Time for some introspective criticism perhaps?

Laught3r · Feb 2, 2011

I would have to agree with you. Many times i do work overtime and bust my butt. But those that I am assisting will give me the worse patients since I am on overtime and i'm getting paid more that night. Yeah the pay is going to make my kid feel better because I missed her game winning goal. Or make my husband feel better because I missed date night. I wish that people will listen to themselves when they say certain things.

eriksoln, BSN, RN · Feb 2, 2011

I would have to agree with you. Many times i do work overtime and bust my butt. But those that I am assisting will give me the worse patients since I am on overtime and i'm getting paid more that night. Yeah the pay is going to make my kid feel better because I missed her game winning goal. Or make my husband feel better because I missed date night. I wish that people will listen to themselves when they say certain things.

Yeah. The last night I stayed, we had this CNA who is rebellious, often refuses to do her work. She was having a bad day and did her "I'm not working the whole hall again" thing. Sure enough, I was on the side that she marked off her list. The nurses knew this and didn't do a thing about it. So, in short, I was primary care all night. My hospital has an issue with CNAs and thats the norm actually, but it shouldn't have been on that night for me. I gotta tell ya, after than night, I don't know if the night shift should be looking for assistance from me or not.

I mean, shoot, have some common sense people. Treat the person helping ya out with kid gloves so they'll want to do it again. Then these are the people who whine and cry cause they are short staffed. :banghead:

Fribblet · Feb 2, 2011

I help out when I can, but I also have an obligation to myself. I'm no use to my unit or the patients if I'm become so burnt out that I quit.

The hospital is obligated to staff the units and floor appropriately. I am not obligated to work myself into depression and injury and let my personal life suffer. There will always be times when extra help is needed, but this martyr mentality is detrimental to us both professionally and personally. Nothing but a larger check and potentially moving up a tax bracket is to be gained by working an absurd amount of hours. If they need me to pick up that much OT, then I'd better be getting disaster pay because that's exactly what my house and life are going to look like after it's all said and done.

I don't like to know that my co-workers are suffering and do my best to prevent it by almost never calling out and always showing up on time, but myself and my family always comes first.

Laught3r · Feb 2, 2011

I would like to see admin work with secretaries. I would also like to see them skip their lunch and never put their bottoms on a chair for six straight hours. I would really love to see them deal with people telling them "no sorry we can't hire any new ancillary staff to help you with copying, typing or gophering because its not in the budget this fiscal year. I hope the patients don't learn that their safety is not in the budget.

eriksoln, BSN, RN · Feb 2, 2011

I help out when I can, but I also have an obligation to myself. I'm no use to my unit or the patients if I'm become so burnt out that I quit.
The hospital is obligated to staff the units and floor appropriately. I am not obligated to work myself into depression and injury and let my personal life suffer. There will always be times when extra help is needed, but this martyr mentality is detrimental to us both professionally and personally. Nothing but a larger check and potentially moving up a tax bracket is to be gained by working an absurd amount of hours. If they need me to pick up that much OT, then I'd better be getting disaster pay because that's exactly what my house and life are going to look like after it's all said and done.
I don't like to know that my co-workers are suffering and do my best to prevent it by almost never calling out and always showing up on time, but myself and my family always comes first.

Granted, if you are working yourself into depression or to the point where fatigue compromises the care you give, not good. Is that really what's going on here though? Not with my unit. Big gap between what you described and the "little bit of flexibility" I'm saying we need.

Truth is, its not unique to nursing either (unpredictable scheduling). Take my brother-in-law for example. He is a truck driver, does semi-local (one day only) trips. Now, its not uncommon for the company to call him and say "no need to come in". A few retailers or warehouses cancel deliveries and there is just no work. Now, other times, he could work three days straight no break and not get the available work done. Sometimes he goes a whole month doing the max. OT he is allowed by law every week. While he is doing it though, he knows.......eh, next week might be one of those weeks I don't have work.

Nursing is the same. If people don't come to the hospital.......there just isn't any work. And, for some reason, when they do come, its in droves. If you are not flexible to some point, and everyone else on your unit has the same mentality...........you can expect to work short an awful lot no matter how well admin. allows staffing to be or how well the manager's ESP was working when they make the schedule.

eriksoln, BSN, RN · Feb 2, 2011

I would like to see admin work with secretaries. I would also like to see them skip their lunch and never put their bottoms on a chair for six straight hours. I would really love to see them deal with people telling them "no sorry we can't hire any new ancillary staff to help you with copying, typing or gophering because its not in the budget this fiscal year. I hope the patients don't learn that their safety is not in the budget.

