N9 Management during short staffing

We can use these tips in our every day prioritizing for clinical survival even if we are not nurse managers yet.

ADVANCING YOUR PRACTICE

Top 10 tips for coping with short-staffing
Linda Laskowski-Jones, RN, APRN,BC, CCRN, CEN, MS, and
Karen Toulson, RN, CEN, BSN

Any unit can be short-staffed from time to time. Use these 10 practical ideas to minimize disruption and maintain the quality of care. If staff shortages are chronic, ask your nursing leadership to address the issue.

1. Prioritize your assignments
Examine your assignments and categorize nursing activities as high, medium, or low priority. Start with the high-priority activities. These include critical assessments and interventions, such as tracheal suctioning. Next, tackle medium-priority duties like teaching patients. Many low-priority activities can be delegated to unlicensed assistive personnel (UAPs), family members, or volunteers.

2. Organize your workload
After receiving report, determine the care that your patients will need. Gather equipment and supplies before entering a patient's room. Give support personnel a list of any missing items and ask that they get them right away.

3. Be a team player
Make a rule that no one can sit until everyone can sit. If you finish your work before others, pitch in. Teamwork creates bonds between co-workers, makes difficult situations tolerable, and enhances patient safety.

4. Use UAPs wisely
Know what you can and can't delegate to UAPs according to regulations governing nursing practice in your state and facility job descriptions.

5. Recruit additional talent
Engage other personnel, not just nurses, to distribute the workload more evenly. The unit clerk, for example, can help you communicate with others.

6. Encourage family participation
When family or significant others are visiting, ask them in a friendly way if they want to help, without mentioning the staff shortage. If they're amenable, offer them suggestions such as assisting with meals. Be sure to thank them.

7. Inform and involve nursing administration
Inform your nurse-manager when staffing is inadequate. He or she may be able to call in staff, offer overtime or incentive pay, reallocate staff, or employ staff from an agency. The nurse-manager may also help fend off time-consuming special requests.

8. Communicate effectively—and nicely
Communicate clearly so that everyone knows the plan for surviving the staff shortage. Safeguard the feelings and dignity of all team members. Assess your own communication style: Do you ever speak in a demeaning or condescending way when you're harried? Supporting each other and being kind smooths the way for everyone.

9. Take care of yourself
During each shift, try to take a break from the caregiver role, even if only briefly. If you can't leave the unit, take a moment for yourself in the break room. To stave off burnout, eat a balanced diet and get enough rest and exercise.

10. Maintain a positive attitude
Attitude is everything. If you go into a challenging situation with a positive, can-do attitude, you can achieve great results. In contrast, a negative outlook can bring down the morale and performance of the entire team. Positive self-talk is an important first step. Tell yourself and then the team that you can survive and even thrive in challenging situations. Reframe the staffing shortage to generate camaraderie and a sense of mastery over apparent obstacles. In time, positive thinking and creative problem solving will become habits for the entire staff.

Source: Nursing2004. December 2004.