Unsafe staffing revisted - what is the cause at your hospital?

hereigoagain · Feb 17, 2009

I don't know the answer for your hospital, but when I hear "staffing", all I can think of is my last shift I worked (actually more than one shift I had this kind of ratio), FIVE patients on vents (some weaning, so needing even more attention, pulse ox is really not the answer for oxigenation in some cases), tube feedings (all of them), IV's and all the other good stuff, all conscious... and me, with one brain, two hands and a broken back taking care of them to the best of my abilities (with one CNA that was exhausted of how many patients she had, so I just left her alone, I didn't "delegate" anything on her, out of fear that she was going to have a meltdown and just collapse, I already saw her crying that day)...what were they thinking? I mean the people that gave me the assignment. I forgot to say, I also "covered" one LPN, that had 30 years experience...so I actually felt embarassed that I had to cover her, but rules are rules. In some cases it is just pure evil greed not to assure adequate staffing, I know a lot of nurses that are not working right now, because of the economy and it would be as simple as asking us, the nurses, for extra staff (we can call in our friend nurses to help when we are shortstaffed), but no, let's suck the juice from the limited number of nurses we have:bugeyes:...who cares about what can happen to the patients or the nurse?

Valerie Salva, BSN, RN · Feb 17, 2009

^Unfortunately, this situation is pretty typlical in nursing.

Mgmt just doesn't give a crap.

loricatus · Feb 17, 2009

At my hospital, the problem isn't that they aren't willing to staff better. There have been openings posted since 2006 on some units. The problem is, there simply aren't enough nurses interested in the position. This may be due to the fact that we are a smaller (but not rural) hospital, that is within one hour's drive of a major metropolitan area (several of them in fact).

Have they tried to bring in agency or travelers as a way to lighten the load, then?

Every place I have worked staff at says the same thing about why the heavy load; but, few have used agency or travelers to really reduce the ratio for the staff. I actually had some friends that were interested in a job where I worked (as staff) and when I asked the NM if they were interested (after giving a stellar resume), I was told that additional staff wasn't in the budget. I think it was a week or two after that, the NM went right back to blaming the horrible ratios on the inability to attract staff because of the nursing shortage.

I really don't believe that line of bull anymore since there are plenty of travelers now willing to go practically anywhere that has a decent wage and a guarantee of work.

Pediatric Critical Care Columnist · Feb 17, 2009

There are lots of reasons why staffing is poor on our unit. It's one of those vicious circle things. The worse it is the worse it gets. When we hear that between January and September of last year, there were 28 nurses hired and at the end of September only 2 were still here, that should be ringing bells all over. But seemingly it's not. When there are 15 full time positions posted and you look down at the bottom of the posting to see the word "REPOSTED" it should be ringing bells all over. But seemingly it's not. When fully half the staff present on a shift is there on OT and you're STILL short, that should be ringing bells all over. But seemingly it's not.

LilyBlue · Feb 17, 2009

Actually yes, we have travellers contracted all the time (especially on nights). Most of them are excellent nurses, too. I am always sad when their 13 weeks or whatever are over. Unfortunately, sometimes even THEY can't be replaced!

It is a dog eat dog unit, to be sure, but I doubt it's much different that many other places, at least not according to what I read on here.

elprup, BSN, RN · Feb 17, 2009

Do you happen to be in California, around the Bay Area, San Francisco? Many new grads from the local private nursing college are still looking for jobs! If you have any info, please message me, or post online. Thanks bunches.

LilyBlue · Feb 17, 2009

I am clear across the country on the east coast. Sorry, I wish I could help. If they are willing to move to the mountains, we have jobs!

al7139, ASN, RN · Feb 17, 2009

At my hospital, the economy is to blame according to the powers that be. Yet, when 3 full time nurses leave from my shift (3pm-11pm), they only hire one new grad to compensate who wont be on their own for at least 3 months with classes/orientation, etc. Yet they expect us to be OK with being scheduled for extra shifts without being asked, and get upset when we are worked so much that we get sick and have to call out. I am on a telemetry/medical unit for STABLE cardiac patients, yet all of a sudden we are getting unstable patients who belong in PCU or ICU because they don't have enough nurses or beds to accomodate these patients. I don't know how many times I have been posted an admission that when I look them up, they are on titrated drips, vent candidates, and so unstable that if you look at them wrong they will code. I then have to go to my ClinII and be very aggressive in refusing the admission because I am not qualified to care for such an unstable patient, but it is a fight every time because of the shortage in nurses. Luckily, they usually back me up in this, and the patient ends up waiting in the ED for a bed in the appropriate unit, but if I did not speak up, they would send me patients that would be a potential hazard to my license and not get the proper care they need at the time.

Travel nurses make more money than I do, but they are experienced and mostly good at what they do. I wouldn't mind if we got some on our unit, but alas, the current economy won't allow it according to management!

Heres a novel idea...hire more nurses for permanent positions to prevent unsafe ratios.

Amy

Tweety, BSN, RN · Feb 17, 2009

Right now we're pretty fully staffed, especially with new hires from the recent graduating class and hopefully they will pass boards. We are short staffed usually only when there are calls in's or vacations. Yesterday two nurses called in sick, but we were lucky that one nurse was willing to work overtime and another was floated from another unit.

Retention the last quarter of last year was over 90% up from the usual 80's. The highest I ever heard of. I think in these uncertain times we're holding on to our jobs and not job hopping. This along with new grads is helping staff our facility.

RN1982 · Feb 17, 2009

We are fully staffed where I work. At my last job, we were short staffed all the time. No float pool to help out because all the nurses were prebooked to go to other units. We were told to suck it up despite how dangerous it was.

Midwest4me · Feb 17, 2009

Our facility is a psychiatric hospital. Enough said? We use lots of agency and are still short-staffed due to the assaultive patients, constant call-ins(use of sick time one to several times a month) and of course the budget.