What would be better? Assistance or an Assistant?

[Julie]

What do you think?

This author thinks hospitals need to rethink their approach to solving the nursing shortage. Ideally, hospitals would increase their nurse staffing levels. But nurses are a finite resource.

Amid Omicron, nurses don't just need assistance. They need assistants.

[JBMmom, MSN, NP]

The first thing that struck me was that I would LOVE to be proning 250 lb patients- (that's practically a two person job!), it's the 450 lb ones that are a challenge. 

This proposal is a great start to help nurses. As mentioned, proning alone is a resource intensive activity. Just recently we had a night where three large patients (all over 300lb) had to be proned on night shift. On our shift we have six nurses (we hope), one tech- two on a lucky night, and one RT- again two on a lucky night. Proning those patients took more than half of the staff for the unit and tied everyone up for at least 20 minutes per prone, and we've gotten pretty efficient at it. But that's one hour of time, and a risk to the other patients on the floor when almost all the staff is tied up. 

We can't keep nurses, techs, or RTs staffed at our hospital. At one time they had posted for LPNs on the company website, but none of us ever saw any working on the floors. Not sure how my hospital in particular would staff these positions either, given that our wages are notoriously low and no one's going to want to work on a COVID unit for low wages. 

Part of the problem is also the culture of the hospital management. Here's an example: we are budgeted for a tech from 7pm-7am and one from 7pm-3am. One morning the tech that leaves at 3am volunteered to stay until 7am because we were busy. Our manager made a point of saying that at 3am if there is a second tech they will be floated to another floor because we're not budgeted for the second tech. This is after we've worked the majority of the year with zero or one tech because of open staff positions, and we are budgeted for seven nurses but usually have 5-6. So our idiot manager, with a budget that is CLEARLY under for the year overall, will not even allow us to keep staff when we're busy because of staffing. That's the kind of stuff that's infuriating. 

[Guest219794]

Now that much of my ER job is caring for boarded, admitted patients, much of what I do could be done by an unlicensed employee. But, I am transporting patients, cleaning rooms, bringing meal trays, fetching pitchers of water and warm blankets.........

1- Having assistants would free me up to do the stuff only an RN can do, would improves patient outcomes, and speed up ER throughput.

2- It isn't going to happen.

[kbrn2002, ADN, RN]

I have to give a big shout out to the incredible nursing staff at University of Minnesota Fairview Hospital. I know they are short staffed like every other hospital. I know they could definitely use some help from unlicensed staff, kitchen staff, housekeeping staff to free up their ability to do the things only a nurse can do.  I was in Minneapolis for over a month while my husband was hospitalized, not COVID related by the way.  You would've never known those nurses were working short.  Their ability to do so much with so little was truly inspiring.  

That being said, watching those nurses manage so well under such difficult circumstances definitely solidified my desire to never work in the hospital setting!

[JBMmom, MSN, NP]

20 hours ago, hherrn said:

1- Having assistants would free me up to do the stuff only an RN can do, would improves patient outcomes, and speed up ER throughput.

2- It isn't going to happen.

Accurate!

I feel for all of my ER colleagues, it's a whole different world I know I could never handle. Thanks for all your efforts!