Working short

[martymoose, BSN, RN]

So I'm noticing now we work short more often than we don't, esp on the pff shifts. The last 2 days I've had 7 pts - on a cardiac stepdown- and nights have had 10 pts apiece. 
It's just not an occasional thing anymore. 
Do other hospitals have some sort of backup in place? Where are they supposed to find staff on short notice- can I get some ideas about what other hospitals do?

And, we already have travelers in that shortage mix ?

It is getting very tiresome and unsafe. Who should be in charge of staffing for inevitable holes?

[RNperdiem, RN]

Where I work, if staffing can't give us a float nurse or a flex team nurse, and nobody responds to the group text begging for work, the manager or assistant manager comes in or the change nurse takes an assignment. I suspect ICU staffing is taken more seriously sometimes.

[martymoose, BSN, RN]

This is with the charge taking 10 pts ? charge always ends up with full assignments . And no one gets a break cause how is anyone supposed to watch 20 pts? 
its disgusting.
oh and they got rid of the float pool about 8 mos ago, and no one is allowed overtime .

[Been there,done that, ASN, RN]

Appears that the powers that be had a plan.. That would be to boost their bottom line, using the sweat off of nurse's backs. Administration knows  you are now working short and they like it. Patient safety is not their concern.

This will not change. Get out of Dodge.

[JKL33]

5 hours ago, martymoose said:

Who should be in charge of staffing for inevitable holes ?

That is management's job.

 

5 hours ago, martymoose said:

Where are they supposed to find staff on short notice- can I get some ideas what other hospitals do ?

It sounds like they should hire some more help and start offering massive bonus rates until the additional help gets up and running.

But those seem like kind of obvious ways to get help, don't they?

I suppose they just can't find anyone to hire given the nursing shortage and all....

[speedynurse, ADN, BSN, RN, EMT-P]

I feel like a lot of things have changed since covid. I know the emergency departments I worked at cut the staffing and then never filled the positions again even once things picked up. Same as the floor units and I think even in the pre-op/PACU environment that I now work for. I don’t know what the solution is but I do think that is an unreasonable ratio for a cardiac step down. That’s actually pushing it for a med surg ratio. I would try to look for other jobs.

[Sour Lemon]

18 minutes ago, speedynurse said:

I feel like a lot of things have changed since covid. I know the emergency departments I worked at cut the staffing and then never filled the positions again even once things picked up. Same as the floor units and I think even in the pre-op/PACU environment that I now work for. I don’t know what the solution is but I do think that is an unreasonable ratio for a cardiac step down. That’s actually pushing it for a med surg ratio. I would try to look for other jobs.

10 is way beyond "pushing it" for med surg. The patients would need to take each other's vital signs and give each other's meds. ?

[speedynurse, ADN, BSN, RN, EMT-P]

I have had 4 to 5 very critical ICU patients at once.....it’s not safe but it happens when a hospital system doesn’t care about sentinel events. Our med surg floor takes 7 patients at all times...before covid.  

[tama18, BSN]

call safe harbor. that usually gets em back in shape pretty quick.

[Nunya, BSN]

And once you've gotten out of Dodge notify JC and your local paper about the dangerous staffing situation.  Sometimes bad publicity is the only thing that changes things.

[NRSKarenRN, BSN, RN]

Safe Harbor legislation only available in Texas and New Mexico.

 

Medscape Nurses  4/26/2019 

Carolyn Buppert, MSN, JD

A 'Safe Harbor' for Unsafe Nursing Assignments

 

[OUxPhys, BSN, RN]

My old hospital there was usually a float pool nurse or a float from another floor that could cover. My current hospital (government) if they can't find a float either they say to call someone in, ask if someone wants to stay for OT, or worse case scenario they have someone mandated (which really isn't any safer).