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?
I'm going to stay focused on the thread topic and let the obviously offensive insinuations go, for now anyway. I wish you the best of luck in that part of your life and hope things get better for you.
Things get better for me????? I was stating facts not asking for your sympathy.
Probably already been said, but it's probably cheaper in the long run to pay you OT prn than it is to hire, train, and retain new staff.
Edit:
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.
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?
Actually, nursing does offer a steady schedule, the one you get every month. I personally refuse to work OT, and I am adamant that THAT IS IT. If you want to do OT for yourself, or some altruistic reason, fine. You never HAVE to sign up for extra shifts. It's your choice, I'm not the bad guy because I don't share your pain.
Ensuring safe staffing is not up to me, it's up to my manager, the staffing office and the CNO. If they are chronically short, go out and hire some nurses. Don't count on me to be willing so they can cut expenses by NOT hiring and save on benefits.
So lets say we staff to the fullest, now census drops....how many people are going to get called off? It doesn't take long to use up all your pto if there is a long stretch of low census. There will always be a few that can take off without pay for a shift or 2, but most of us work because we have to.
If I turn down OT, or call in sick (genuinely) for a shift, I do not, for one minute, feel that I'm letting my coworkers down or letting them drowned. My shift WILL get filled by someone else. Or another nurse WILL accept that OT shift and be darned happy about it.
Maybe it's because of how it's run where I work, maybe it's because I work within a unionized workplace, but it's very, VERY rare that we worked shortstaffed. Do I think that we are understaffed? Sure. I would love for there to be 2-3 more nurses on a busy surgical floor. Or another nurse to help with my LTC med pass and treatments. But save for a very few shifts that our central scheduling office couldn't find any nurse and straight time or OT, we don't work short staffed. (And these shifts were sunny, beautiful, hot Saturday afternoons in the middle of the summer......hmmmmmmmmmmmm)
Specializes in ICU, Home Health, Camp, Travel, L&D.
I can't *believe* you'd suggest that we all take up the slack for each other and *just maybe* feel a little pinch right where our personal plans are! I mean, we want to work for a facility that is just all about us...so you can just take your nagging somewhere else!
T says, as she flips her hair, rolls her eyes, and sighs from her never scuffed clogs.
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.
Actually I don't stay silent. I don't write letters to admin. or anything of that nature, but if I feel like I'm getting that "burnt" thing going, I tell em my charity OT is coming to an end for a week or two. Not willing to risk my license. For the most part, when I have the "warning" flag up..........lol, I get lots of help. Charge nurses make sure my D/C's are done for me, admits are done for me. They know I'm not being a baby and complaining, that when I say "I'm feeling fatigued" I mean it and they help. So, there is a good bit of teamwork on my unit.
Anyway. I look at it from a "you'll attract more flies with honey than with............" POV. Imagine:
1. A unit with people willing to do OT WHEN THEY CAN, NO, NO FORCED SLAVERY that for the most part takes care of its own. People are able to handle their own schedule requests by trading with one another, they work out who is working what holiday amongst one another and true "emergencies" that the staff can't solve on their own are rate.
2. A unit with low moral. Its a complete "punch in, punch out, collect your check" warehouse mentality. People complain about not getting the holidays they want, and often call offs occur on said holidays. Complaints of "schedule requests" not being granted run rampant, and requests stack the manager's desk every day for this and that. There are holes on the schedule that need filled, no one wishes to do it, and the people working that day are considering calling off because they know no help will be made available. Management blames the nurses for it all, and the nurses sound like............well, the people posting here.
Ok. Now, imagine a group of nurses from #1 going to the manager and saying "Ya know what, we think it would do the unit a lot of good if there were a unit clerk a little later in the day.
Then imagine the nurses from group 2 doing the same.
Who has a better chance of "initiating change" in the system? Its not a difficult riddle, trust me, so don't read too much into it.
So lets say we staff to the fullest, now census drops....how many people are going to get called off? It doesn't take long to use up all your pto if there is a long stretch of low census. There will always be a few that can take off without pay for a shift or 2, but most of us work because we have to.
It's a fine line trying to juggle staffing......
Exactly.
I left a unit not too long ago that was TOXIC. Had a lot of..well, nurses who would have agreed with the posters here. TOXIC. It was as if the place existed so they'd have a place to work.
Remember a year or so ago when just about every hospital in the nation was low census for a good period of time? These nurses walked around in circles "squawk squawk, this isn't fair, I used up all my PTO for vacation, they need more patients, they have to do something". Such an interruption to their schedule it was. Of course, when census spiked for a week or two it was right back to "don't call me, I'll call you".
You have to pick your poison.
Work in a place that is so staffed that someone is being sent home on a regular basis..................or work somewhere that is a little more borderline with staffing, needs some help from time to time, but offers steady hours to the full time people. I choose the later.
Here's an idea.... Management or whoever schedules should learn to schedule correctly. Once in awhile needing to call people to come in is understandable. Where I work it is a daily occurance on multiple shifts. I am sick of it. I do not want to be guilt tripped like other RNs at my facility are into 16 hour days multiple times a week. I have yet to see a manger take one for the team and stay longer or care for patients!
If I turn down OT, or call in sick (genuinely) for a shift, I do not, for one minute, feel that I'm letting my coworkers down or letting them drowned. My shift WILL get filled by someone else. Or another nurse WILL accept that OT shift and be darned happy about it.
