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?
If you allow staffing to simply be "a management issue" or leave it to them to handle it, you'll get what you asked for, and you won't like it. Like I said before, simply dumping the problem in admin.'s lap and saying "Eh, not in my job description, I am hired to work X hours and if I do more I'll miss way too much beauty sleep.................." is the road we've been taking, and it has not worked. How many times do we, as nurses, have to walk headfirst into the same wall before we say "Oh gee, that hurts, I better go around next time."?
Again, listen carefully this time...............................IT IS YOUR PROBLEM. No one else has to go into work and take extended assignments (lol, admin and management leave the exact same time day after day, regardless of your personal ratios). No one else skips their breaks because they are spread too thin, no one else cancels plans cause they have no clue when they will be leaving, no one else deals with any of it except us. The ONLY group the consequences of being short handed fall upon is............US. Its a nursing issue, not a management or admin. issue. What is their motivation to change anything?
I'll ask this too. For everyone who takes the (lol, cough) "If I help too much, admin. and management will never learn their lesson and I'll be enabling them." approach.....................has anyone ever, anywhere or anytime...........seen this actually have any effect? Not me. Raise your hand if you've ever had a manager say to you or announce in a meeting "Gee, no one wants to help out and assist their coworkers. I really need to change the way we do things. In fact, I'm going to overhaul how we staff completely so you guys never have to work short again. Thank you all for showing me the light and applying such tough love when it was needed. I am a changed person and now I see what I need to do to help you give the quality of care these patients deserve................blah blah".
[Looks around, see's no raised hands] Thought so.
I happen to go to school to finish up my BSN and work and have custody of my 3 year old grandchild after raising my children to adulthood. I go to work to take care of my patients and make money. I have never been considered more than just a employee who fills a shift so I feel its their company and nurses are not valued in most facilities. You are entitled to your opinion I just have to do more in life than work and management doesnt give a rat's ass about staff. I for that reason am in business for myself proctoring home health care aide exams til I finish school . Work is work and it will always be work.
I happen to go to school to finish up my BSN and work and have custody of my 3 year old grandchild after raising my children to adulthood. I go to work to take care of my patients and make money. I have never been considered more than just a employee who fills a shift so I feel its their company and nurses are not valued in most facilities. You are entitled to your opinion I just have to do more in life than work and management doesnt give a rat's ass about staff. I for that reason am in business for myself proctoring home health care aide exams til I finish school . Work is work and it will always be work.
Probably because you haven't acted like anything more than that.
No matter what your outside problems are, what degree you are going for...............its a give take relationship with management and admin. If you go in with the "this place exists so I have a place to work" views and are just another warm body, thats how they'll view/treat you..........just another warm body.
Imagine a manager who has to stretch the budget a bit to make ends meet staffing wise. If their unit is filled with team players going out of their way to help, they might do it. If they are filled with "its managements problem" types..........eh, they probably don't feel so obligated to save you from yourself and correct the staffing.
I refuse to be bullied into working OT, by management or by a co-worker with issues.
QFT? Eh? No idea.
If you are to the point where people are bullying you for ANYTHING, much less just coming in to do OT from time to time...........your problems are far beyond this thread's topic.
It is the responsibility of management to staff a health care organization appropriately. If cajoling, wheeling & dealing, or depending on financially foolish incentives or the desire of employees to look out for each other is necessary to ensure safe, appropriate staffing ... there are not enough staff. And since staff = good outcomes -- the bread & butter of the business -- the organization better figure out in a hurry how to fix the problem.
I personally work very, very little OT. I grew up in a family of hourly wage earners, and I was taught from an early age to learn to live within my means on regular salary. "If you depend on overtime to pay your bills, there will come a time when you can't pay your bills" was drilled into my head.
It is not my fault when my coworkers work short, nor is it their fault when I have a night from hell because we're short on nurses. When I did departmental budgeting in my corporate life before nursing, we used a figure of 2% to estimate "nonproductive" staff time including unexpected absences. This seems to be a foreign concept in health care. And look at the result.
Probably because you haven't acted like anything more than that.
No matter what your outside problems are, what degree you are going for...............its a give take relationship with management and admin. If you go in with the "this place exists so I have a place to work" views and are just another warm body, thats how they'll view/treat you..........just another warm body.
Imagine a manager who has to stretch the budget a bit to make ends meet staffing wise. If their unit is filled with team players going out of their way to help, they might do it. If they are filled with "its managements problem" types..........eh, they probably don't feel so obligated to save you from yourself and correct the staffing.
