Time for some introspective criticism perhaps?

[eriksoln]

OK. Everyone has read a complaint about short staffing and what not on here. Unless this is your first time on the site and this is the very first thread you have ever opened, you've seen it.

I too balk at the staffing levels admin. expects us to function under. Don't preach to me that you want to see "5s" on the surveys when you barely staff well enough for "3s".

With that said, I'd like to take a look at the staffing problem from a different, more introspective angel. I recently finished doing a boat load of OT this pay period. Too much to be honest. Problem was, every time I went in to do a four hour evening shift, it turned into a twelve hour overnight shift. That plus one daylight shift in which there was no aid (hence the need for nurses) but we still had our usual ratios and.........well, I did my part to "take one for the team" these past two weeks. My life outside of work is in the ditches and no paycheck is going to make me happy about it.

So, I'm talking to a night nurse one of the times I stayed and she is boobing her head back and forth telling me "He he, I can't believe you stayed but I'm so glad you did. We would have had to take (X) patients if you didn't stay. I can't function with that many patients. I don't know how you do it though, I don't do OT, its too tiring. I NEVER DO OT."

OK. Thanks for the info. legally blonde wanna be. You basically just got done telling me that if the roles were reversed you'd be out the door letting me function with (X) pt load. Nice, I'll remember that next time.

As I look around my unit, I do notice her approach to "helping" when things get tight is the norm. Very few people do OT or come in on a day off to help their coworkers from having to deal with excess stress. Everyone walks around with this idea of what it is they want to do and wont stray from it one way or the other. Ask them about changing their schedule because one day is overstaffed and another is short.........forget it. Ask them to work a weekend thats not "their weekend"......boo hiss.....they'd rather see their coworkers drown. And holidays............forget it, everyone thinks they are the only one's with a family and plans.

So, with regards to running short staffed, how much of it is us (nurses) doing it to ourselves? How much of it is us not answering the phone, saying "its not my problem" while we know our coworkers are at work drowning.

Heck, there was even a thread in here of someone calling off because they found out they'd be floated. Ummmm, next time your unit is short and the M/S nurse refuses to help out, I hope they remember that day.

Me, I do more than my share of taking some of the "pain" in the helter schelter schedule. I work my off weekend from time to time. I stay to help other avoid bad days. I often come in on off days. Holidays..........just give me T-day and I work Christmas Eve, Christmas day, New Years Eve and day. Granted, I am flexible to the extreme but my gosh........a little bit of flexibility would do wonders for the work environment.

I just don't understand the people who think they are ever going to have a "steady" schedule. Nursing never has nor will offer that unless your are in an office or something. Did they not know that when they got into it?

[General E. Speaking, RN, RN]

It is easy for me to pick up OT- my only child is 18yrs old. I see both sides. One side: it is usually the same people over and over that are able to pick up OT. I guess some could view these folks as "helping" the unit more than others. Other side: if my daughter was younger and still in daycare, it wouldn't be so easy. Some peoples personal situation doesn't allow them to come in on their days off- they have obligations.

I do help out in a pinch but lately, the mgmt scheme seems to be "come in today and I will take you off X day" hence, no OT. I see that always obliging mgmt and shifting my schedule around to accommodate the unit does help out my fellow nurses, but it never really solves the problem of adequate staffing to begin with.

My hospital has recently implemented that charge nurses in ICU take patients before an on-call nurse can come in. Previously, we had a free floating charge. Some days this works okay but other days it is dangerous and difficult on the rest of the nurses who have a difficult assignment, unruly family members or a patient that is circling the drain.

Out on the Tele floor, they are upping the nurse pt ratio to 6:1 (used to be 5:1 w/ free floating charge). Now the charge nurse has to take 2 patients and can't call in the nurse unless she is about to get a 3rd. As the former charge nurse on that unit I can see how this would work some days but other days it would be sheer madness.

The answer is adequate staffing to begin with and not relying on already tired nurses to come in and pick up the slack.

[BettyBoop01]

I know in my case I stopped coming in for OT after being burned too many times. If you offer to come in for 4 hours, you get dumped all the patients the day nurses dont want any more. You end up doing WAY more than your fair share and then staffing begs you to stay all night. Staffing calls every single day I am off begging me to come in, and at first I used to go. Then I realized no one else does it because you get treated so badly when you do.

Example, went in 3-7 to "help out". Day nurses each get to give away 1 or 2 patients. WHo do they give ya? The confused guy jumping out of bed, the post op that needs 2 units prbc that was ordered at 9am, the lady thats been on the call light every 20 minutes to pee, the two patients whose admit paperwork were not done yet, basically all the patients they didnt want anymore. Its like 8 hours worth of running around you try to stuff into 4 hours. You just get dumped on. And then they treat you badly because you leave at the end of the 4 hours which has runed into 6. After a few times coming in to help out, you see why no one else does it. Everyone is burned out, everyone. The floor is a revolving door of staff coming and quitting.

