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?
the epic flaw to the "its management's problem" argument is that....................no, its not. its your problem. instead of looking from the angle of defending the days you call off or can't come in...........look at if from the angle of when you are at work. short staffed, no one answers their phone. you are already over ratio, people screaming and hollering for a nurse cause they have gone hours without seeing anyone and no help on the way. they still admit more people, they still pull your aid to sit on another unit and they still expect you to be done on time. sounds like its your problem to me. i don't see management, admin., supervisors, hr...............no one else in this scene..........feeling the bite of being short staffed.
thats my point. and, unfortunately, when we decide not to do something about it, and the whole situation runs away from us to the point where care is compromised, it also becomes our patients problem. now, idk, i've been nursing five years and i have become a little harder/more bitter/less sensitive than when i came in but...............that still bothers me.
i tried to make this point in a few previous posts above. you can see with your own eyes why nursing spins its wheels.
take it from an old nurse, it will not get better and you will know if you are on a good team if individuals work together.
if everyone values their job and are truly patient advocates,
they will band together and present the solution to management. if that is rejected and you do the
consistent ot, it is time to review your choices in nursing. there are other options in nursing or
beyond... you can see how divided this thread is and management adores that. nurses have more
education now, but what good is that when you lose sight of the fact that you are unable or unwilling or not interested (its managements problem not mine) to be a change agent.
my stance remains if you work short staffed and it feels unsafe it is, and you may risk your license.
ot-you may pm me if you like, i have some other ideas,hopefully insightful..
LOL. OK, I'll play along. Its kinda like my cats. If you put them on your lap to be petted, they leave. Then they come back a couple minutes later. Why? Cause they like it to have been their decision to be there, not yours.
I am saying "A". If you can only help out once every couple months........so be it, thats what you can do. You might/probably bring other things than flexibility to the table too.
If you can come in once or twice a month to help..........cool. Love ya. I'll break my back trading days with ya when you want off cause I know you'll save me from a bad night sometime down the road.
If you are like me and.........well, then I'd say get a life, but hey, we all need someone on the unit who is flexible.
Point is, just a little bit from everyone will move the boulder closer to where WE AS NURSES want it. The only thing I am against is not coming in at all EVER.......when you could.......just cause it gives you some juvenile "Ha ha, I thumbed my nose at management" feeling.
Eriksoln, I've treated you cordially and with respect, and I expect the same in return.
As we have all said, we agree with A, with pitching in to help in rare urgent situations - there's no issue with that. Maybe its your definition of rare that differs with the majority of posters on this thread?
Trading days off and preplanning is good and is a completely different situation than last minute frantic phone calls. If float pool, PRN, and on call nurses can't cover things on the unit enough to where these calls are being made many times per month, there are big issues. Obviously people pitching in is good, but we can do better than that by working for lasting change. Address the reason for the issue instead of merely reacting to it.
You have yet to tell me how staying silent and accepting any shift you are called in to do will result in any changes to the unit? How about attempting to work for permanent meaningful change with the persons who can make that happen - management, committe, or, people like NNOC/CNA? Being a voice for your unit will do more than just keeping the status quo. Have a couple of leaders on your unit meet with your manager and show their overtime numbers, and how costs would have been saved by hiring another staff member for float pool/more staff on call for example. Or maybe staff needs to start refusing to accept dangerous patient loads if your unit is having this situation happen repeatedly. Long term objective changes are what we should focus our time and energy on advocating for.
I don't get a warm and fuzzy feeling when I thumb my nose at management. I don't have any fantasy crusades. I know my unit sucks for staffing and I know they may suck worse if I leave, because they keep hiring people who do the silliest things, like giving mealtime insulin and not feeding the patient, then I have to come in and just about do somersaults to keep people alive.
Ok. So I came up with a schedule that helps me have a home life and helps the unit out because it involves me working every other weekend. That is more than I am required to do, because the requirement is one weekend out of every three. I can live with this, it's fine. What I have a problem with, is management not even paying attention to time-off requests for things like holidays and then staff us with half the recommended amount of nurses because everyone else wanted off. Well no sh** sherlock, of course we want holidays off, it's managment's job to deny some requests because we actually still have patients and someone needs to take care of them every single day and night, regardless of what else is going on in the world.
Seriously. Don't make a really stupid schedule. And if I do show up knowing I will have 6 ICU-style patients because some goofball flupped up the schedule, you should be paying ME overtime just for showing up when I knew it was going to be horrible. I don't call out; I show up and do whatever the heck is required to get through the shift. Yes it would be a nice thing if my coworkers could show up sometimes extra to help with those rough times, but you know what? Management didn't offer them any extra $$ or even a thankyou, if they choose to come help me. I can only bring homemade goodies to work so many times before I don't want to cook anymore.
