Telling patients you're short-staffed

DreamyEyes · Mar 9, 2010

I do not go around announcing it, but if a resident asks, I will tell them. Mainly because I don't want them to think that I'm ignoring them.

NP Sam · Mar 9, 2010

I know we are not supposed to inform patients that we are short staffed because they might feel guilty and "try" something theirself. Sometimes you have those patients that want what they want when they want it and give you attitude and say "why can't you do it?" This happens ALL the time. When you have 32-35 patients on a hall and three CNAs we can't do everything at the same time. Some CNA's have it worse than that! Especially when some things require two CNAs. I am guilty of telling patients that I am the only one on the hall right now. Omg after dinner is the worst. Usually one CNA goes on break right after the resident eats and it really gets tough then (taking patients to bathroom, patients wanting to go to bed NOW, baths still to give, etc.:grn:) I never say we are short staffed though.

I think that was a mini-vent.

NurseCubanitaRN2b, BSN, RN · Mar 9, 2010

Bottom line is that the MAIN reason why the facilities DON'T want you to inform patients or family members that they're short staffed because that will give them a reason to call the state. They're trying to cover their butts. They pass it off that they're concerned about the residents but in reality I don't see it often. When I worked in the SNF I've seen first hand how the administration doesn't care that you're short-staffed and they purposely DON'T call someone in and the reason is that way they can save money. At the end of the year the administrators get a nice fat bonus for all the money that they saved. You do have some administrators that care, and will make sure that you're fully staffed, but there are the majority who just don't care and all they care about is that their pocket book is stuffed!

GonnaBSN · Mar 10, 2010

"Many times I have been given this warning. You never tell visitors or outside people about short staffing because you don't want to give them cause for alarm and give them an excuse to call the state and complain. Let them draw their own conclusions. And you never tell the patient because that is putting the patient at emotional jeopardy, a form of abuse. The patient just lies there and worries whether anybody will see to his needs. He doesn't need the emotional distress."

Well said! I completely agree. And don't forget that emotional wellness can speed recovery.

asun21ta · Mar 10, 2010

I don't tell the patients that we are short staffed, but they could usually figure it out since it happened so often. I do not believe in lying to them about being short staffed. If they ask me, I tell them the truth. Why should I lie to them and possibly get in trouble for not doing something that should have been done hours ago? I am no slacker and I refuse to allow my patients to think I am slacking on the job when the real problem is a staffing issue. I figure since it's "their home" it's their right to know.

Families usually pick up on it as well. At my last facility, families could care less how busy you were. They would come into another patients room and even the break room to get us! I remember one Mother's Day, the Schedulers gave so many people off, there were only 6 CNA's in a 130 bed facility! One CNA came in for her first day of orientation and she was given 20 patients to care for instead. (she never came back after that weekend!) It was horrible. Imagine the stress all of us had working short staffed on a holiday with an orientee. Lets not forget that a ton of family members where there because it was Mother's Day. (the DON called in and asked that we not tell the families and residents we were short staffed!) That was my most horrible day as a CNA! lol :uhoh3: :uhoh3: :uhoh3: :uhoh3:

NM_CNA · Apr 3, 2010

We have a policy against saying it as well. Most of the time, the residents have already figured it out. If they ask, I don't have a problem telling them. I've been b!tched out by a resident for taking too long to answer a call light (1 of me, 20 residents) on a bad day. And I don't see why family members calling state should be a bad thing. Maybe state needs to see it so it gets fixed. It's not fair to the workers or the residents to have 1:20 ratio, 5 call lights going off, and 4 nurses chatting at the station.

caliotter3 · Apr 3, 2010

Good reason, the emotional distress. I'm divided on the issue however. In my facility the patients get very indignant, upset and even angry when they watch me from their rooms with my linen cart flying back and forth into everyone's room but theirs. They wonder why they're not getting their bed made, or why I'm not supplying their morning care, emptying their comode, etc. It's even worse when the family members are watching you, they come right outside of and into (this happened once) the pts room I'm currently in to ask, 'When you gonna get to my mother? It's after lunch and she said she didn't even get any washclothes!'. Cherry on top is when they say it in the tone of voice that's supposed to make you trip all over yourself jumping to their tune.
I've had pts get up out of their beds in the morning and sit in a chair next to their bed where they can see into the hall and watch as I go from room to room. After awhile when they see I'm not coming anywhere near their room unless it's glucose time, they tell me their tired and want to get in the bed. When I tell them that they can, they say, 'yes sugar but I can't get back in until you make my bed, I've been waiting all morning'.
When I get irrate pts I have no problem telling them that either they're not on my assignment or that they'll have to wait a little longer because we're short staffed. I was told that telling them that isn't getting us any pity by them, but their pity isn't want I want. I'd like to assure them that I'm not ignoring them or picking and choosing who I'll help for that day. When dealing with my pts, I don't want to come across as uncaring, crass or plain rude. I want them to know that, 'yes, I see you, however it'll be just a little while longer or I don't have you today but maybe I'll get to help you tommorrow'.
To me that's a little piece of mind instead of the worrying that they'll do if they feel ignored. Also, I think it's fair since it's the CNA/TECH that the patients will take their anger out on anyway.

I rotated who I went to first and last on my assignment each day. That way I had a ready answer for those who were upset because I couldn't get to them soon enough. It didn't make anyone any happier but me, because I felt it was the fair thing to do with the resources (me) available.

CoffeemateCNA · Apr 3, 2010

I never, ever tell a resident or family member that we are short-staffed. The resident tells the family, who tells the nurse, who tells the charge nurse, who tells the DON, who tells the administrator, who comes back to the CNA and chews them out for saying such a thing. "Oh, you know we're not short, you personally ONLY have to take care of what, 25 people?"

I always answer residents or family members by saying, "Oh, we're doing just fine today." I am neither confirming nor denying it.

BUT. . .

The ones that are able to ask are usually astute enough to figure out that my working 1-2 halls by myself and running around like a madman means that something fishy is up.

Oh, wait, that's normal. :)

sandygirl123, CNA · Jul 9, 2014

I always thought that is was so the patients and the families would not get mad at the nursing home. Like a lot of you I never would go around broadcasting that we were short. But, I did not go around hiding it. If a family member ask if we were short I would say yea someone called off. I never expected them to fell sorry for me or tried to make them feel obligated to do my work for me. I just wanted them to know that I was simply did not care about my job or about the wellbeing of their loved one. I think that each time a nursing home in understaffed it should be documented, a lot of times there is more fells, more pt having to wait then maybe the state would look at it and change the number of pts someone can have.