My DD is a doctor and one of my DDIL's is a nurse practioner and I know they worry so much about bringing it home to their families.

To make things worse the governor of Missouri today released this statement:

"This week, our Missouri Department of Health and Senior Services released revised guidance for long-term care facilities in Missouri that choose to establish an Essential Caregiver program and/or resume general visits either inside or outside the facility.

Facilities should have a policy in place to determine how contact with loved ones can occur while protecting the health of residents. Each facility will ultimately make the decision as to whether or not to adopt this guidance."

Here in FL they've now allow visits in nursing homes. And, I'm guessing rehab hospitals too? My brother has been in a rehab hospital in OH for going on 3 weeks. No visitors. It's awful for him. When he was in the acute care hospital for a week before being transferred, he was allowed visitors. His daughter showed up one day while he was being transferred from the rehab hospital to the acute care hospital for radiation treatment and she was allowed to stay with him in the waiting room at the acute care hospital. But she/anyone can't visit him in the rehab hospital. I wish they all lived in FL.

While I understand the desire to be with loved ones I also hope for those that insist that they have the strength to know and forgive themselves if they unknowingly infect their loved ones.

When my husband was in the nursing home I elected not to visit him when I was not feeling well because I knew the air handling system could easily spread any germs that I had all over the facility. Since Covid can be an infection without symptoms no one can know if they carry it or not. People visiting may not only be infecting their loved one but others who may be more frail. Flu killed 23 people at my husband's home from Thursday to the following Tuesday when finally no one was lost.

I have some nurse friends, and hear NOTHING from them. They really don't have time to chit chat or anything.

Moni

There was a front page article in the Journal about how the under-staffing results from years of hospitals cutting back on staff to save money. I saw this myself in the mid 90's, my department was running higher and higher FTE's just to save money. We were running FTE's over 120, that's a recipe for mistakes. It's a large part of the reason I switched careers.

On yesterday's local news they led with a story about "A massive outbreak of Covid in a hospital". They talked about this as a disaster, fast spreading, large numbers of cases, numerous patients and staff infected. Then at the end of the story they said it was five cases, that's a tiny number in a large medical center type setting in Boston. Talk about hyping a story for ratings...

Okla, I'm not sure what you mean, but I'm a research administrator at a hospital. We're all busy. Some are helping patients and some are finding answers to keep patients from being hospitalized. It was during the course of work. No one was chit-chatting.

P.S. Happy Research Administrator's Day to anyone else who also does this work!

https://nationaldaycalendar.com/national-research-administrator-day/

Rob, I think Okla is saying her friends haven't had time to contact her.

Working in a hospital as a nurse or CNA is rough anyway, can't imagine what it's like now in areas where Covid 19 is widespread.

Raye, what is an FTE?

Rob, like Ray said, my friends are plum worn out when they get home, and have to now deal with home life, they don't have time to chit chat with me.

Also, for future use... My name is Moni, I live in Oklahoma. :)

Moni

full time equivalent

Raye, in what hospital department did you work that you found to be understaffed? I've never found that to be the case in the patient/customer facing folks I've interacted with. Maybe even the opposite.

An FTE is the amount of work an employee can accomplish in an eight hour shift. At 100, (it's a ratio) your working full tilt. Normal range in the hospital back them was 80. Anything over that puts patients at risk due to errors. The day shift typically computed the numbers but sometimes I would stay over and help. That's how I knew we were running too high.

Caroline I hope you are feeling better. Please take care of yourself because this winter will be rough.

Having worked on a med-surg floor for many years, Elmer, we were always understaffed. Always. Even now, working in an office, in telephone care, we are understaffed. I just did 6 1/2 hours of overtime Saturday to help out and had another coworker who came in off her vacation to work a full 12 hours shift that day. We were always short of medical support people too, most days they only had one or two going between multiple floors. Guess who got to pick up the slack when that happened?

I did experience my hospital cutting back on staffing - how they did it was thus: typically in my ICU our nurse:patient ratio was 1:2 (in some states, that is a legal mandate for critical care, but it is a generally accepted standard nationally I believe).

However, some patients who were very unstable or on complex, multiple life support devices required 1:1 (or even more in an "all hands on deck" scenario, for portions of the shift). The management would try very hard to not call another staff member in to cover the uneven ratio; we were required to "flex up" to cover care needs - so we would have 1:3 ratios routinely.

Another scenario in which that would happen is for whatever reason there were not enough staff scheduled to cover all of our available beds - vacations, sick calls, gaps in scheduling/ shortfalls in hiring; or people were told to stay home or had been sent to staff elsewhere in the hospital because of vacant beds - but patients would be admitted regardless, and we had to "flex up" again. Sometimes many of us would be "flexed up" already when a very unstable patient would be admitted. (Because it was a specialty unit, the hospital couldn't just pull any available nurse from another department and give them an assignment)

In those circumstances it is very difficult, to put it mildly, to give all the attention and care one might like, or should, to one's assignment.