Well, here is another view...your shift may be filled by someone-travelers and agency nurses.
One hospital replaced all nurses on certain floors with all agency and travelers every shift.
This meant that each day patients would have different nurses from agency/traveler group
including the charge nurses. This saved the hospital lots of money in benefits etc.
And the hospital is a well known teaching hospital in a major city. The original nurses employed were in a union, but the hospital reorganized (bought by another group).
So when members say it is not my problem, be aware in some cases management will fix it..
Actually I don't stay silent. I don't write letters to admin. or anything of that nature, but if I feel like I'm getting that "burnt" thing going, I tell em my charity OT is coming to an end for a week or two. Not willing to risk my license. For the most part, when I have the "warning" flag up..........lol, I get lots of help. Charge nurses make sure my D/C's are done for me, admits are done for me. They know I'm not being a baby and complaining, that when I say "I'm feeling fatigued" I mean it and they help. So, there is a good bit of teamwork on my unit.
Anyway. I look at it from a "you'll attract more flies with honey than with............" POV. Imagine:
1. A unit with people willing to do OT WHEN THEY CAN, NO, NO FORCED SLAVERY that for the most part takes care of its own. People are able to handle their own schedule requests by trading with one another, they work out who is working what holiday amongst one another and true "emergencies" that the staff can't solve on their own are rate.
2. A unit with low moral. Its a complete "punch in, punch out, collect your check" warehouse mentality. People complain about not getting the holidays they want, and often call offs occur on said holidays. Complaints of "schedule requests" not being granted run rampant, and requests stack the manager's desk every day for this and that. There are holes on the schedule that need filled, no one wishes to do it, and the people working that day are considering calling off because they know no help will be made available. Management blames the nurses for it all, and the nurses sound like............well, the people posting here.
Ok. Now, imagine a group of nurses from #1 going to the manager and saying "Ya know what, we think it would do the unit a lot of good if there were a unit clerk a little later in the day.
Then imagine the nurses from group 2 doing the same.
Who has a better chance of "initiating change" in the system? Its not a difficult riddle, trust me, so don't read too much into it.
Maybe its just that my experiences have been very different from yours. I have always worked in large hospitals with float pool, PRN staff, and a staff member routinely on call. We don't really have the issues of routine last minute phone calls for staff to come in, but if we did, I'd be doing some deep inquiry as to why we couldn't prevent that problem from happening in the first place. The complaints about staffing that I've seen on this board mainly relate to nurse : patient ratios being high, not that staff is calling out or not agreeing to OT.
Are you in a small hospital? I hadn't thought of this before, but for small community hospitals I can see how the last-minute-phone-call issue may legitimately be there, though, I'd still wonder why there wasn't a heavier on-call system in place, or a back-up use of agency/PRN nurses.
Charge nurses are a valuable source to speak to for day to day issues, however for permanent change I'd recommend that you do "write letters to admin". If there are that many issues on your unit that one person not agreeing to OT can routinely (sorry but the way you put it, it sounds routine to me) cause dangerous staffing levels, then at least try to fix the situation for the future.
I went to my manager because we would routinely have 9 total patients during the day and do our own admits/discharges, which was difficult to keep up with and patient care was suffering. I wrote out a list of suggestions to help lift nursing's burden by changing a couple of policies/slightly changing equipment. I was told that the omnicell system was too expensive to implement(running out of equipment took up a lot of our time), and of my policy changes (with research studies backing it up), was told that the hospital was "slow to implement changes" and not to expect much, but that it was forwarded on. A few minor time-saving changes such as a redesign of our medroom were approved and implemented in the end. It wasn't much but was a start.
Absolutely people should be helping each other out when it works for them, and I'm surprised why anyone would have issues with pre-planned swapping/schedule changes - maybe the staff just aren't good together. A balance does need to be looked at for last minute phone calls though.
Exactly.
I left a unit not too long ago that was TOXIC. Had a lot of..well, nurses who would have agreed with the posters here. TOXIC. It was as if the place existed so they'd have a place to work.
Remember a year or so ago when just about every hospital in the nation was low census for a good period of time? These nurses walked around in circles "squawk squawk, this isn't fair, I used up all my PTO for vacation, they need more patients, they have to do something". Such an interruption to their schedule it was. Of course, when census spiked for a week or two it was right back to "don't call me, I'll call you".
You have to pick your poison.
Work in a place that is so staffed that someone is being sent home on a regular basis..................or work somewhere that is a little more borderline with staffing, needs some help from time to time, but offers steady hours to the full time people. I choose the later.
When census was low a year ago we had a group of people who volunteered to be called off more. Sure, of course, there were those who were living paycheck to paycheck who had concerns when it was their turn to be called off. We also implemented a heavier on-call system, so when census did spike we didn't have those issues of last minute phone calls to people who already made plans. There are a myriad of options out there to pre-plan for many potential staffing issues before they get out of control.
If you are in a smaller hospital, well, that will require some more creativity. But I'd love to brainstorm with people on this thread as to how to help solve your department's issues if you are in a smaller hospital. :)
Ummmm, next time your unit is short and the M/S nurse refuses to help out, I hope they remember that day.
mcleanl
176 Posts
Things get better for me????? I was stating facts not asking for your sympathy.