No warm blanket for you !

The nursing shortage is front page news these days … or at least within the past year. It seems everyone knows that nurses are in demand and that hospitals can't find enough. Sign-on bonuses ! Winter plans ! WHATEVER YOU WANT if you come work here.

Really ? So why was I called into my nurse managers office last night and told that because our census has been so consistently low, they are going to be reducing hours ? WHAT ? Are you kidding me ? I should have noticed though, really. Because my shift yesterday wasn't so busy that I couldn't take a leisurely twenty minute lunch and I even peed once. Something is surely wrong when you have time to do all that. I can't believe I didn't notice.

Apparently there is a fine grey line that is blurred somewhere between the patient census/staff ratio numbers and the numbers reported back on customer satisfaction via Press Gainey. I wish I knew the formula. We are supposed to whittle the nursing staff down to the point where you don't get a lunch and don't get to pee because you are covering half of the E.R. BUT not so far that the Press-Gainey scores start to slide down the slippery slope.

And yet you must be able to still meet the tight time lines now required for STEMI and CAP. Never mind that those times are only met because every other patient one in the ER is IGNORED while the whole nursing crew (of two and maybe a tech !) is sucked into the care vortex of getting it all done for that patient ON TIME.

And so the little box on the assessment form that says "warm blanket provided" will sometimes go unchecked. But the heel clackers will notice that it us not checked and they will want to know why no warm blanket was provided. Hmm...I wonder what I will tell them ?