What every nurse should know about staffing

gardendigger · Aug 12, 2015

A young nurse I know that works in a rural community hospital went into work for her night shift on a med-surg floor. Much to her surprise, her manager decided to "let her handle"the 5 patients by herself. Two of the patients were confused and required bed alarms. I work in a large hospital, and it's just written in stone that a nurse is never staffed solitary,period, even if there's just one PACU patient waiting for a bed. This is out of safety concerns for both the patient and nurses. I just was dumbfounded. I'm wondering if there's something here that needs reported, or have I been working in Nirvana? By the way, she just accepted a new position at a different hospital this morning.

jadelpn, LPN, EMT-B · Aug 13, 2015

The age old situation--

The actual nurses on the unit are not in a place where they can be everywhere at once.

The ones who come close to being everywhere at once are mysteriously hounded into leaving/retiring/getting 'let go' and what the unit is left with are too little nurses, a high census.

And don't even get me STARTED on being "part of the solution" or actively engaging in assisting with scheduling. "We need more staff" "NO, you do not need more staff" says the manager who is not a nurse, or who has not been a nurse on the floor in some time, "in other units (

Then starts the discussion (or the lecture) on how nurses need to learn to do more with less.

When healthcare became a business model, it became a business that is charged by people who are in the business of business. Not in the business of people, especially ill people. So then it became a situation of "lets let the PATIENT think they are getting more while using less, but degreed less, so they will be fully impressed with the credentials, and not notice the fact that no one has looked at them for 6 hours" kind of a situation.

Shared governance only works if management is willing to work it. If the nurses on a unit are claiming that the unit patients are suffering due to lack of sufficient staffing, the first response is typically a look of complete disbelief....and stern talks regarding better time management skills. Then some cool inservices on the same.

At the end of the day, your patient is going to be discharged on the day and time the money runs out. Whether they are "ready" or not. So what a nurse does and/or doesn't do means little to those who are in the money business. Just run around, do everything with a smile, and change your attitude. Then get them the heck out so we can move on. And it doesn't take many nurses to do that. Oh, ya, and don't kill em in the process.......

lindarn · Aug 13, 2015

Why is nursing, the only department in the hospital, who are expected to, "do more with less"?

Other non patient care areas, are always staffed appropriately, always get their breaks and lunches rarely leave an hour late, etc. Especially well staffed, are areas that include CEOs, Administrators, Management, etc.

Why doesn't the Hospital CEO, let HIS/HER, secretary go, along with the rest of the office staff, instead of letting go the unit secretaries, nurses aides, housekeeping, etc? These individuals. while nice to have, are not directly involved with patient care. They are not necessary. Unit secretaries are lifesavers, that answer phones, run interference with visitors, other departments.

The hospital CEO can type his/her, own reports, do his/her, filing, get an answering machine to answer the phone lines. THEY can be replaced with machines, and there is NO effect on patient care or outcomes.

Why are the departments, who are responsible for patient care and outcomes, ALWAYS ON THE CHOPPING BLOCK WHEN THERE ARE BUDGET ISSUES??

And don't get me started on," hotel like lobbies", artwork, grand pianos, concierge services for patients and visitors. No one's life was ever saved because of artwork, grand pianos. That is the budge that needs to be cut.

JMHO and my NY $0.02

Lindarnn RN, BSN, CCRN

Somewhere in the PACNW

martymoose, BSN, RN · Sep 12, 2015

Why is nursing, the only department in the hospital, who are expected to, "do more with less"?
Other non patient care areas, are always staffed appropriately, always get their breaks and lunches rarely leave an hour late, etc. Especially well staffed, are areas that include CEOs, Administrators, Management, etc.
Why doesn't the Hospital CEO, let HIS/HER, secretary go, along with the rest of the office staff, instead of letting go the unit secretaries, nurses aides, housekeeping, etc? These individuals. while nice to have, are not directly involved with patient care. They are not necessary. Unit secretaries are lifesavers, that answer phones, run interference with visitors, other departments.
The hospital CEO can type his/her, own reports, do his/her, filing, get an answering machine to answer the phone lines. THEY can be replaced with machines, and there is NO effect on patient care or outcomes.
Why are the departments, who are responsible for patient care and outcomes, ALWAYS ON THE CHOPPING BLOCK WHEN THERE ARE BUDGET ISSUES??
And don't get me started on," hotel like lobbies", artwork, grand pianos, concierge services for patients and visitors. No one's life was ever saved because of artwork, grand pianos. That is the budge that needs to be cut.
JMHO and my NY $0.02
Lindarnn RN, BSN, CCRN
Somewhere in the PACNW

OMG LIKE LIKE LIKE - a thousand times like this comment. This is why nurses leave.

martymoose, BSN, RN · Sep 12, 2015

Lol no kidding on the Piano. we have one, and when I am leaving at midnite, that dumb thing is still playing in an empty lobby. I always wonder how much electric it uses. Why the *** is that on at that time of day? seriously? and the suits have the gall to yell at me for punching out 6 minutes late, because I was toileting someone. ughhh

kbird03 · Sep 19, 2015

I agree! Funny and sad how you never see a nurse in uniform in the hospital cafeteria! Hospitals need to hire waitresses and hotel personnel, so us nurses can do our job safely!

kbird03 · Sep 19, 2015

We have a piano too that plays to an empty lobby í ½í¸¤

kbird03 · Sep 19, 2015

We also have many classes and money spent to train us on hourly rounding with a smile and a script to up play up our service!!

lindarn · Sep 19, 2015

Perhaps you should mention it at a staff meeting, when they start to talk about budget cuts.

I would do so far, as to take out my cell phone, making sure that the clock, and empty lobby are in full view, and record the piano playing at 0100.

JMHO and my NY $0.02

Lindarn, RN, BSN, CCRN, (ret)

Somewhere in the PACNW

emtb2rn, BSN, RN, EMT-B · Sep 19, 2015

I agree! Funny and sad how you never see a nurse in uniform in the hospital cafeteria! Hospitals need to hire waitresses and hotel personnel, so us nurses can do our job safely!

Hospitals have cafeterias?