Time for some introspective criticism perhaps?

12 OK. Everyone has read a complaint about short staffing and what not on here. Unless this is your first time on the site and this is the very first thread you have ever opened, you've seen it.

I too balk at the staffing levels admin. expects us to function under. Don't preach to me that you want to see "5s" on the surveys when you barely staff well enough for "3s".

With that said, I'd like to take a look at the staffing problem from a different, more introspective angel. I recently finished doing a boat load of OT this pay period. Too much to be honest. Problem was, every time I went in to do a four hour evening shift, it turned into a twelve hour overnight shift. That plus one daylight shift in which there was no aid (hence the need for nurses) but we still had our usual ratios and.........well, I did my part to "take one for the team" these past two weeks. My life outside of work is in the ditches and no paycheck is going to make me happy about it.

So, I'm talking to a night nurse one of the times I stayed and she is boobing her head back and forth telling me "He he, I can't believe you stayed but I'm so glad you did. We would have had to take (X) patients if you didn't stay. I can't function with that many patients. I don't know how you do it though, I don't do OT, its too tiring. I NEVER DO OT."

OK. Thanks for the info. legally blonde wanna be. You basically just got done telling me that if the roles were reversed you'd be out the door letting me function with (X) pt load. Nice, I'll remember that next time.

As I look around my unit, I do notice her approach to "helping" when things get tight is the norm. Very few people do OT or come in on a day off to help their coworkers from having to deal with excess stress. Everyone walks around with this idea of what it is they want to do and wont stray from it one way or the other. Ask them about changing their schedule because one day is overstaffed and another is short.........forget it. Ask them to work a weekend thats not "their weekend"......boo hiss.....they'd rather see their coworkers drown. And holidays............forget it, everyone thinks they are the only one's with a family and plans.

So, with regards to running short staffed, how much of it is us (nurses) doing it to ourselves? How much of it is us not answering the phone, saying "its not my problem" while we know our coworkers are at work drowning.

Heck, there was even a thread in here of someone calling off because they found out they'd be floated. Ummmm, next time your unit is short and the M/S nurse refuses to help out, I hope they remember that day.

Me, I do more than my share of taking some of the "pain" in the helter schelter schedule. I work my off weekend from time to time. I stay to help other avoid bad days. I often come in on off days. Holidays..........just give me T-day and I work Christmas Eve, Christmas day, New Years Eve and day. Granted, I am flexible to the extreme but my gosh........a little bit of flexibility would do wonders for the work environment.

I just don't understand the people who think they are ever going to have a "steady" schedule. Nursing never has nor will offer that unless your are in an office or something. Did they not know that when they got into it? Last edit by eriksoln on Feb 2, '11
I would have to agree with you. Many times i do work overtime and bust my butt. But those that I am assisting will give me the worse patients since I am on overtime and i'm getting paid more that night. Yeah the pay is going to make my kid feel better because I missed her game winning goal. Or make my husband feel better because I missed date night. I wish that people will listen to themselves when they say certain things.

Quote from Laught3rI would have to agree with you. Many times i do work overtime and bust my butt. But those that I am assisting will give me the worse patients since I am on overtime and i'm getting paid more that night. Yeah the pay is going to make my kid feel better because I missed her game winning goal. Or make my husband feel better because I missed date night. I wish that people will listen to themselves when they say certain things.

I help out when I can, but I also have an obligation to myself. I'm no use to my unit or the patients if I'm become so burnt out that I quit.The hospital is obligated to staff the units and floor appropriately. I am not obligated to work myself into depression and injury and let my personal life suffer. There will always be times when extra help is needed, but this martyr mentality is detrimental to us both professionally and personally. Nothing but a larger check and potentially moving up a tax bracket is to be gained by working an absurd amount of hours. If they need me to pick up that much OT, then I'd better be getting disaster pay because that's exactly what my house and life are going to look like after it's all said and done.I don't like to know that my co-workers are suffering and do my best to prevent it by almost never calling out and always showing up on time, but myself and my family always comes first.

I would like to see admin work with secretaries. I would also like to see them skip their lunch and never put their bottoms on a chair for six straight hours. I would really love to see them deal with people telling them "no sorry we can't hire any new ancillary staff to help you with copying, typing or gophering because its not in the budget this fiscal year. I hope the patients don't learn that their safety is not in the budget.

