Why Do Nurses Allow Understaffing?

Nurses General Nursing

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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.

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.

It is within our (indirect) control...Just don't take the job...In every staff nurse interview I have had, I always ask about ratios, and have turned down job offers, d/t crappy ratios, and given feedback on the issue...

We can effect change by gaining admin roles, and shifting the paradigm, thus making better ratios...

I have spoken up at jobs whose ratios have worsened (in meetings, managers' offices, etc.) and have never been fired or even counseled, for that matter...

Apathy is not something we should teach new nurses...

Hospitals (et al) need us, more than we need them...

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Specializes in med/surg, geri, ortho, telemetry, psych.

It's not a question of nurses "allowing" anything. It's about being there to do your best to cover, even when there are not enough of us. And for alot of people, it's about a paycheck. Not a paycheck to buy brand named clothes or new jewelry, but to pay rent and buy groceries so our kids can eat. I know this for a fact because it is why I work whether staffing is adequate or not. All I can do is the best I can, and I do it. Maybe someday I will be in a postion to decide what is "allowed", but for now I just have to deal with it.;)

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Specializes in Utilization Management.
It is within our (indirect) control...Just don't take the job...In every staff nurse interview I have had, I always ask about ratios, and have turned down job offers, d/t crappy ratios, and given feedback on the issue...

We can effect change by gaining admin roles, and shifting the paradigm, thus making better ratios...

I have spoken up at jobs whose ratios have worsened (in meetings, managers' offices, etc.) and have never been fired or even counseled, for that matter...

Apathy is not something we should teach new nurses...

Hospitals (et al) need us, more than we need them...

I ask, Hogan. But I've been lied to. Those who speak up a lot about things like that where I've worked have been passed over for promotions and, while not actually "counseled" about their staffing ratio opinions, have been "counseled" about other things that wouldn't cause a ripple if another nurse did them.

Not trying to teach apathy by any means, but awareness of how the system works.

I'd love to hear from nurses who actually did complain about staffing ratios and were able to effect the change that you speak of, because I've never seen it happen, not once. More than anything, our profession needs a dose of reality.

We cannot be responsible for something we do not control. Period.

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It's not like nurses "allow" understaffing. Nobody ever asked my opinion about how many patients I would like to take, otherwise I would not "allow" to run myself to death with unsafe and unreasonable assignments.

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None of us can do it solo.

When WE together documented unsafe staffing and threatened to hand out leaflets on the sidewalk WE finally got our charge nurse unassigned, a break relief nurse, and staffing by acuity as determined by the nurse who assessed the patient.

WE tell a supervisor who tells us the patient does not need 1:1 nursing the he or she can assess the patient, chart than assessment, and assume responsibility for the patient along with a second patient. (This is ICU).

I my experience you need a united nursing staff willing to get together off duty, a plan, and a hospital that cares about it's reputation.

It is a long struggle. But I think we will win safe staffing.

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Specializes in Utilization Management.
None of us can do it solo.

When WE together documented unsafe staffing and threatened to hand out leaflets on the sidewalk WE finally got our charge nurse unassigned, a break relief nurse, and staffing by acuity as determined by the nurse who assessed the patient.

WE tell a supervisor who tells us the patient does not need 1:1 nursing the he or she can assess the patient, chart than assessment, and assume responsibility for the patient along with a second patient. (This is ICU).

I my experience you need a united nursing staff willing to get together off duty, a plan, and a hospital that cares about it's reputation.

It is a long struggle. But I think we will win safe staffing.

Space, I have the utmost respect for any nurses who get together and can actually accomplish goals.

It can backfire, though. I recall some nurses striking to end mandatory overtime and they did win their case, but then Tenet closed the hospital.

I think some NYC nurses did get their situation improved.

The problem is everywhere, except CA, where a union and the government got involved with staffing levels.

So IMO, unless a union or government or JCHAO gets involved (I have to wonder why the almighty JCHAO is so silent on this patient issue, perhaps the most important patient issue of all????), administration will keep nurse staffing to a minimum.

Of course, this is all just my personal opinion. I respect others' opinions, but after all these years in the healthcare field, and listening to 2 generations of nurses c/o staffing, I believe that my opinion is a reasonably intelligent conclusion.

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WE at my hospital started meeting about 20 years ago. It took us awhile to relize we needed a union.

It actually took longer than 12 years: http://www.calnurses.org/assets/pdf/ratios/ratios_12year_fight_0104.pdf

Then after achieving the ratio law we had to fight the governor to keep it.

Main ratio page: http://www.calnurses.org/nursing-practice/ratios/ratios_index.html

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