The norm on my floor for med surg at nights was 8 + patients and as a fairly new grad I have to tell you it feels dangerous. My first night off orientation they tried to give me 10 patients by myself. You read that correctly. TEN.

Anyway, I found a new job. But I can tell you why we dont want to come in and work OT all the time, because they are purposely understaffing. It is not the exception it is the rule. You come in and they make you feel like a jerk for leaving. And then they call you the next day and it starts again. Then they make you work short every shift and pretend they cant schedule staff properly. They can, they just wont. They want fewer nurses to do the work to save them money.

Since I have quit, staffing has continued to call me and beg me to come in. I DONT WORK THERE ANYMORE.

[tencat]

By agreeing to so much overtime, a nurse is NOT helping the issue or other nurses. The issue is with management and their lack of planning and staffing. By agreeing to come in on our days off, we are only encouraging them to keep understaffing because they know someone will always be there to take the shift. I feel for you, but YOU are allowing the cycle to continue by picking up those extra shifts and working understaffed. If all the nurses could stick together and say, "Um...NO", that would force management to rethink their scheduling.

Patient safety and care are being compromised anyway when there is not enough staff, so not agreeing to an extra shift isn't going to tip the scale.

[General E. Speaking, RN, RN]

Example, went in 3-7 to "help out". Day nurses each get to give away 1 or 2 patients. WHo do they give ya? The confused guy jumping out of bed, the post op that needs 2 units prbc that was ordered at 9am, the lady thats been on the call light every 20 minutes to pee, the two patients whose admit paperwork were not done yet, basically all the patients they didnt want anymore. Its like 8 hours worth of running around you try to stuff into 4 hours. You just get dumped on. And then they treat you badly because you leave at the end of the 4 hours which has runed into 6. After a few times coming in to help out, you see why no one else does it. Everyone is burned out, everyone. The floor is a revolving door of staff coming and quitting.

The nurses at my unit would try this when someone came in to help. When I was charge nurse, I wouldn't allow it. Not fair for that nurse to get every single train wreck, new admission or needy patient.

[TheChair1]

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.

Do you guys have mandatory overtime at your facility? Are you being forced to miss out on all these wonderful opportunities with your family or are you choosing to?

[guest64485]

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.

If there always is a nurse to cover via last minute calls to homes of RNs, instead of preplanned methods like float pool, then management won't make any change. Volunteering to work is nice but it does not change anything in the long run. Its not that I don't think nurses should do something, I just disagree with the method of putting more pressure on coworkers to pick up shifts, because its not merely rare staffing issues here and there from rare bad snow days or mass illness(everyone should pitch in on rare extenuating circumstances), it is an issue all the time, and really, the issue stems from management not scheduling nurses to work in the first place in anticipation of common, common staffing issues.

I would instead recommend going to the manager with the suggestions of internal changes like creating a float pool department etc, or do something like joining the CNA/NNOC and work with them to prevent the problem from happening in the first place. I have given my money to the CNA cause because they are enacting legally mandated changes to help this exact problem. Professionalism is working to enact permanent change - fixing the cause instead of merely reacting to the symptoms.

[Horseshoe, BSN, RN]

The norm on my floor for med surg at nights was 8 + patients and as a fairly new grad I have to tell you it feels dangerous. My first night off orientation they tried to give me 10 patients by myself. You read that correctly. TEN.

Anyway, I found a new job. But I can tell you why we dont want to come in and work OT all the time, because they are purposely understaffing. It is not the exception it is the rule. You come in and they make you feel like a jerk for leaving. And then they call you the next day and it starts again. Then they make you work short every shift and pretend they cant schedule staff properly. They can, they just wont. They want fewer nurses to do the work to save them money.

Since I have quit, staffing has continued to call me and beg me to come in. I DONT WORK THERE ANYMORE.

This is exactly why I am so glad I chose ICU. They CANNOT give you more than 2 patients during the day (though there are days where that feels like too much). Same with OR and a few other specialties, you only have one person at a time to keep up with-they cannot try to screw you like that. I feel for you guys and totally understand why nurses today are so fed up with administration and feeling more and more beat down. I think nurse to patient ratio is the single most important issue to nurses today.

[NightOwl0624]

We have big time staffing issues on our floor. Our manager is "working on it". She's been "working on it" for a long time.

What gets me about staffing is, why is it our responsibility? We have a manager, we have a staffing office, our house managers know our situation, and still, we are understaffed. Staffing office will tell the charge nurse "we don't have anyone to give you. Start making phone calls." So the already over-worked charge nurse has to walk away from her 6-7 patients and spend the next hour trying to find a nurse to come in and work extra, (and no one answers their phone anymore, including me. We're all too tired and frustrated to work any more than we are already scheduled). Shouldn't this be someone else's responsibility?

Anyway, to the OP, sure it is nice to help out your coworkers in a pinch, but when it is everyday, there are more serious problems that need to be addressed - and that is NOT the nurse's responsibility, IMHO.

