The Nursing Shortage

AnnieRN · Nov 19, 2000

I work in a community hospital intensive care unit in upstate New York. (I used to live in Ellicott City!) The shortage of nurses has limited the amount of critical care beds in our hospital. When I started here five years ago we ran a ten bed unit. Now we only run a five bed unit. We only have seven full time nurses left and two per diem nurses to cover all the shifts. What have we done to try to help this situation? We tried sign on bonus' but the nurses left after they fulfilled their contract. We are working with the nursing school to try to recruit the stronger graduates to come into our unit. But at this point the only thing that can further help is more money. We feel that a critical care differential might lure interested med-surge nurses to work in critcal care. Our hospital also purchased a balloon pump that is not being utilized because there are not enough nurses to safely manage the patient that would require this. Nurses are of course called in on days off and asked to stay late almost everyday. I hope this helped.

Cheri · Nov 20, 2000

Yes, your response does help. Have you had to work manditory overtime and take an "unsafe Load"? I read an article that addressed the nursing shortage, one solution was that nursing needs to clean up their image. How do you feel about that? Most nurses speak in terms of money, but I have also heard that the work-load is not worth the extra money. It is a shame that beds are being closed and a balloon pump goes unused. I currently live in Ellicot City.

fergus51 · Nov 20, 2000

The nursing shortage in critical care has been in the news here lately. I live in BC Canada, and recently a woman who was supposed to get a new liver had her surgery cancelled at the last minute because there wouldn't be enough nurses to be able to care for her in the ICU after surgery.

hollykate · Nov 20, 2000

I work at a level one trauma center in one of the ICU's. We have had a huge shortage in the South for a few years now. But no shortage in the ICU's. We do have triples in the CCU, but that has to do with the acuity. The CCU doesn't get a lot of vented, unconcious pts- we also have a CTICU, etc.

I have never had to work mandatory OT, but I have voluntarily put in my share of it.

I don't know about the money. We don't offer a differential between ICU and floor, but the SICU has a wait list to come work there. And I don't know what the Nursing Image is- around here, when I meet people and tell them I am a TICU nurse, I get respect I never expected.

One thing thats keeps me at this hospital is the fact that I get to be involved in cutting edge new stuff- interesting new procedures etc. That seems to recruit a lot of nurses looking to advance skills.

I think you can't really recruit a happy med surg RN to critical care for a few dollars. Either you like the vents, Swans, transvenous pacers, or you don't....What I am reading here, though is a little scarey- cancelled surgery? Yikes.

Cheri · Nov 20, 2000

I am currently doing my senior practicum in the CT-ICU and the surgeons have to check with the charge nurse with regard to staffing BEFORE starting a case. In other words, nursing dictates if the case is done, if there isn't enough staff, the case is not done. It really upsets the surgeons, but it does address the issue of triples- not related to acuity. With regard to image, the article I read said that nurses should clean up their professional image. I have heard repeatedly in school that nurses should dress professionally and not in clothes that look like pajamas with cute little pictures on them. The point one of the professors made was, how can you earn respect if you are wearing little green frogs all over your shirt. I am not sure if I agree with that point of view. I think that is what they are talking about when they say, "image."

Stormy · Nov 22, 2000

The nursing shortage seems to be an issue felt by countries around the world. I work in a unit where nurses are requested to work overtime almost on a daily basis. When they refuse to come in, mandatory overtime is instituted. Our staff are getting tired and concerned about patient safety. It is not uncommon for our unit to refuse admittance of patients because of inadequate staffing. Patients are transferred to facilities several hours away. We have even had to transfer patients to other provinces on occasion when an ICU/CCU bed could not be found. We also have elective surgeries that must wait for an adequate staffing/beds to become available.

Cheri · Nov 22, 2000

Your situation sounds horrible- I can't imagine. What do you think is the primary reason for such a shortage? I wonder if nurses are afraid of being replaced? I read some figures and apparently this is just the begining- it is projected to get worse over the next 20 years. I have read plenty of articles about this issue and the solutions they propose, however the people writing the articles are not the ones out there practicing, Quite frankly, I think the nurses who are out there working in the ICU's have keen insight on the problem. I would love to hear some of your solutions to this shortage

Stormy · Nov 23, 2000

I think there are many reasons for the current nursing shortage in our province. Firstly, funding cutbacks associated with regionalization that happened here about 5 years ago, compounded by lack of insight by our governments about funding formulas was the initial insult to our healthcare system. We lost a lot of our young nurses to the USA as well as lost a lot from the profession completely with initial cutbacks. Over the last few years, our working conditions are such that we have lost even more because of job dissatisfaction. The other issue is the numbers of nursing students graduating from schools and colleges has plummeted. There were decreases in enrollments due to nursing no longer being an attractive profession, as well as numbers reduced due to funding for education being cut. Our nursing programs are 4 year degree programs, with the diploma programs having been phased out recently.

What are we trying to do to address these issues (and others)? Management and staff are working together to develop recruitment/retention policies. Our hospital is offering attractive bonuses to new staff, and are devising ways to keep those valuable nurses that we have. Continuing education has, of course, been targeted as high priority. The govenment has recently given our region $150,000 to be used for education programs. We are just starting to address these topics. If anyone has any ideas....

ccunite · Dec 12, 2000

In northern Calif. we've been trying to hire direct from the nursing schools (Juniors & Seniors). We used Travelling Nurses for several months to tide us over, but we've padded up our ICU-CCU staff-list abit now to allow for vacation-time. By law, we only take 2 patients apiece, but sometimes new patients are kept waiting in the ER while we get move-out orders from the MDs, pack the "least sick" out & clean the rooms, moments before new admits come rolling in.

We have 15 ICU-CCU beds & 8 Trauma ICU beds and they've been mostly full since August. We feel "squashed" when staffing is tight or short & the surgeons continue operating, the GPs keep admitting & refusing to move-out the longterm/stable patients.

It's harder to staff for the 12-hour night shift, despite the good pay & differentials. Also, I notice that the majority of us are around 40 years old & older, with decrepit joints & bad backs. I was hoping to retire early (before age 50) or move to a non-clinical area, but I love what I do despite feeling so bushed by the intensity!

oramar · Dec 13, 2000

ccunite, you should try recruiting in Pittsburgh. There is a gold mine of experienced nurses and nursing schools.