Working short

[mstearns09]

This seems to be happening more and more again at my facility. We are scheduled to have 5 aides and 2 nurses on the floor during my shift (we have 54 residents right now). Lately, we've been short at least 1 aide and while when I first started, we were able to work short with no problem, we have so many 2-person assists now on top of one resident who has to be a 1 to 1 the entire shift that it's become impossible to work short.

Last night, we worked short and a resident chewed me out because I told her she had to wait until we were finished with two other residents before we could help her. I explained to her as calmly as possible that we were short 1 aide because the third aide for our hall had to go to the emergency room and receive a blood transfusion. She told me it wasn't her fault; I told her it wasn't mine either. She's a rather demanding and bossy woman anyway and I think she wasn't expecting me to stand up to her.

Another resident was so demanding that she called one of the hospitals in our county to get help! The nurse had already explained to her that she was going to have to wait patiently until we were able to help her.

What are your tricks to working short? We ended up having someone come in early for the next shift so we managed to get everyone in bed and cared for but I was about to have a small child-like fit before it was said and done. The DON's hands are tied as far as hiring more aides; the administrator has the budget on lock-down and seems more concerned about dollars than resident care.

[JDZ344]

Also hoping for some good tips here...

[RN1485, BSN]

I feel your pain! I work in the memory care unit with 16 residents. Usually there are suppose to be two aids in memory care at all times. However, I was told a few weeks ago that scheduling will change to where only one aid is in the unit at night (the shift I work). So last night I busy toileting a very difficult resident when another resident decided to try to go to the bathroom by herself and ended up falling on the floor b/c she can't walk. I had to call one of the aids from the AL unit to come back and help me. Also 1st shift doesn't come in til 6:45 and they are suppose to have someone come in at 5 to help me get people up, but they keep messing up the schedule so that I'm left getting everyone up on some days. The RCC said that it will have to stay short like this until the aid, who's away until August, comes back....I don't have any tips really. I just wanted to vent my frustration as well.

[AJ_427]

Being short-staffed is way too common at where I work. If you work enough shifts where you are really short, you will know what to do. First of all, you speed things up (speeding up is a huge issue where I work). Imagine that you normally walk for 8 straight hours and when you are short staffed, you run as if someone is chasing you . I normally stay away from slow aides because I won't let someone lazy bring me down with them (sorry if I sound like a b**** but that's reality). I tell my charge nurse that I'm not going to do this and that (prioritize!!!) and if she doesn't like it then oh well. It is her responsibility to call aides if we become unexpectedly short staffed. If we have to split the residents, I will pick the easy ones if I have a very hard assignment originally. Lastly, I don't take breaks. I can work 16 hrs straight without sitting down for 5 minutes. I always finish on time and get things done at least somehow the way they are supposed to be done. I help out those who need it but in my opinion, everyone needs to be able to work short staffed shifts.

I will write this again: we will be short staffed until tragedy happens and someone gets hurt. It will happen. And of course, the aides will be blamed. It is so sad that money is the number one priority for the people who run these places. To put it in simple words: NOBODY GIVES A ****. Not about the residents, not about the care we provide, not about the standards of living, not about the aides. I almost quit my job 2 weeks ago because nobody gives a damn about these residents. When people stop caring, everything falls apart. That's why I see new aides come and go every day.

PS- Yeah, but we are always good with staffing when the State is about to come hahaha. Oh man, I hate my bosses.

[duskyjewel]

Running short....the bane of my fricking existence! Problem is, it's the new normal where I work. The days we actually have the number of aides we are supposed to have are the ones that are a rarity.

I have no tips to make it better. All I can tell you is accept that you are only one person, and you can only be in one place at one time. Do what you can do, and leave the consequences to the brain-dead, shortsighted management that inisists on running your unit that way. The problem is that "consequences" is just code for bad things happening to people. But what can we do about it? Nothing.

This is killing me spiritually. I am in the process of either changing out of the CNA career field or trying to find a job somewhere else. I am heavily researching every single choice and have narrowed my field down to basically one company that I think I can trust based on reviews written by employees and former employees, to actually give a crap about good patient care. I am watching their job postings (and thankfully they have been posting like mad... I am just waiting on the right one to crop up) and will apply only to them. I can wait until I can find something better, but I am emotionally already gone and can't wait to get out for real.

The comment about staffing being great during state audits... yeah, I work in a hospital, and it was like a different place while JAHCO was there.

I have tried over and over again to tell my higher ups that I am incapable of the "excellent patient care" this organization advertises when I have 12-15 high acuity patients that I am responsible for. There are literally times when I never see several of my patients except for vitals, because they are low maintenance and I am too busy with the needier ones. If I don't even have time to refill someone's water pitcher and ask them if they need anything, how is that "excellent?!" And when someone is left sitting in urine or stool for half an hour because I have to clean up someone else and completely change their bed, how is that "excellent?" I can only do these things so fast and do them thoroughly. If I leave stool on someone because I am rushing, they will have skin breakdown and then require more care later on. Most of the front line RNs agree with us aides and are appalled at our staffing levels. They have begun to complain to the charges and the directors as well. But the people who actually are in charge of the staffing levels keep saying that we are fine according to their ratios. Many of the RNs I work with are perfectly willing to come help with a bath or difficult transfer when asked. Especially the ones that are most upset about the CNA staffing always come to help. However, some RNs wouldn't answer a call light if a patient was on fire. (If you are an RN and offended, sorry, but it's true.) I have come out of a room after doing care to find out another call light has been going off for ten minutes or more. The other aide is in another patient room doing care also, and may have an RN with her, and other RNs are passing meds......so the call light just doesn't get answered......

As to things changing once something bad happens to someone, I wish. I work in the unit that has one of the worst fall rates, if not the worst, not just for our hospital, but for the whole hospital system. And yet they just keep right on running us short. It is unconscionable, and we aides keep pointing out how even though the fall rate is terrible, they keep running us short! Here is a perfect example of the problem. Call light went off for 12 minutes with no answer. Obese patient has special commode in room for her use, and decides to give up because she has to go to the bathroom and gets up on her own. Some idiot did not lock the wheels on said commode, and she almost fell because of it. When I go in the room to check on her, she tells me this whole episode. I immediately apologize and go talk to my charge. Her comment: "well maybe we should put a bed alarm on her." I mean, really? The two major safety issues of someone forgetting to lock wheels and no one answering her call light for over 12 minutes shouldn't be addressed, let's punish the patient by restricting her movements. This is the kind of reasoning we are up against!

Sorry this is so long, and such a rant, but this issue is particularly troublesome to me. I did not get into this job to neglect patients. As to telling patients we are short, trust me, we don't have to. They figure it out. They ask me if we are short, I don't tell them! I feel like I am doing wrong by someone every single shift I work, because I just cannot do everything they seem to think I can do for that many people. That's what I mean when I say it is killing me spiritually. I have got to get out, but am still trying to figure out whether I should find another CNA job (with no illusions about the fact that it's as bad or worse nearly everywhere else) or just get totally out of direct patient care and go be a pharmacy tech.