I agree. Admin. DO NOT earn their salaries or bonuses. If they really want to fix healthcare, start by limiting admin. salaries.

With that said, since that ain't gonna happen...................why not put some effort into the things that are under control. I'm not saying everyone has to be Superman when it comes to answering the call for help, but it doesn't take much to make a world of difference for your coworkers. They'll see you in a different light for it.

If we don't take care of each other, why should anyone else be in a hurry to save us?

guest64485 · Feb 2, 2011

The hospitals I've worked at have had full time float pools/internal agency nurses, and regular staff aren't told if they are being floated until arriving on the unit. That seems to alleviate most of the urgent issues, but the problem is more that management won't allow more RNs to work/calls them off. 1:6 is the norm on the day shift med surg unit - were they to change that to 1:5 as a norm or at least have an admission RN, then they'd be much better equipped if there was an issue with mass sick call outs for example.

A lot of hospitals do not staff proactively in anticipation of problems, they instead staff as if every day will be a quiet smooth day. Problem is, those days are rare. There will always be a code, or a nutty unrelenting family member or a violent patient, or a rush of admits. Hospitals are aware of these recurring issues yet do not act on them as they should.

I appreciate that you are trying to find ways to improve how we work, but staffing is an employer issue, not an employee issue. More managers need to step it up and take a few patients here and there when those critical staffing needs come up if regular staff are unable to come in. If employees bend over backwards to satisfy the employer's every need then why would the employer feel the need to change things? Nurses give up quite a lot already - you don't have to search far to see the posts about people not eating and not peeing during their shifts or staying over and charting off the clock. I'd say its time for the employer to step up. WHY do nurses always have to take the fall and be the martyr?

My manager once bemoaned how if we could cut our overtime, then they could afford to hire another person. Well, maybe if they staffed properly in the first place then there wouldn't be a need for that OT. A proactive manager is much better than a reactive one.

The solution as I see it is to have decent ratios to being with, a person doing a task they can drop to take a full patient load if need be, such as admission nurse or a nurse doing chart audits, and have a dedicated float pool for nurses and pcts (with a last resort being to float people from other departments), and have managers be required to step in as charge nurse if need be, staff pcts properly and cross train pcts as unit secretaries.

eriksoln, BSN, RN · Feb 2, 2011

The hospitals I've worked at have had full time float pools/internal agency nurses, and regular staff aren't told if they are being floated until arriving on the unit. That seems to alleviate most of the urgent issues, but the problem is more that management won't allow more RNs to work/calls them off. 1:6 is the norm on the day shift med surg unit - were they to change that to 1:5 as a norm or at least have an admission RN, then they'd be much better equipped if there was an issue with mass sick call outs for example.
A lot of hospitals do not staff proactively in anticipation of problems, they instead staff as if every day will be a quiet smooth day. Problem is, those days are rare. There will always be a code, or a nutty unrelenting family member or a violent patient, or a rush of admits. Hospitals are aware of these recurring issues yet do not act on them as they should.
I appreciate that you are trying to find ways to improve how we work, but staffing is an employer issue, not an employee issue. More managers need to step it up and take a few patients here and there when those critical staffing needs come up if regular staff are unable to come in. If employees bend over backwards to satisfy the employer's every need then why would the employer feel the need to change things? Nurses give up quite a lot already - you don't have to search far to see the posts about people not eating and not peeing during their shifts or staying over and charting off the clock. I'd say its time for the employer to step up. WHY do nurses always have to take the fall and be the martyr?
My manager once bemoaned how if we could cut our overtime, then they could afford to hire another person. Well, maybe if they staffed properly in the first place then there wouldn't be a need for that OT. A proactive manager is much better than a reactive one.
The solution as I see it is to have decent ratios to being with, a person doing a task they can drop to take a full patient load if need be, such as admission nurse or a nurse doing chart audits, and have a dedicated float pool for nurses and pcts (with a last resort being to float people from other departments), and have managers be required to step in as charge nurse if need be, staff pcts properly and cross train pcts as unit secretaries.

Right. And back when there really was a "nursing shortage" a lot of these things were actually being done (well, more so than now anyway) because retaining RNs was more of a priority.

