Would more nurse aides solve the problem of always feeling short-staffed?

smf0903 · Apr 19, 2016

It would be awesome to have more aides. I work nights on a med surg floor (more medical than surgical), and there are many nights we have no aide. We are the floor that the aide gets pulled from when another floor needs an aide, which totally sucks because we get a lot of sundowner patients. The aides we do have are awesome and such an enormous help...and are total rock stars at their jobs. I doubt anyone will answer that they don't need or wouldn't appreciate additional help :)

westieluv · Apr 19, 2016

I agree that more aides would help a lot, but I also think that full-time admissions nurses would be amazing. Admissions really break up a shift and interfere with getting your tasks for the shift done, and they come at the worst possible times most of the time. To know that there was always going to be someone available to tuck the patients in, go through the admission assessment, and get orders would be amazing!

And not practical, because they would have to pay them nurses' wages, although I know that I, for one, would work for a few bucks less/hour to strictly do admissions, I'm not sure how others feel.

NightNerd, MSN, RN · Apr 19, 2016

It would help some, but it will not replace the skills and knowledge an LPN or RN is able to use. I love Westie's idea of an admission nurse!

llg, PhD, RN · Apr 19, 2016

more aides ... more secretaries ... more housekeepers ... more phlebotomists ... etc. They would all help.

But we would still need more RN's to handle those things that only RN's can do. And we would need more RN's to coordinate the services of all those other people. So while more "other people" would help ... it is not a "fix" for the underlying problem. RN's are the desired role because RN's are the most flexible employee. We can cover all the positions and don't need as many supervisors and coordinators watching over our practice.

But yes, more support staff would be great.

nutella, MSN, RN · Apr 19, 2016

From hospitals to LTC facilities, it seems that nurses everywhere are feeling short-staffed every day. I wonder if instituting a ratio of nurse aides to patients would go a long way towards solving this problem. In California there is a legal ratio of nurses to patients, but often there are only one or two aides for 30 patients. If there were more aides, call lights would be answered more quickly and nurses would have more time for nurse-level duties while patients would get more aide-level care. (Although nurses should be willing to help with toileting, etc. if necessary.)
Nurse aides make a lot less money than nurses do, even considering benefits, etc. so I'm thinking that hiring more aides would help everyone without breaking the budget for the health care facility.
What do you all think about a mandated aide to patient ratio?

Well - yeah it would be great to enough enough aids - who actually work - so that patients do not have to wait for non nursing things...

But, that is not going to happen I guess. Nurses put up with everything and anything and since there is no nursing shortage, nurses will continue to cover everything and anything. Nurses rather cry in the break room or stay longer unpaid as opposed to speak up as a collective. Instead of investing money into staffing that actually helps, big money goes to management and consulting services to see how else we can "service" our clients better...

LadyFree28, BSN, LPN, RN · Apr 19, 2016

Well - yeah it would be great to enough enough aids - who actually work - so that patients do not have to wait for non nursing things...
But, that is not going to happen I guess. Nurses put up with everything and anything and since there is no nursing shortage, nurses will continue to cover everything and anything. Nurses rather cry in the break room or stay longer unpaid as opposed to speak up as a collective. Instead of investing money into staffing that actually helps, big money goes to management and consulting services to see how else we can "service" our clients better...

:yes:

That is the HUGEST elephant in the room...

People are in the hospitals and facilities because of NURSING care-not management, not the CEOs, because they need US.

Instead of doing less, and having LESS it would be an excellent idea to actually invest into the hospitals and staff, not just into making sure the CEO has a raise, especially when many haven't got one in years and are doing more with less.

nynursey_ · Apr 19, 2016

I have mixed feelings about this.

Our Nursing Supervisor will often use this phrase in an attempt to make the nurses' feel they're being considered in the staffing needs: "We can't give you a nurse, but because you're at 2 PCA's, we'll give you a PCA instead."

Famous last words.

The vast majority of the time, the complexities of the patients require nursing care, and not basic ADL needs. If you have a ratio that has to bump to 1:5 due to the rise in ER visits, and some of these patients are mixed step-down patients, that gives you an entire floor of potentially one 1 stable person to a nurse. Sending an 'extra' PCA is not a consolation prize. I'd much rather nurses be staffed adequately than ancillary staff. With the aforementioned situation, there is virtually nothing to be delegated, and not another nurse to be found to be delegated to.

Rexie · Apr 19, 2016

I agree that more support staff would be great. The aides that we have are spread terribly thin. That being said, they also have to be aides that are there to work and not hide in the back room playing on their phones. I worked on a floor where if we were offered a smaller patient load without a CNA, we would choose that because the CNA we had wasn't a whole lot of help.

I would be concerned that TPTB would (if they could get away with it) give us more CNAs and then a patient load resembling sub acute rehab - around 20 patients per nurse.

AJJKRN · Apr 20, 2016

At my work one of the floors is trialing a 6:1 ratio with an aide to each nurse. The aides are bored and the nurses are running their asses off to tell the truth AND I think in the end it's more expensive on the floor.

My vote would be a 4:1 ratio with podding with another nurse while sharing and aide who would then have an 8:1 ratio. Heaven I tell you! Then we would be able to do our jobs (with charting included), educate and take care of our Pt's effectively AND meet the expectations of customer service satisfaction and the hourly rounding we're expected to do! :cool:

KatieMI, BSN, MSN, RN · Apr 20, 2016

The problem is, in order to notably unload nurses we will need to give aides (and other support staff as well) more training and more knowledge, and I am not sure it would be good. Physicians already made this mistake with midlevels.

I hate to let my aides to do vitals. Not because aides are bad - they are excellent at what they are doing, and do wonderful job, - but because they do not know how to assess. They see "funny gesture every time I take blood pressure, and she says it hurts". I see "midwife's fingers" of acute hypocalcemia, and I call not only for calcium replacement, but also for question if patient really needs that much Lasix, for just one example.

It would be really good to get someone busy exclusively with communications, calling for orders from very elusive specialist, making procedure schedules and hunting RDs and other support services... but it will be again on me to make sure that person knows to tell RD what patient from ### will or will not eat. One hospital I know made resource team responsible for "difficult" IV placement 24/7, "difficult" to be deemed as decided by the staff RN. Within a year, 9 out of 10 floor nurses in this hospital forgot everything about IV placement except resource team page number.

I will appreciate more physical help, that's for sure, and more sitters instead of tying people down to beds and drugging them. Maybe even more dietary aides to feed those who are too weak, and some "activity aides" to keep a LOL with pre-terminal dementia happy.