Understaffed and sick of it!!

welcome to allnurses

venting is good for the soul

sorry to hear that work is crazy

hope things improve soon

working short staffed sucks period. whether it's for a nurse,rt or aide. i just came home from working on a really poorly staffed floor. a physician came on the floor and saw how we were working and immediately called the supervisor. that's the only time you see action. when either something horrible happens or an md complains. hope your situation improves. :smiletea2:

My name is Kate and I'm a Respiratory Therapist, though I am not a nurse and I hope that you don't think I'm intruding in your space here, I just have a problem and I would like to know if Nurses are feeling the same way. I work in an LTAC facility and we are facing what I call outrageous cutbacks in staffing, with RN's, LPN's, CNA's and RT's and we're all pretty sick and tired of this issue.Katie

The only way the situation could change for the better is if the staff feels so strongly about the cutbacks that they are willing to walk if it does not get better. Safety is a big issue. Really, it is the biggest issue of all. If you and the others agree that your licenses are at risk and the situation is unsafe for your patients, than the staff should request a meeting and lay it on the line. You really must be willing to leave for this to work. Money is what is motivating the cutbacks, but they can not operate without the staff cooperating. I do not believe that they will be willing to find a completely new group of staff members to replace you. Do you?

BTW, I am not advocating for anarchy, but I do believe in safety for patients and for staff.

No easy answers. You must all band together and fight for safe care levels.

This is exactly what happens at the facility I use to work at. It was my first nursing job, and because the work load was beginning to burn me out I left. It was brought up several time to administrators, but they never did anything about it. I had up to 60 patients, depending on what shift I worked on. It was way too much. And if the aids were short there patient load would increase from 10 to 12.

Dangerous, it is true. That is why I didn't want to stay I felt it was unsafe practice.

I wonder when the media writes about a nursing shortage, do they include the jobs where the facilities are so understaffed that staff is burnt out in months and each day the nurse wonders if she/he will have a licence at the end of day.

I wonder when the media writes about a nursing shortage, do they include the jobs where the facilities are so understaffed that staff is burnt out in months and each day the nurse wonders if she/he will have a licence at the end of day.

No, I don't seem to recall any mention of that.

Tonight, I am working at a facility that saves money by having one nurse work two units. The other two units have one nurse each. I will probably have the double unit as I am the agency nurse. How my night will fly by!

This is also the place that does not have TB syringes so if I have to give morphine SQ, it will be with a 1cc insulin syringe.

What do you think of a trach/vent unit with 12 patients, 1 nurse 1 RT (who also does trach care for the rest of the building and checks those on bipap at hs and o2 and the crash carts are stocked. Also assists with assessments and codes. Also (maybe) 1 CNA? Used to have 2nurses and 1 RT (no cna).

]Honestly, I think you might want to think about moving on.

]Are there are other places to work now that you have some experience to back you? Have you considered acute care instead of a sub-acute/rehab type facility?

]I can see the value of a group meeting with administration but I think you're fighting the corporate monster there.

]I'm an RT too... just for a few years now too. I work in a faith-based Trauma Level ll hospital, and I won't say the loads are cake but they aren't dangerous either. Floors are 12-15 Pts with Txs; ICU is 5-7 vents with maybe a BiPAP, HHN, or a trauma Pt added during the shift. There is usually time to do your job thoroughly and also deal with the things that come up... be that a Rapid Response, a trauma, a Code, a trip to CT, extra ABGs/EKGs, or helping out with a Pt. The tasks that equal good Pt care, not just good time management.

]I realize you probably care about your Pts, especially long term vent dependant ones, and worry about their care if you weren't there. Leaving them would naturally evoke some guilty feelings on your part. But honestly, they will likely find another RT just out of school again who will be conscientious but unaware of the employment options who will pick up where you left off.

]I love being in ICU, keeping my Pts clean, the vents stable, helping out with basic Pt care. I know it's only assisting compared to what the RNs do, and the knowledge they use (not kissing a$$ here... I really do know and appreciate the skills. If I was younger I'd probably get my RN) but I feel like I'm contributing to someone's well-being, plus helping my coworkers. It's job satisfaction compared to honed time management skills.

]Another benefit is that I'm always adding to my knowledge of acute care. I had a vent last night... ICB, shift to the right, a Swan-Ganz, ventriculostomy, an IV pole that looked like a bunch of grapes. I only had the vent... the RN had all of that to manage. But it is sooooo much more interesting.

]Feel free to PM if you like. I read this site all the time because I learn so much... but I do feel like I'm butting in where I don't belong so I don't post much.

]Good Luck whatever you decide!

Under-staffing, poor equiptment, lack of equiptment and supplies seem to plague many LTC facilities. Bnding together, enlisting family support, bringing legal/safety concerns to the attention of administrators is just the tip of the problem. I have no concrete answers but I know we need to value our work partners and patients more.

I am also an RRT/RPFT and have worked as a Respiratory Care Practitioner for over 16 years and graduate RN school this May. I agree that healthcare in general with it's cutbacks causes facilities to be understaffed. Where I work, it is nothing for a therapist on night shift to go out to do 15-20 HHN txs and between the 2 of them cover ER, CCU, OB/nursery, ABGs, EKGs, ICGs, etc. During the day, I have done 3 rounds on a floor with 8-10 HHN txs and then 4 PFTs that day all in about 10 hours. Nursing is just as understaffed. It;s nothing 2 or 3 ER nurses (1 of the nurses doesn't work that often) to cover a very busy ER with 2 doctors working during the busiest part of the day. America needs help!

Under-staffing, poor equiptment, lack of equiptment and supplies seem to plague many LTC facilities. Bnding together, enlisting family support, bringing legal/safety concerns to the attention of administrators is just the tip of the problem. I have no concrete answers but I know we need to value our work partners and patients more.

That is true. However, administrators' bonuses are sometimes tied into how much money they can shave off of their budgets. It can really drive how the place functions when all the top brass think that way.

One of the things that is really striking, is that in some LTC's (and actually, I have seen this in a home health agency also) you can observe how well, the owners and comptrollers (I think that is the title), are living. For staff in these bare bones facilities, to see them dressing expensively, driving luxury cars, and taking their 8th vacation of the year, it is such a disconnect.

Here you are, sharing that single pulse ox between 4 units, using second rate equipment, constantly scrounging for supplies, with one nurse covering two units at nite, working short, watching the rush to fill any empty beds, and you wonder. You share a chilly restroom (noticeable in the winter) with all the support staff in a busy hallway, but the administrative offices all have private restrooms. They are air conditioned, but you have a wet towel around your neck to keep from fainting in the summer because your part of the building is not air conditioned (it's an old building, you know, too expensive to upgrade). The bonuses that resulted from all the money that was saved by creating the conditions that you work in every day, were made off of your labor. Sometimes it is so obvious, that staff are just commodities to these people, and the nursing home or the home health agency is just a money making vehicle or investment to the owners far away in that sunbelt state. Meanwhile their representatives are living it up in the Caribbean again. But, you'll know when they return, because they'll be breathing down your neck to do things more economically. Why would you need TB syringes when you can use insulin syringes for just about anything? Need an IM syringe? You better have a really good reason. Catheter kits, throw something together... We need to tighten our belts.

This does not begin to address the reality of how well you can provide care to the residents and patients, you are responsible for. Do I sound bitter?

Well, this is reality. I do not have the power to change everything, but I can advocate for better working conditions, and the tools to take care of the patients in the best way possible. Never feel sorry for banding together and demanding safer ratios.