Quote from FribbletI help out when I can, but I also have an obligation to myself. I'm no use to my unit or the patients if I'm become so burnt out that I quit.The hospital is obligated to staff the units and floor appropriately. I am not obligated to work myself into depression and injury and let my personal life suffer. There will always be times when extra help is needed, but this martyr mentality is detrimental to us both professionally and personally. Nothing but a larger check and potentially moving up a tax bracket is to be gained by working an absurd amount of hours. If they need me to pick up that much OT, then I'd better be getting disaster pay because that's exactly what my house and life are going to look like after it's all said and done.I don't like to know that my co-workers are suffering and do my best to prevent it by almost never calling out and always showing up on time, but myself and my family always comes first.

Quote from Laught3rI would like to see admin work with secretaries. I would also like to see them skip their lunch and never put their bottoms on a chair for six straight hours. I would really love to see them deal with people telling them "no sorry we can't hire any new ancillary staff to help you with copying, typing or gophering because its not in the budget this fiscal year. I hope the patients don't learn that their safety is not in the budget.

The hospitals I've worked at have had full time float pools/internal agency nurses, and regular staff aren't told if they are being floated until arriving on the unit. That seems to alleviate most of the urgent issues, but the problem is more that management won't allow more RNs to work/calls them off. 1:6 is the norm on the day shift med surg unit - were they to change that to 1:5 as a norm or at least have an admission RN, then they'd be much better equipped if there was an issue with mass sick call outs for example. A lot of hospitals do not staff proactively in anticipation of problems, they instead staff as if every day will be a quiet smooth day. Problem is, those days are rare. There will always be a code, or a nutty unrelenting family member or a violent patient, or a rush of admits. Hospitals are aware of these recurring issues yet do not act on them as they should.I appreciate that you are trying to find ways to improve how we work, but staffing is an employer issue, not an employee issue. More managers need to step it up and take a few patients here and there when those critical staffing needs come up if regular staff are unable to come in. If employees bend over backwards to satisfy the employer's every need then why would the employer feel the need to change things? Nurses give up quite a lot already - you don't have to search far to see the posts about people not eating and not peeing during their shifts or staying over and charting off the clock. I'd say its time for the employer to step up. WHY do nurses always have to take the fall and be the martyr?My manager once bemoaned how if we could cut our overtime, then they could afford to hire another person. Well, maybe if they staffed properly in the first place then there wouldn't be a need for that OT. A proactive manager is much better than a reactive one. The solution as I see it is to have decent ratios to being with, a person doing a task they can drop to take a full patient load if need be, such as admission nurse or a nurse doing chart audits, and have a dedicated float pool for nurses and pcts (with a last resort being to float people from other departments), and have managers be required to step in as charge nurse if need be, staff pcts properly and cross train pcts as unit secretaries.

Quote from AyvahThe hospitals I've worked at have had full time float pools/internal agency nurses, and regular staff aren't told if they are being floated until arriving on the unit. That seems to alleviate most of the urgent issues, but the problem is more that management won't allow more RNs to work/calls them off. 1:6 is the norm on the day shift med surg unit - were they to change that to 1:5 as a norm or at least have an admission RN, then they'd be much better equipped if there was an issue with mass sick call outs for example. A lot of hospitals do not staff proactively in anticipation of problems, they instead staff as if every day will be a quiet smooth day. Problem is, those days are rare. There will always be a code, or a nutty unrelenting family member or a violent patient, or a rush of admits. Hospitals are aware of these recurring issues yet do not act on them as they should.I appreciate that you are trying to find ways to improve how we work, but staffing is an employer issue, not an employee issue. More managers need to step it up and take a few patients here and there when those critical staffing needs come up if regular staff are unable to come in. If employees bend over backwards to satisfy the employer's every need then why would the employer feel the need to change things? Nurses give up quite a lot already - you don't have to search far to see the posts about people not eating and not peeing during their shifts or staying over and charting off the clock. I'd say its time for the employer to step up. WHY do nurses always have to take the fall and be the martyr?My manager once bemoaned how if we could cut our overtime, then they could afford to hire another person. Well, maybe if they staffed properly in the first place then there wouldn't be a need for that OT. A proactive manager is much better than a reactive one. The solution as I see it is to have decent ratios to being with, a person doing a task they can drop to take a full patient load if need be, such as admission nurse or a nurse doing chart audits, and have a dedicated float pool for nurses and pcts (with a last resort being to float people from other departments), and have managers be required to step in as charge nurse if need be, staff pcts properly and cross train pcts as unit secretaries.