I'm kinda looking at it from a "We know the leadership won't fix it, but lets at least do our part." view. I'm a firm believer in dealing with the cards you are dealt. Its often a choice between doing that, or just simply criticizing what cards you are handed and nothing getting done (cause it doesn't change what cards you get). Fact is, although it would take minimal money and assertiveness from the leadership to solve staffing, its not an issue to them cause they don't feel the bite of it when it goes wrong. They aren't going to fix it, it'd take away from their time spent figuring out what to do with that bonus coming next month.

When I was a landscaper, I hated snow removal days. You could be out there 36hrs straight before everything was all said and done. The more people that showed up for it, the less time you spent on the field. I always showed up for it when I was assigned to snow removal. Some weren't so reliable. They thought nothing of coming up with some outlandish excuse they couldn't make it (their grandmother died for the fifth time). That meant probably another 5 or 6 hrs on the field for everyone else. Do you think the manager for a second suffered from this? Nope. They still only did the jobs that didn't require getting out of the truck and by no means did they stop taking calls for more jobs to be done. We suffered through it, the workforce. Eventually people learned to.........well, "motivate" their coworkers to come in.

People love to talk about nursing being a profession and all, but put a road block like staffing issues in our way and we go right back to the blue collar "its administration's problem" train of thought.

mcleanl · Feb 2, 2011

Okay....Eriksoln I read your post and the first thing that came to my mind was this was written by a man (and I am sure I will get flamed for saying that!). Here it goes........I have two children for which I must arrange child care, cook all meals and make lunches, do laundry, take to sporting activities and help with all homework. I volunteer at the school when I can and clean the house, maintain the lawn and pay the bills, arrange doctors appointments and any other thing that needs to be done.

I could go on for days about the things that I am responsible for OUTSIDE of work. I don't know your situation but I committed to work three days a week and that is what I can give. Back in the day, before kids, I loved over-time......not so much anymore!

In my last postition we had a handful of guys working in the unit...they were all second career nurses. One had been a landscaper, one had been a carpenter and so on and so forth. They all talked about how easy three shifts a week is compared to their previous jobs. They always joked about the female nurses saying "they complain about everything, they don't know how easy this job is." One day an older nurse I work with said......."I think you might find this job easy because when you go home your job is done, when most of these women go home their job is just beginning." Of course she put a few choice words in there as well.

Don't worry about what others are doing......if you want to do OT, do it......you can't know what other peoples situations are.

INLPN93 · Feb 2, 2011

In LTC if you pull any extra shifts, you become the only person they call to fill shifts.

It is a laziness issue on the part of management and scheduling.

There are nursing mangement and voluntary on-call nurses being paid to be on call and come in but most won't if they can get a sucker to say yes.

Behind the name and before some inflated title is RN and they can work the floor just the same as I can the LPN.

Nursing management in LTC needs to lose the attitude that they are above floor work and actually manage a scheduling situation.

There may still be some LTC DON/ADONs that do work the floor but I haven't seen one in years.

So, no I don't do OT/extra shifts unless I need the money. I am in fact not the only nurse on the schedule and I am not being paid to be on-call.

After 18 years, I am not continuing to be played like a fool. I have a life just as the other nurses and management. So, I rotate my taking an extra shift that way I do help but I don't become the only one and others realize they can too.

DroogieRN · Feb 2, 2011

I help out when I can, but I also have an obligation to myself. I'm no use to my unit or the patients if I'm become so burnt out that I quit.
The hospital is obligated to staff the units and floor appropriately. I am not obligated to work myself into depression and injury and let my personal life suffer. There will always be times when extra help is needed, but this martyr mentality is detrimental to us both professionally and personally. Nothing but a larger check and potentially moving up a tax bracket is to be gained by working an absurd amount of hours. If they need me to pick up that much OT, then I'd better be getting disaster pay because that's exactly what my house and life are going to look like after it's all said and done.
I don't like to know that my co-workers are suffering and do my best to prevent it by almost never calling out and always showing up on time, but myself and my family always comes first.

This. What other profession expects you to come in on your days off and work like the dog you do when you're actually scheduled? Yeah, I am going to do that to myself. I feel awful for my co-workers when I know they are short but I work my butt off on my three 12s (which often morph into 14s), never report off, always pitch in to the point that I myself am often behind and generally try to bring a positive attitude to the proceedings. I occasionally stay for OT but I never pick up and I don't feel guilty. If there is someone at whom ire should be directed, it is the person(s) who staff at a bare minimum to the point that one report-off throws the whole hospital into a tizzy. Just my :twocents: