Why Do Nurses Allow Understaffing?

[RNfaster]

I am preparing to begin nursing school. It boggles my mind that people work in places that understaff.

I am definitely going to go for an advanced degree. I think it can't help but get better with a masters. But if nurses banded together, couldn't something change for the better? (Consider nursing ratios in California --CA is a great state for employees overall as I see it.)

When she heard I was planning on studying nursing, a former cardiac critical care nurse told me NOT to work at a hospital. I thought she must have gotten tired of it and things surely have improved. But now, I am wondering, and thinking I will consider doctors' offices (as a NP), pharmaceuticals, etc. Maybe it's just working med-surg that is so nutty. Maybe it gets better on other units.

--I love to work hard. But not simply running my butt off. I'd like to use my mind more...to be able to care and listen to patients a little more.

When I worked in "corporate America." we had time to bond with our coworkers, to advance our skills and teamwork, to work pet projects, to really delve into things. It wasn't a crazy race just to provide the bare minimum.

Any thoughts? Sorry I was so long-winded. It was a hard night.

[Bluehair]

huh?

I learned how to be a nurse...

I never learned to give up my seat to a doc

I learned to question orders that don't seem right

I learned to take control

I learned to respect my peers

I've spoken up since graduation day, and am still here...

Shame on any nurse for allowing her/himself to be "bred out of nursing"

I am administration, and I listen, and have my nurses' backs every day...

I don't buy all of the nonsense... you claim we learned it in school...i claim they were already like that...

Here here! I agree with you. And you are not alone. I too am in admin. and have my staff's back, speak up freely to upper admin and/or physicians when things are wrong, work as staff at the bedside when things are hitting the fan (even if only for an hour, it can be a big help).

Bred out of nursing? What does that mean? Yes, it can be a frustrating, overwhelming career at times. I see no reason why someone should completely abandon their nursing career due to bad experience in a few hospitals. There are sooo many options out there, and hospital nursing is just one. And not all hospitals are bad. Yup, it's a business, that's a fact. So is every other job I can think of. Last I checked, that is what is involved in working for a living. Just my opinion.

[IndianaPM]

There is only one real reason that nurses don't have appropriate staffing.

It's because we do not own the hospitals.

We are just employees, and nowhere in the business world do employees have any say over employment. Nowhere.

So the answer is, when nurses own the hospitals, then they will have the right to have a say in staffing.

Of course on that day, Hell will simultaneously freeze over and flying pigs will be seen cavorting in the clouds.

Sonoran, hang in there. It's a shame to admit, but it's true. The allmighty $ is more important to these hospitals than giving great patient care. They figure that agency nurses are too expensive, paying us overtime is too expensive, so they just understaff and make us run. You'll find a good facility, I'm sure of it.

As bad as agency nurses often are, we use quite a bit on our floor. They can't carry as many patients as the rest of us, and they aren't always extremely competent, but they can take the less acute ones, and a few can even do an admission. Worst case, they can answer the phone for us and pass a few meds.

We've got some automated internet thing that recruits them for us. Our staffing office loves it apparently, so I say keep them coming.:welcome:

[rita359]

if we are short a nurse on the floor, we get 5 pts instead of 4

I don't know where you are or what kind of nursing you do but on our med surg units every nurse I know would jump for joy if they only had 5 patients. My nurse patient ratio last pm was 1:8 though it is usually 1:7.

[hogan4736, BSN, RN]

I don't know where you are or what kind of nursing you do but on our med surg units every nurse I know would jump for joy if they only had 5 patients. My nurse patient ratio last pm was 1:8 though it is usually 1:7.

unless your fresh post op hip is different than mine, you should only tolerate 5:1...

8:1 is criminal, and is only acceptable for SNF or acute rehab...

[dcnballmom, ASN, RN]

i agree - staffing has more to do with cash flow than patient care - my corporate offices have determined that for my facility - which is 2 stories and 4 wings - that there should only be 1 GNA on midnight shifts at times and 2 nurses cover the entire building - i myself am responsible for 40 patients on 2 wings - and i get in lots of trouble if a lab value is missed or a skin sheet on a decub is not filled out in a timely manner - LTC staffing is a joke

[Hellllllo Nurse, BSN, RN]

What administration considers adquate staffing rarely agrees with what nurses or staffing studies say is adequate. But admin is the one making the decisions.

[UM Review RN, ASN, RN]

What administration considers adquate staffing rarely agrees with what nurses or staffing studies say is adequate. But admin is the one making the decisions.

That's only because they own the place. Nurses are the only employees I've ever run across who don't seem to get this pertinent information -- they own it, they run it. Nurses are employees in this scenario and have no say.

Of all the rules and regs that JCHAO could come up with to assure good patient care, you'd think staffing would be high on their list. They have the numbers and they read all the studies that back up maintaining good staffing levels.