Well ....have to disagree here eric, sorry
What my management would do is simply call me every time someone was sick .....they would call twisting my arm
eg ' I know you finished at 2330 last night but would it be alright if you would do a 0700 tomorrow .... it would still be before your day off so you would have a day to get over it' etc etc
And no sooner after saying 'thankyou for coming in' .... they will forget I'm here working OT.
Meanwhile I'm working tired ... I've cancelled something I had planned, my family is missing out and I'm in a higher tax bracket which means i'm only going to clear about $50 extra for a 12 hr OT shift.
I'm at greater risk of not caring for my p'ts as well as I should and also risk injuring myself.
Management doesn't reward me for my loyalty ... a thankyou will be all I get
That's true! Guess what, I would even flex my shift to do nights...sometimes days... just to help the staffing! I do this since my job don't do OT anymore, so I have to work my a** off. Well, it'll help my baby's needs, but it'll feel much better when people appreciate our help. Now, if I do this.... do you think others will do it too when our shift is understaffed? Ha! NOT!
My facility won't pay OT either. So it ends up being the few of us that are part-time that get guilted into coming in. Never mind, that if we want to take one of our weekend rotation days off, then that also has to be filled by a part-time person. I'm part-time for a reason. If I wanted to be full-time, I'd work full-time and get the full-time benefits.
If the facility refuses to budget for people to call in sick, then the facility will be short.
It's not up to to nursing staff to make the budget work, it's up to the bean counters. It's already the nurses' responsibility to:
1) Do all the nursing work.
2) Do all the aide work because if they're short, it's up to the nurses to pick up the slack.
3) Do the respiratory therapists' work because how dare we call them for something we can do ourselves.
4) Do the physical therapists' work because well, they can't put the patient back to bed, they're off in 15 minutes.
5) Do all of the cleaning that the housekeeping staff doesn't want to do, because it wouldn't be "teamwork" if the nurses didn't pitch in.
6) Go to pharmacy to pick up our medications because they're short-staffed.
7) Hunt for equipment because it would be just crazy to expect the equipment people to bring it, after all, they're at lunch.
8) Call the physician because well, isn't a rule that only nurses can call physicians to clear up whatever anyone else wants in the hospital.
9) Position the patients in radiology because you can't expect the radiology people to do everything in radiology.
10) Pass the meal trays, after all, it's an infection control risk for anyone other than a nurse to enter a patient room.
11) Pick up the meal trays, because well, see above.
12) Walk down to the cafeteria to fetch whatever the dietary department forgot to put on the meal trays.
13) Get coffee for a room full of visitors, after all, the coffee maker is in the visitor lounge so that it's convenient for the nurse to get to it.
14) Fix the television.
15) Fix the coffee maker.
16) Fix the monitor because you don't want the equipment fixing people to actually have to come to the room, that would be crazy.
17) Fix the computer, because the computer people aren't going to come to the floor.
18) Fix the printer, see above.
19) Fix the phone in the room.
20) Fix the phone at the desk.
21) Answer the phones, because the secretary is a bit busy on a personal call to answer the phone, besides, it's just going to be some other department wanting you to call the doctor anyway, so might as well answer it.
22) Unstop the toilet, after all, maintenance is busy, oh wait, no they're not.
23) Clean up the water spilled on the floor from the toilet, because housekeeping doesn't actually mop the floors if there's something on the floor, that's the nurse's job.
24) Reorder everything the way whatever department wants it ordered because of course the way the physician ordered it will never work.
25) Give directions to every single person that walks down the hall, because they didn't want to bother that nice lady at the information desk.
26) Other tasks as necessary for patient care. Remember, we're a TEAM!
Sorry erik, but at the end of the day, I'm not going to feel bad for delegating the staffing to the people who are refusing to pay for it. I've got too many other people's jobs to do during the day. At some point, I've got to let someone in the hospital actually do their own dang job.
most everyone i know would like to have your problem. here there is no option to get overtime and plenty of ppl would take it if there were.
Now don't get me wrong. If I have something big planned, hecks not, can't come in. The only reason I'm here in PA is that I wanted to spend more time with my parents while they are still around. I'm not going to skip out on a ballgame with my dad just cause someone called off for the umpteenth time and they can't cover it.
But anyhow, yeah, I've heard of hospitals like yours. Once you hit 40hrs, you are done for the week no matter what happens. Thats rough. A hospital not too far from mine placed an 8hr OT cap on their nurses. So, the ones who are getting out an hour late every day weren't getting pink slipped and, if you wished, you could pick up one extra day/week. I think that place got it right. Keeps people like me from doing too much and shows some lenience with the chronically late.
