Feeling Like a Yo-Yo…
We have a new staffing matrix at my Hospital. It doesn’t affect me greatly as I work 2 shifts a week in the Ick-U as a Tele Tech and 1 shift a week on Med-Surg. However, it affects me enough that I’ve been called off every Friday for the last 3 Friday’s (the days I am assigned to work on Med-Surg). The matrix allows for one Nurse and a Unit Secretary up to 5 patient’s. At 6 patient’s the Unit Secretary goes home and the Aide gets called in up until 7 patient’s. At 7 patient’s a second nurse gets called in and the aide gets sent home and placed on call until the unit reaches 11 patient’s, whereby, the aide must come back in. Well, last night Med-Surg had 2 patients, got a patient transferred from the ICU (chest pain and on Tele), and then had a Pediatric admit and a Geriatic admit. This brought us to 5 patients. I was called in at the start of the shift because blood was to be given to two patients and there were additional admits planned. So. When we have low census, I not only play aide, I play Unit Secretary, and back up Tele. It is a very chaotic, unorganized way to work…what I do is vitals, HS cares on one patient and then go back to the Nurse’s station to put in orders, etc. To make matters even worse…after I did HS rounds and midnight vitals, I had to prepare all of the charts for the next day. About 3am we transferred a paitend from Med-Surg to ICU. I had to tear down the Med-Surg chart, breakdown the room (patient had been in ISO for C-Diff), take the patient over to the Ick-U, set up the Ick-U room, put the new ICU chart together, input all of the orders, run Tele strips, and help the patient (who had raging diarrhea)…the patient was not following instructions and being non-compliant with everything so doing a simple maneuver like a pivot transfer to the commode was difficult. I ran my TAIL off!!! I am trying to find the shiny side of the penny, and I am trying to convince myself it is a great matrix that teaches me fantastic time management and organizational skills…but I don’t buy it one minute. We got a shitty matrix because the big-wigs are cutting corners so they all get humongous bonus checks. It was said in a staff meeting that if we as a group could hold on until January, the staffing patterns would go back to normal…we all know what the translation is: “work your current staff beyond belief so they quit…but only after working enough to meet corporate financial needs and then hire new, inexperienced staff at lower wages.” I’m trying to do what is asked, but it is difficult….to balance the workload, some things get missed. That bugs the hell out of me!
November 29,2008 at 18:34
Wow, that sounds like a headache. You’re an awesome CNA/Unit Clerk/Tele tech if you can manage all of that in a single shift.
I’d definitely try to go to management about this. While you may feel that it will not make a difference either way, at the very least it could make you feel a little better to have your voice heard, and no one knows for sure what could come out of it.
I’ve definitely had nights like this, except for being the tele tech since I’m not cross-trained (none of our aides are). There was a period of about two years where I was the only CNA on a BUSY 30-bed ortho/neuro med-surg unit that also specialized in total joint replacements. That was hell! I was always ambulating a pt– which took like 20 minutes, turning someone over, or taking care of a total care pt (at any given time we’d have 10 or so). Add this all up to the fact that you have 4 nurses, which means the charge nurse takes six of her own and the other nurses take 8 pts a piece…and that’s a formula for me wanting to resign every morning when I got off.
So then I went PRN because I started back in school and I really make my own hours now. I always heard the entire time I was the lone CNA, “Well, we really are trying to hire some people. I’ve got one or two people in orientation now to work nights with you…” But yet, it wasn’t until I went PRN and cut back my hours that they are OVERSTAFFED for CNAs. They actually normally have too many scheduled at night.
November 30,2008 at 18:34
Thanks Trauma Junkie for putting my work issues into perspective…your 30 bed ortho/neuro unit sounds like a tremendous amount of work…I do a lot, never take my lunch or 15 minute breaks because I am on the floor all night, and am barely managing to get all the work done. However, I don’t have patients that require the critical thinking and care that an ortho/neuro unit would need. That you do that as the only aide on the floor is amazing…when staffing patterns are like what you describe and I am experiencing…it IS a formula for wanting to resign…and, I am tempted to resign after my Friday’s. The only thing keeping me at my place of business is the incredible staff I work with. Also, every time I resign a health-care position because of poor management or unrealistic staffing protocols, I stick my foot back in the business world and stop going to school. I am really trying to stick this out until I finish my RT program. Soooo, I am considering doing what you have done and going PRN. That may give me some options in terms of not killing myself during my working hours. Additionally, because I am getting called of and placed “on call” I am thinking of getting another job. Once I can consolidate in my head that I am earning enough not to have a financial pit-fall, the other issues will seem less stressful. I guess I mostly have a problem with the staffing matrix because I care about my job and want to be a stellar performer. Most of the other aides are letting things go in terms of patient care… just doing vital sign rounds, inputting orders, and watching the Tele’s in a half-assed manner. I haven’t been able to let myself do that yet…but, I know there is always a light at the end of the tunnel, so I will either figure something out, or something will change. I am apt to think the latter will occur because all of the Nurse’s are rebelling against the new matrix and are having their aides stay even when the census doesn’t call for an aide….