Why can't we tell pts/families we're understaffed?

[delphine22]

OK, OK, I know why. It's because it makes them feel unsafe, that they won't get good enough care, that they won't hit the callbell when they need to bc they don't want to be a "bother" because we're "already so busy."

But mgmt is SO ADAMANT about us never speaking to pts about staffing, it makes me feel as if they're protecting themselves from something. A bad reputation in the community, perhaps?

I don't normally say this. But if I'm late with something simple, like a ginger ale, I may say, "sorry, I had to grab it, we're short techs tonight." Sometimes a short, truthful explanation goes a long way toward pt satisfaction, as opposed to them just thinking I was lazy or Facebooking.

Other times someone else has said something to the pt before me, and they say to me, "I hear you're short staffed."

True, our hospital is a business and we shouldn't discuss business with clients. But a little nagging voice in the back of my head says to me that this may be one of the ways to effect change, if the community starts to hear about what goes on here instead of us just complaining to each other. (We are in a notoriously union-unfriendly state.)

No, I'm not going to start discussing staffing with pts or their families. Often a pt will say to me, "You must have a lot of pts," like a backdoor way to test staffing levels (these old people are savvy), and I will simply say, "I do have other pts, but you are my focus right now."

Just wanted to hear some other opinions.

[T-Bird78]

The facility doesn't want to appear mismanaged, disorganized, and cheap. By telling pts the facility is understaffed it gives the impression they don't care and can't find people to work. It could also look like a lazy excuse to be slow or forgetful even though we know that's not the case.

[CantDecideUsername]

Funny, a patient in the dr office I work in is a nurse. She began to tell me yesterday how stressed she was and how many short-staffed the hospital has been....

Suddenly her eyes got wide and she clapped her mouth, as she realized she divulged something she's not allowed to be discussing

I kind of laughed because this ain't news to me! I know that all hospitals are cutting staff and squeezing pennies from every which way

[Caffeine_IV]

You gave the reasons why. It would open us up for more complaints and lawsuits. They would feel they are getting subpar care.

That said pts aren't stupid. They can tell when we are short and will even ask how many patients we have. I don't lie or complain to them.

[TheCommuter, BSN, RN]

But mgmt is SO ADAMANT about us never speaking to pts about staffing, it makes me feel as if they're protecting themselves from something. A bad reputation in the community, perhaps?

Nurses who mention short-staffing to patients and their family members exponentially increase the facility's chances of entering litigation procedures. After all, you are fueling the plaintiff's case by divulging that not enough staff is present to provide the minimum standard of care.

Once you start saying "We're running short-staffed today," the patient with the undesired outcome can find an astute attorney who can solifly confirm the staffing problems through the initial discovery process by requesting the staffing records that healthcare facilities are mandated to maintain.

Loose lips sink ships. Try to refrain from mentioning understaffing unless you'll enjoy the thought of being deposed in three to five years after a patient or family member files a lawsuit for alleged malpractice, neglect, false imprisonment or some other tort.

[malamud69, BSN, RN]

Don't worry...the patients and families will let "you" know your under-staffed...besides...to adhere to a famous Einstein addage(paraphrased poorly-my apologies) Just do your job and shut up! Guess what- nobody cares anyway!

[Fiona59]

That's an eye opener. In my hospital in Alberta, if patients ask, we admit it. When we are meant to have three patients and now have five they know. Beds are closed if there are no nurses to man them.

The patients and their families then complain to the government about nurse/patient ratios, short staffing and the politicians feel the pain as well.

[toomuchbaloney]

Not mentioning staffing levels when they are inadequate is simply a business model of keeping the customers in the dark about an important aspect of their care.

[anon456, BSN, RN]

I admit it. We somehow manage to make the nurse-patient ratios work every day but we are often short techs. I will tell the patient or family "we are short techs tonight so I apologize if I am late with getting your child's bath done tonight" but will still encourage them to use the call light if they need anything. I have never had a family indicate they are unhappy with this, they are actually very understanding and appreciative of when I do make time to bring them things for comfort.

[mmc51264, BSN, MSN, RN]

It is like with kids-the pts know already. We don't have to say anything.

[NotReady4PrimeTime, RN]

Another difference in acute care between Canada and the US is that we don't have such a thing as "patient care tech". On my unit, I do ALL aspects of care for my patients. Our nursing assistants (when we have them) don't even empty our urometers. Sometimes they help with turns but usually find somewhere they have to be instead. So we RNs (our unit has no LPNs) help each other. It's not hard for patients/families to figure out we're short-staffed. They can see it quite clearly. They are even able to see beyond our walls when the patient has been approved medically for transfer out of ICU and are still there three days later, sitting up eating spaghetti and playing Angry Birds.

[AdamantiteEnigma]

Understaffed is a four-letter word