Short staff=neglect?

[Cryssfriend]

I am a nurse in a long term/post op rehab facility. I have been a nurse 3.5 years and this is my second facility.

I have worked short/under staffed (as in accordance to state regulations I am referring to) many times of course, it comes with this field. But the last couple weeks at my current job has gotten really bad. I currently don't remember the last shift I was fully covered with CNAs. I am currently working NOCs because we were short nurses. They have me doing 5 12s with 2 days off.

From 2-10pm we are suppose to have a med aid for 2 hours and 4 CNAs with our current census. Tonight we had a med aid and 3 aids until 8pm then only 2 aids. My next shift there is 1 med aid, 1 CNA, and a light duty CNA for staffing.

I am getting really tired of lack of staff. I have no idea how this is suppose to work.

My main question now is coming down to how much of my own license am I risking every time we are running short and at what point am I being neglectful if I don't turn the facility into state (or whoever is above the company)? I have tried to talk to my DNS and director.. all they can say is they have tried... please- any advice will help.

[KatieMI, BSN, MSN, RN]

In any facility, including LTC, if things come to the level that you feel as not able to provide safe care for your patients, the best way is to tell the Powers that you've got life too and will work only, and ONLY as many hours as you'd signed for. If you're full time, it means 36 to 40 hours/week or whatever is written in your employment contract, period. Otherwise, just put your phone on silence and do not pick it up.

If within a week they don't stop bothering you, update your CV and bring up your bye-bye note. And, yeah, let them know that shortage of staff is fact of THEIR biography, not yours, and that you are not going to risk your license, your health, your life, or those of others because they are not doing what they're paid for.

[ChryssyD]

Unfortunately, there isn't much that you or even your facility's management can do; you can't get blood out of a stone, and you can't create staff out of thin air. Perhaps they could look into staffing agencies or travelers, but a lot of places hate to use them because they're so expensive. Not as expensive as settling the inevitable lawsuits will be, but that would require thinking and we can't have any of that.

The joys of nursing in a for-profit system! Overworked and underpaid is the norm in LTC, even in sub-acute/rehab. You did state it's been really bad the last few weeks--did the facility recently lose some staff? Relatively short-lived staffing crises aren't uncommon, and if the place is offering something nice like a sign-on bonus, maybe things will get better soon.

For now, you could explore other options in the area, just in case you decide you have to jump ship. When you're at work, prioritize as best you can to make sure the patients who probably need you the most are seen first/most often. And when you're asked to work a few more hours or just one more shift, use the N-word: NO!