[nurse2033, MSN, RN]

I applaud your dedication to your work and your patients, but you said it yourself, it is coming at a high cost to you. Nurses who don't work overtime are looking out for themselves and I am one of them. I think if you pitch in in an emergency that is one thing, but it seems every day is an emergency. I get put on call for scheduled shifts (when census is low) which eats up my vacation time, then they might call me the next night, when I have plans. I think that when staff pitch in often they are enabling poor management practices. Management is using you up because it is so much easier to just appeal to you to cover a shift than deal with the long term management of hiring and retaining staff. I admire you for your dedication, but please dont' criticize other staff members who are putting themselves first before a large corporation who probably doesn't care about your sleep, health, or relationships. Being lazy is one thing. I have even gone part time (2x12) because I needed some time to recharge. Now, I'm so much more productive, happy, and engaged at work. Don't feel guilty to say "no" to overtime. It's one thing if you want the work and need the money, but otherwise stay home.

[Guest717236]

[quote=Fribblet;4763643

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.

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 .

I respect this approach, but the reality is that if you are not sharing it can resultin your coworker (like Eriksoln)who is consistently picking up time

getting burnt out or physically ill.

The most extreme example as of a friend of mine who worked constant

over time, death resulting.

The death was not caused by overtime, but the intense work commitment he made to his patients and unit was a contributing factor.

In an ideal situation, everyone should be willing to share. The team should decide what is reasonable and if the nursing acuity is unrealistic,

as one team speak to the issue of appropriate coverage.

I know 2 things 1) Management can care less along as someone is willing to do the dirty work and

pick up extra work when others are not.

2) Nurses are their own worst enemy, by not addressing this issue that Eriksoln/and others

are consistantly picking up the slack, they risk losing a great coworker off the unit.

Someone will need to replace that role, and it will fall to senior staff not the new

person who is hired.

When nurses do not band together and speak in one voice, nurses like Eriksoln may move on, so

have the kleenx tissues at hand.

:crying2: Nurses with dedication like Eriksoln are becoming fewer and

fewer, don' t take them for granted....:crying2: Be sure his unit would have a difficult recovery period if he choose to depart for a better working situation

.

[Fribblet]

I respect this approach, but the reality is that if you are not sharing it can resultin your coworker (like Eriksoln)who is consistently picking up time

getting burnt out or physically ill.

No. The coworkers who are constantly picking up the OT are the reason they are getting burnt out and physically ill. The fact that I don't do it very often, does not force them to. They choose to. If they choose not to, then maybe management would be forced to staff better.

The most extreme example as of a friend of mine who worked constant

over time, death resulting.

The death was not caused by overtime, but the intense work commitment he made to his patients and unit was a contributing factor.

I'm sorry to hear about your friend. Did his place of employment force him to pick up all the OT, or did he choose to?

In an ideal situation, everyone should be willing to share. The team should decide what is reasonable and if the nursing acuity is unrealistic,

as one team speak to the issue of appropriate coverage.

I know 2 things 1) Management can care less along as someone is willing to do the dirty work and

pick up extra work when others are not.

Of course management isn't going to do it. They expect us to rather than do what they need to do and staff a unit appropriately.

2) Nurses are their own worst enemy, by not addressing this issue that Eriksoln/and others

are consistantly picking up the slack, they risk losing a great coworker off the unit.

Someone will need to replace that role, and it will fall to senior staff not the new

person who is hired.

No. Management is our enemy in this scenario. Management is the one who needs to staff the unit. It's their responsibility. By picking up all the slack, we're sending the message out that it's okay, we don't need extra staff. This is management's problem and responsibility.

When nurses do not band together and speak in one voice, nurses like Eriksoln may move on, so

have the kleenx tissues at hand.

When we do not band together and speak with on voice, we continue to have unsafe staffing levels.

:crying2: Nurses with dedication like Eriksoln are becoming fewer and

fewer, don' t take them for granted....:crying2: Be sure his unit would have a difficult recovery period if he choose to depart for a better working situation

.

And that's not my fault. It's a management failure.

[gonzo1, ASN, RN]

Eriksohn, I have great respect for you and you sound like someone I would love to work with, but if you don't feel like your "team" is working as a team to keep your unit running smoothly, then you probably need to look at moving to another team.

I completely agree with all the above posters that picking up overtime even when it is detrimental to you just to keep your unit running smoothly will only keep management from making the changes they need to make. I was once in this position and picked up overtime till I was totally wrecked. I was the darling of the unit as far as management went. Then when the recession hit. I was let go like a hot potato. So I learned that you pick up when it benefits you, and when it doesn't then you let management worry about it and just enjoy your day off. WE nurses need to stop enabling management and all their poor decisions. I have worked in both types of units, with people who never did their fair share, and units with totally dedicated people who always helped out no matter what. Fortunately right now I am working in a unit with very mature, grown up staff and there are very few issues. Take care of yourself and good luck