That's true! Guess what, I would even flex my shift to do nights...sometimes days... just to help the staffing! I do this since my job don't do OT anymore, so I have to work my a** off. Well, it'll help my baby's needs, but it'll feel much better when people appreciate our help. Now, if I do this.... do you think others will do it too when our shift is understaffed? Ha! NOT!
IDK. No OT at all doesn't seem to be the answer to me. I'm very "go with the flow" when it comes to scheduling. I take OT when it is offered. On the other hand, when they are calling people off for low census and its my turn..........eh, no harm, I can even make it "no pay day" instead of using up my PTO cause...........well, I'm ahead on bills from doing OT. Thats how it works. For most people, I think the pluses and minuses add up to equal one another at the end of the year. Now, for me.........eh, lol, well, I'd have to be called off a lot.
My facility won't pay OT either. So it ends up being the few of us that are part-time that get guilted into coming in. Never mind, that if we want to take one of our weekend rotation days off, then that also has to be filled by a part-time person. I'm part-time for a reason. If I wanted to be full-time, I'd work full-time and get the full-time benefits.
If the facility refuses to budget for people to call in sick, then the facility will be short.
It's not up to to nursing staff to make the budget work, it's up to the bean counters. It's already the nurses' responsibility to:
1) Do all the nursing work.
2) Do all the aide work because if they're short, it's up to the nurses to pick up the slack.
3) Do the respiratory therapists' work because how dare we call them for something we can do ourselves.
4) Do the physical therapists' work because well, they can't put the patient back to bed, they're off in 15 minutes.
5) Do all of the cleaning that the housekeeping staff doesn't want to do, because it wouldn't be "teamwork" if the nurses didn't pitch in.
6) Go to pharmacy to pick up our medications because they're short-staffed.
7) Hunt for equipment because it would be just crazy to expect the equipment people to bring it, after all, they're at lunch.
8) Call the physician because well, isn't a rule that only nurses can call physicians to clear up whatever anyone else wants in the hospital.
9) Position the patients in radiology because you can't expect the radiology people to do everything in radiology.
10) Pass the meal trays, after all, it's an infection control risk for anyone other than a nurse to enter a patient room.
11) Pick up the meal trays, because well, see above.
12) Walk down to the cafeteria to fetch whatever the dietary department forgot to put on the meal trays.
13) Get coffee for a room full of visitors, after all, the coffee maker is in the visitor lounge so that it's convenient for the nurse to get to it.
14) Fix the television.
15) Fix the coffee maker.
16) Fix the monitor because you don't want the equipment fixing people to actually have to come to the room, that would be crazy.
17) Fix the computer, because the computer people aren't going to come to the floor.
18) Fix the printer, see above.
19) Fix the phone in the room.
20) Fix the phone at the desk.
21) Answer the phones, because the secretary is a bit busy on a personal call to answer the phone, besides, it's just going to be some other department wanting you to call the doctor anyway, so might as well answer it.
22) Unstop the toilet, after all, maintenance is busy, oh wait, no they're not.
23) Clean up the water spilled on the floor from the toilet, because housekeeping doesn't actually mop the floors if there's something on the floor, that's the nurse's job.
24) Reorder everything the way whatever department wants it ordered because of course the way the physician ordered it will never work.
25) Give directions to every single person that walks down the hall, because they didn't want to bother that nice lady at the information desk.
26) Other tasks as necessary for patient care. Remember, we're a TEAM!
Sorry erik, but at the end of the day, I'm not going to feel bad for delegating the staffing to the people who are refusing to pay for it. I've got too many other people's jobs to do during the day. At some point, I've got to let someone in the hospital actually do their own dang job.
If you are doing half that list.............time to move on. I don't, not at my place. Passing trays, fixing things...........many of our dept's are union and would FLIP A BIRD if they saw you doing stuff that was in their realm of responsibilities. I don't do any of that stuff.
See, if you move on and a lot of other nurses get the same idea.............then everyone in here would get their way cause admin./management would really have a staffing issue on their hands. Sort of a "vote with your feet" thing.
Ummmm, next time your unit is short and the M/S nurse refuses to help out, I hope they remember that day.
Psychtrish39, BSN, RN
290 Posts
I happen to go to school to finish up my BSN and work and have custody of my 3 year old grandchild after raising my children to adulthood. I go to work to take care of my patients and make money. I have never been considered more than just a employee who fills a shift so I feel its their company and nurses are not valued in most facilities. You are entitled to your opinion I just have to do more in life than work and management doesnt give a rat's ass about staff. I for that reason am in business for myself proctoring home health care aide exams til I finish school . Work is work and it will always be work.