The other thing that I do, is I have a PRN job and it's on a unit, in a different hospital, that is really well staffed so my PRN days are when they need me the most, and they aren't trying to dump on me. So my "extra" days may be hard work, but they make me feel appreciated, and I am more likely to say "yes" if I pick up the phone when that facility calls me, than I am to say "ok" when my fulltime job calls me.
Let me give you an example. I had one holiday off this last season: thanksgiving. I worked the rest of them and they were bad, because they were scheduled to be understaffed by a wide margin. The schedule was all made out and I could see that it was badly done. The night before thanksgiving, the charge nurse called to beg me to come in the next night. She was trying her best to call in personal favors so they would have something resembling a skeleton crew. Was there any mention of incentive? I mean money, folks, not brownies or soandso will like me more or whatnot. No, because management did not care if there were enough people working.
So no, I did not go in. If there had been incentive I would have rearranged my family's holiday to go help out. And when the rest of the holidays showed up, I was in the other boat and I didn't become angry with my coworkers for not coming in, I pointed the blame right where it needed to be: management. Don't make a horrible schedule and you won't have so many deaths. Period. Oh, to top all that off they promised incentive for every single extra shift for december, then didn't pay the actual money when the checks were made out. Seriously?
No, it doesn't feel triumphant or good, to tell management to learn to do their flippin' job properly! It does, however, feel absolutely necessary. I decide what things I can do to help my unit, and I do them, without fail. But there has to be some give and take or I will no longer be the giving, helpful soul that I am. The nurses do not need to do all the giving in this scenario, seeing as how we are constantly in the bent over position, taking it orificeways and holding each other up enough for management to **** us again.
You knows I luvs ya Erik, but if you had called me after I've already been called just so I'd answer seeing it was you on the ID, I would be very PO'd at you once I put it together. I really would.
You knows I luvs ya Erik, but if you had called me after I've already been called just so I'd answer seeing it was you on the ID, I would be very PO'd at you once I put it together. I really would.
Oh, that was a friend of mine who didn't get along with management. I called and told them I was there and they were like "OMG, I'll come in then. I thought it was just (manager's name) trying to call me in so one of her favs could have off". We did that all the time. I don't do that now cause I'm not friends like that with anyone on my unit. That was when I was a travel nurse.
Specializes in Oncology; medical specialty website.
I've actually been caught up in this before too. It was at my first nursing job ever. I'm......talkative and blunt by nature. So, I walked around talking about how "If the favor doesn't get returned to me once in awhile, maybe I should be more like you guys and just work w/e I feel like." A few nurses agreed with me and............yes, I know, its not a good thing........we formed a little click of people who helped one another out on the schedule.
Being flexible, you'll find it does come back to you more than you think. There have been times where they call someone to come in and no one answers. I'll get out my cell, call someone myself (someone I have the number of from personal use) and tell'em "hey, I dont wanna have 10 pts tonight. You not coming in cause you don't want to or cause you can't?"
After hearing the one who has saved them from being in a bind is now the one in need of help, they sometimes decide to come in (unless they really weren't coming in because they couldn't, of course).
I'm say, erase all this mumbo jumbo and just.........be a little more flexible, be more of a team (no clicks) and things could improve for everyone.
Picture: A very large stone that has to be pushed a few feet. If the whole unit does it, it gets done with minimal effort from each individual. If only half the unit does it, each individual must spend twice the effort to get the desired result. If only a few people are doing it........................yeah, you get the picture.
Not only is that a dirty trick, it's bullying, and you can bet your bippy I would report you to HR for that.
Specializes in Trauma Surgery, Nursing Management.
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.
I couldn't have said it better myself! This is EXACTLY why we are all in the bind that we are in...working our fool butts off during our scheduled shifts, only to be called by management on our day off to work "just for a few hours". We end up getting burned. The management doesn't care because the shifts are covered, and they can go home and drink hot toddies and watch TV secure in the knowledge that the "numbers" worked out for the day. It is despicable the way that nursing management in particular does not adopt the mindset of "you scratch my back, I'll scratch yours." The favors that we as staff nurses do for management is quickly forgotten when we need time off for ourselves.
When I am in charge, I try very hard to let the nurses that agree to stay over to finish up cases when they are NOT on call go home early on the days that they ARE on call if the surgical schedule allows. Sometimes we have a very heavy case load and I am begging nurses to stay, and sometimes we have a light case load and we can let people go home early. Who do you think is at the top of my list to let go early? I never forget the nurses that have helped me out when I am in a bind, and I always return the favor, DESPITE the reaming that I get from my own managers. It is difficult for me to identify with and agree with managers who are not willing to do the hard labor themselves.