Okay....Eriksoln I read your post and the first thing that came to my mind was this was written by a man (and I am sure I will get flamed for saying that!). Here it goes........I have two children for which I must arrange child care, cook all meals and make lunches, do laundry, take to sporting activities and help with all homework. I volunteer at the school when I can and clean the house, maintain the lawn and pay the bills, arrange doctors appointments and any other thing that needs to be done. I could go on for days about the things that I am responsible for OUTSIDE of work. I don't know your situation but I committed to work three days a week and that is what I can give. Back in the day, before kids, I loved over-time......not so much anymore!In my last postition we had a handful of guys working in the unit...they were all second career nurses. One had been a landscaper, one had been a carpenter and so on and so forth. They all talked about how easy three shifts a week is compared to their previous jobs. They always joked about the female nurses saying "they complain about everything, they don't know how easy this job is." One day an older nurse I work with said......."I think you might find this job easy because when you go home your job is done, when most of these women go home their job is just beginning." Of course she put a few choice words in there as well.Don't worry about what others are doing......if you want to do OT, do it......you can't know what other peoples situations are.

In LTC if you pull any extra shifts, you become the only person they call to fill shifts.It is a laziness issue on the part of management and scheduling.There are nursing mangement and voluntary on-call nurses being paid to be on call and come in but most won't if they can get a sucker to say yes.Behind the name and before some inflated title is RN and they can work the floor just the same as I can the LPN. Nursing management in LTC needs to lose the attitude that they are above floor work and actually manage a scheduling situation. There may still be some LTC DON/ADONs that do work the floor but I haven't seen one in years.So, no I don't do OT/extra shifts unless I need the money. I am in fact not the only nurse on the schedule and I am not being paid to be on-call.After 18 years, I am not continuing to be played like a fool. I have a life just as the other nurses and management. So, I rotate my taking an extra shift that way I do help but I don't become the only one and others realize they can too.

Quote from FribbletI help out when I can, but I also have an obligation to myself. I'm no use to my unit or the patients if I'm become so burnt out that I quit.The hospital is obligated to staff the units and floor appropriately. I am not obligated to work myself into depression and injury and let my personal life suffer. There will always be times when extra help is needed, but this martyr mentality is detrimental to us both professionally and personally. Nothing but a larger check and potentially moving up a tax bracket is to be gained by working an absurd amount of hours. If they need me to pick up that much OT, then I'd better be getting disaster pay because that's exactly what my house and life are going to look like after it's all said and done.I don't like to know that my co-workers are suffering and do my best to prevent it by almost never calling out and always showing up on time, but myself and my family always comes first.

It is easy for me to pick up OT- my only child is 18yrs old. I see both sides. One side: it is usually the same people over and over that are able to pick up OT. I guess some could view these folks as "helping" the unit more than others. Other side: if my daughter was younger and still in daycare, it wouldn't be so easy. Some peoples personal situation doesn't allow them to come in on their days off- they have obligations.I do help out in a pinch but lately, the mgmt scheme seems to be "come in today and I will take you off X day" hence, no OT. I see that always obliging mgmt and shifting my schedule around to accommodate the unit does help out my fellow nurses, but it never really solves the problem of adequate staffing to begin with.My hospital has recently implemented that charge nurses in ICU take patients before an on-call nurse can come in. Previously, we had a free floating charge. Some days this works okay but other days it is dangerous and difficult on the rest of the nurses who have a difficult assignment, unruly family members or a patient that is circling the drain.Out on the Tele floor, they are upping the nurse pt ratio to 6:1 (used to be 5:1 w/ free floating charge). Now the charge nurse has to take 2 patients and can't call in the nurse unless she is about to get a 3rd. As the former charge nurse on that unit I can see how this would work some days but other days it would be sheer madness.The answer is adequate staffing to begin with and not relying on already tired nurses to come in and pick up the slack.