I wish all nurses would write to the ceo's of the hospitals and WRITE TO YOUR LOCAL NEWSPAPERS & NATIONAL NEWSPAPERS & NEWSHOWS!! YOU CAN DO THIS ANONYMOUSLY THROUGH EMAIL. WE ALL NEED TO STAND TOGETHER AND STICK UP FOR EACHOTHER AND OUR PATIENTS!! I am lucky that 2 doctors in my area who were sick of their patients not getting any care opened up their own heart hospital and make sure that we only take care of 4 patients on the floor & 1-2 in the icu.

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience.

Our hospital has [finally] started trying to solve, or at least deal with temporarily, the problems:

NOT ENOUGH GRADS: All the major hospitals in the area coughed up some large $$$ to the local college to help fund more "slots" in nursing school. By that I mean, more faculty so they can admit more students. They have enough applicants, so that is not a problem, so far.

DAY-TO-DAY STAFFING ISSUES: There is an 'in-house' registry you can just go to the nursing office and sign up for; you get paid separately from your regular paycheck (less taxes), you can sign up for 1 1/2 and 2x pay. Nurses can share a 12-hour shift, usually 6hrs each, works great on days, not so well on nights. Then the charge nurse has several options: per diem, out of house registry, in-house registry. At 0400 and 1600, all of the 'like-area' charge nurses (Adult Critical Care, Maternal-Child Health...) meet, discuss haves and needs, future needs, esp from L&D to NICU, consider floating eek.gif mad.gif If all else fails, she gets on the phone and starts begging, goes around to current staff to see if anyone wants to "stay over" 4hrs (the beggee who agrees usually demands that it counts as a "float"! biggrin.gif On our large unit, 13-18 nurses per shift, depending on census, the charge nurse gets about $1.50 extra an hour, and [usually] doesn't get an assignment. S/he deserves combat pay. There are usually 3 admit nurses who go to deliveries and transports; they take a relatively light assignment.

NEW GRADS: They should be protected!!!! Preceptorships, new grad programs are vital! Didactic as well as practical are needed to get them up to speed in a healthy fashion! ALL new employees, even non-new grads, DESERVE an orientation, one that is free from "Congratulations! You're "IT" tonight!" Floats and registry nurses DESERVE a staff nurse resource. These new nurses are a resource that cannot, and should not, be abused and wasted!!!

I keep saying this: if we don't nurture these youngsters, us senior citizens are NEVER gonna get to retire!!! Let's focus on solutions!

[This message has been edited by prmenrs (edited January 31, 2001).]

[This message has been edited by prmenrs (edited January 31, 2001).]

[This message has been edited by prmenrs (edited January 31, 2001).]

I quit my hospital nursing job due to short staffing. A typical ICU assignment went from 1:1 or 1:2 to 1:3, even with 2 (or even 3) vents. One nurse had a balloon pump pt (pretty much unstable by definition) and they told her she had to take another pt. IABP's used to ALWAYS be 1:1. They used to ask if I could take another pt in addition to my fresh open heart pt. "Not on my license", was my response. We filled out unsafe staffing forms and called the hospital administrator on-call at home every single shift. (One of them had the nerve to complain about being awakened at 3 AM--and caught a blistering earful from the charge nurse!)It didn't seem to make any difference.

We used to have an in-house agency and OT incentive staffing programs which worked beautifully, but someone decided they were too expensive. Our unit manager disappeared after 5 PM every day and NEVER answered her home phone or pager. She would not give us the authority to hire agency or travelling nurses or offer incentive pay. They tried making us do mandatory OT for a while until someone clued in the state nurses association (our bargaining unit), which informed the hospital that leaving after your scheduled 12-hr shift was NOT abandonment if the hospital failed to properly staff the unit, and to knock it off.

There were also never enough techs to assist with care. I was lucky if I had enough time to throw my meds at my pts, scribble a few VS's, and turn them--maybe twice--in a 12-hour shift. Forget baths, teaching, even changing lines in a timely fashion; and any semblance of TLC. I drove home every night feeling inadequate and depressed that my pts had received far less care than they needed or deserved, and scared for my license.

Every time I talk to one of my former co-workers, or any of my friends currently working bedside care (and judging from many posts on this site), it's gotten worse, not better. I wouldn't even consider going back to hospital nursing as long as conditions remain this bad.

We worked short on weekends every 2-3 weeks. But the problem was "solved", our matrix was changed. We have to take on more patients.

Even though they changed midnights matrix, they still are short-staffed probably every other weekend. So they're working a cardiac step-down with 7 patients redface.gifne nurse. That's why I left midnight shift, it was never staffed to matrix. Plus they usually have no or only one aide.

I must say our nurses work over whenever they can. But most nurses are getting burnt out and not working over as much.

Today{sat.}our 29 bed unit will be staffed with 2 R.N.'s & 1LPN. It's a med-surg unit,mostly pulmonary/diabetes ie geriatrics,NH pt's .About 75% need assistance with ADL's.We may or may not have 1 nursing assistance. Management feels we are adaquately staffed.But I work there &know better.I sick to death of working like a dog just to give minimal care&frustrated by the lack of options,short of quitting. I really care about these pt.'s & I'm afraid for their safety.The other RN who works weekends with me is totally burned-out but needs the job,reluctant to stand up with me .So here I go once into the trenches,hope I don't cause harm.Wish me luck

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