From what I continue to read on this forum, and from my own experiences in my 12 years of nursing, the dichotomy of management and staff is vast. The very basic principle of happiness and harmony is "Do Unto Others." It is difficult for management and staff to be on the same page when their respective objectives are differing. There will always be problems, misunderstanding of expectations, and resentment from both parties if we all can't be reading from the same sheet of music. I have to tell you, the most successful marriage of management and staff nurses that I have seen is when I was deployed with my state disaster team to Katrina. We had ONE OBJECTIVE. And that was in a disaster site with almost NO support. We got the job done, and did it WELL.
It eludes me as to why hospital systems cannot seem to get their mess in a pile and not only be a support to the nurses who are breaking their backs to cover shifts for whatever reason (short staffing, call outs, improper scheduling by a nit-wit who can't add), but also will offer their OWN services to fill in the gaps. Is that really so difficult?
If we keep plugging the holes, there is no reason to get an engineer in to fix the dam.
Specializes in Oncology; medical specialty website.
OMG...............really?
LOL. OK, I'll play along. Its kinda like my cats. If you put them on your lap to be petted, they leave. Then they come back a couple minutes later. Why? Cause they like it to have been their decision to be there, not yours.
I am saying "A". If you can only help out once every couple months........so be it, thats what you can do. You might/probably bring other things than flexibility to the table too.
If you can come in once or twice a month to help..........cool. Love ya. I'll break my back trading days with ya when you want off cause I know you'll save me from a bad night sometime down the road.
If you are like me and.........well, then I'd say get a life, but hey, we all need someone on the unit who is flexible.
Point is, just a little bit from everyone will move the boulder closer to where WE AS NURSES want it. The only thing I am against is not coming in at all EVER.......when you could.......just cause it gives you some juvenile "Ha ha, I thumbed my nose at management" warm and fuzzy feeling.
Seems like this is more about pleasing you.
Wait until you have a few years under your belt...and five doesn't really count. When you've been working decades in this profession, you get to know that your time off is precious, and that no matter how much you pitch in, it will never be enough, and someone will always be there to b*tch that you're not doing enough to help out.
Staffing should be a management issue but I agree the ones who suffer most are the other nurses. What we should do is ban together and stop accepting assignments that aren't safe and potentially put patients and our licenses at risk. The answer here isn't to be martyrs and take on more and more and excuse poor staffing but to defend ourselves against it. Taking on 10 patients, working tons of O/T, etc. isn't the answer. In the end all the staff just ends up sick, exhaused, burnt out and that is no way to live our lives professionally or personally. Learn to set boundaries and work with other nurses not to fill the holes but hold management accountable in their jobs. That is when things will change. It isn't easy and nurses need to come together but it is doable. We want to be treated as professionals we need to hold other professionals responsible as well. That can mean saying no and staying firm.
Specializes in Trauma Surgery, Nursing Management.
I rarely work extra. I feel that I do well to do my 3 scheduled days to the best of my ability. I'm near burnt out as is.
I work as charge nurse at night and I don't try to pity or beg staff into coming in. The majority ALWAYS say no and I do not blame them one bit.
We work hard and give a lot of ourselves so our time off is precious.
When I say no or ignore a request to come in..I'm not thinking "haha management you won't get another hour out of me."
It has taken a few months but management has heard our cry and we do have more staff on the way!
I can't imagine a staff member saying "no" to coming in extra as snubbing their noses at management. I think that it has everything to do with maintaining a healthy work/life balance. We need to pay attention to ourselves and our own needs in order to be prepared to take care of the needs of others in our profession. BALANCE is key.
Ummmm, next time your unit is short and the M/S nurse refuses to help out, I hope they remember that day.
Guest717236
1,062 Posts
i tried to make this point in a few previous posts above. you can see with your own eyes why nursing spins its wheels.
take it from an old nurse, it will not get better and you will know if you are on a good team if individuals work together.
if everyone values their job and are truly patient advocates,
they will band together and present the solution to management. if that is rejected and you do the
consistent ot, it is time to review your choices in nursing. there are other options in nursing or
beyond... you can see how divided this thread is and management adores that. nurses have more
education now, but what good is that when you lose sight of the fact that you are unable or unwilling or not interested (its managements problem not mine) to be a change agent.
my stance remains if you work short staffed and it feels unsafe it is, and you may risk your license.
ot-you may pm me if you like, i have some other ideas,hopefully insightful..