But no. They come in, throw MORE paperwork at us and leave, turning a blind eye to the fact that the more work we have, the more patient care suffers. I can't tell you how many times we've had to revamp our entire charting system (a task that takes us up to half of our workday!) and costing a facility millions of dollars a year, on a seeming whim from JCHAO, but JCHAO never ever comes down from on high and says, "Hey, 8 patients is just way too many for a day shift on an ortho unit."

Makes me wonder whose side those people are on, anyhow. :angryfire

*getting off the soap box now*

[fancymom]

Wow. What a fabulous thing if we nurses were actually allowed to complain, or have any say-so about the fact that one nurse does the work of 3!!

I was a NNICU nurse for almost 8 years, and it only got owrse, never better. And to my understanding from my nursing friends, it's gotten even worse over the past 3 years since I have left.

I am currently seeking a job working from home. Why? HA! Because of this very discussion. I got TIRED of working like a dog, getting paid nothing, and being so completely stressed out that I couldn't stand it anymore. I started to worry about losing my license. I was taking care of 2 jets and a vent at one time! I was being used and abused.

Whew! I feel better :)

PLEASE don't be like me! If you ever get an assignment that is overwhelming and you do not feel comfortable with it, speak up!! After all, it is not their license or careers at stake...it's yours.

[UM Review RN, ASN, RN]

Wow. What a fabulous thing if we nurses were actually allowed to complain, or have any say-so about the fact that one nurse does the work of 3!!

I was a NNICU nurse for almost 8 years, and it only got owrse, never better. And to my understanding from my nursing friends, it's gotten even worse over the past 3 years since I have left.

I am currently seeking a job working from home. Why? HA! Because of this very discussion. I got TIRED of working like a dog, getting paid nothing, and being so completely stressed out that I couldn't stand it anymore. I started to worry about losing my license. I was taking care of 2 jets and a vent at one time! I was being used and abused.

Whew! I feel better :)

PLEASE don't be like me! If you ever get an assignment that is overwhelming and you do not feel comfortable with it, speak up!! After all, it is not their license or careers at stake...it's yours.

Problem is, it's everywhere you go.

I fail to see how nurses should bear any responsibility for this issue because it is not and never has been, in nurses' control.

Therefore, it seems unfair that nurses are penalized for making mistakes due to poor staffing.

The people who really do have the power to change the problem have been walking all around it and never addressing it except to blame the nurses. Problem is, the nurses are victims of the healthcare status quo too, and the result is a nursing shortage.

I cannot speak up about an issue like this at any job. I will get fired. I am not a volunteer nurse; I have a family to feed. Understaffing is part of the territory. If you become a nurse, be aware that there is not much you personally can do about staffing.

[StacieRN, RN]

I should have added that nurses allow understaffing and abuse by EVERYONE, because nursing school brainwash nurses into being "martyr marys".

I agree with Nursing school being a big part of the problem. I actually got a poor practical grade because my instructor came to me at my lunch and wanted me to help a fellow nurse give her patient a bath. The bad grade was because I finished my lunch first instead of dropping it and rushing to give a BATH.

I'm stubborn enough to see how ridiculous that is. Even as a paid employee, I have the right to a lunch. As unpaid slave labor for the nursing program that I was paying big bucks to - heck no! :angryfire She wanted that bath done right then she could go do it herself.

Other, more malleable students, I'm sure, were brainwashed that their needs come last. Hence the problem today.

I agree with the earlier posters that said nurses are in this position because nursing services aren't billed for separately. It would actually mean the hospital would not benefit from skimping on nurses and would help to make sure that the reimbursement was more in line with nursing care given. DRG don't take into account that the less sick patients may actually need more nurse face-time.

I think it's appalling and insulting that nursing is including with the room charge. When, as everyone has said, WE are the reason patients are in the hospital.

:trout:

[fancymom]

Oh my!! I totally understand the lunch issue!

I can't tell you how many times I only got about 15minutes to inhale my lunch during my 12 hour shift!!

When I first graduated from nursing school and I used to watch the older nurses sit calmly and eat their lunch, taking their FULL 30 minutes...sometimes a little longer. I used to think, how lazy!

But they weren't lazy!!! They were SMART!!! HAHAAAA!! :trout:

Besides, I think a 30 minute lunch during a 12 hour work day is criminal!!!! Hell, doctor's offices get an hour and a half!!! Holy Moses!! I would have KILLED for half that!!

Maybe if hospitals treated their nurses a little better, they would never be understaffed!

[StephOScope]

I don't know where you are or what kind of nursing you do but on our med surg units every nurse I know would jump for joy if they only had 5 patients. My nurse patient ratio last pm was 1:8 though it is usually 1:7.

It would make sense to assume it isn't on a M/S unit, I think the statement was made by someone who also works on a cardiac unit, although admittedly I didn't look back to see. It's not just about numbers, it's about acuity of the patients on the unit. Five can seem like a bus load or a godsend, depending on the care they need.

Let's not trump each other with how tough we've got it--it's not fair and it's not realistic.