This kind of "flexible staffing" became entrenched, even as the nursing shortage of the 1980s abated (a time when it was unavoidable - you couldn't staff nurses that didn't exist), as the idea of applying productivity standards in hospitals came into vogue. The problem is, the sicker the patients are, the more care and attention they need, the worse productivity for a nursing unit is, unless the staff members on duty take on more patients to keep or beat that overall (ie 12 nurses for 24 patients) 1:2 ratio. And so, that is what we were asked to do more and more frequently. "Flexing up" was an official, if unwritten, policy. We would be praised for meeting productivity goals when we were exhausted from "flexing up".

"An FTE is the amount of work an employee can accomplish in an eight hour shift."

Maybe this was how it was used where you were. I've never heard it used for measuring production. What kind of "medical professional", as you've claimed to have been, is measured based their output or production?

This isn't the common usage of the term. It's a personnel/HR/headcount/management and budgeting term. If a normal work week is 40 hours, one full time worker = 1 FTE. If the department has one full time and one half time worker (20 hours per week), they would have 1.5 FTEs. If those two were falling behind in what needs to be done, they might be asked "would having another one-half FTE be enough or do you need more?" It's used for budgeting and management purposes.

In most professional jobs I've encountered, actual productivity is managed and goals are set but few are susceptible to being actually measured on a per person basis. Except maybe for pill counters, who I consider to have professional training but who mostly don't do professional work.

When I was in hospital for three days starting July 4 the floor staff was just getting over the shock of this spring's pandemic, where the ICU was filled and regular rooms were 'converted'. The whole area was stressed in the same way, so there were no 'reserves' to help staff the overflow.

Everything appears stretched even now, when the area is relatively calm as regards COVID. My DH and I want to drop our current primary MD. A specialist referred us to another primary. DH called scheduling today. The doctor can see us the last week in February.

Correct, Elmer, we always used the abbreviation FTE as you describe; and productivity goals were set for the unit or department, not for individuals - but whether the unit's goal was met was and is part of the formula for determining individual raises (as were the department's HCAHPS scores) and the onus for meeting the goals fell upon the staff, as I described.

Raee, we also calculated FTE's for the prior months work and used that to calculate how much work that required of each person. It was probably a JaCO (can't remember if that's how it was spelled but that's how we pronounced it) requirement at that time in that state. We didn't use it to set raises, they were frozen for most of the 80's...

As always, I passed over Elmer's comment, I would gather he claimed FTE's are something I made up - that's his usual comment.

No, you've misunderstood, I think I explained it adequately. Your work area may have misused it in the way you describe, that's not the normal connotation or use of the abbreviation/term.

My comment was about your habit of trying to falsely enhance/augment whatever work you did that you refuse to describe, as being something much more than it obviously was.

What's helpful teslastar?

_________

It's even harder now. Supply chain issues are affecting hospitals. It's crazy to think that the lack of a specific top for a tube, can keep the tubes from getting to you for instance. There are far more supply issues than that though.

People are so worn out that they're quitting, or retiring. I know of a place that's offering finders fees for people who can steer people to apply.

Even knowing the way, having the boat built and steering isn't getting us to the end of this.

"Even knowing the way, having the boat built and steering isn't getting us to the end of this."

Not as long as too many people are willing to throw another log onto the Covid fire.

In Michigan all health care facilities are begging for staff. Wish I was still able to work because I would be right there. Just read today for nice bonus's for staying 3 + months. Elmer, you are lucky you live in a well staffed area, not the case most places. And if you think otherwise, you are wrong.

The person I was responding to (in a conversation from last year) often represents herself as a "medical professional" while I believe really being just a lab tech. An important job but to describe it as she often does to insinuate being more in the know and professionally educated and so authoritative about the often misinformed comments she makes is misleading and I think intentionally so. My comment in this old FTE discussion was accurate. If she and her department were subject to output quotas, it's because she was doing worker bee tasks and being held to a "so many per hour" standard. Again, no problem with that, but professionals are rarely so managed. Other than like pharmacists.

Yes, there are medical personnel staff shortages in many places. . Most especially in states where there are low rates of public mask wearing, politically caused premature instances of lifting restrictions, and higher percentage populations of truth deniers and as a result, lower vaccination rates. The case stats have been so influenced after the initial outbreaks last year.

Yes, I liked your comment. Even though I know you mean the South.

********

We're not the only place though. You know Montana's just as bad, right? 😉 As an example. Check out Mayo's maps.

But yes, the unmasked places are the low vaccination and high hospitalization rate places.

Sigh.

rob, I didn't only have the South in mind but many states down there are more than deserving of criticism for their problems and irresponsible conduct. But they're not alone same problems and generally the same causes elsewhere too. I checked the Wash Po map before responding, it's a quick and easy factual source, except for data from states who have been caught fudging their reports. Yes, I knew of Montana and Idaho, also northern and more central Midwest states. Same issues, same causes, same inaction and same denials. This is a map of cases per capita, not absolute numbers.

Click to enlarge

All that matters is medical personnel is stretched really thin...They're human, and we cannot keep pressing them.

Please do what is it right

A fellow came by the house today to pick up something I was giving away. During the course of our conversation the topic of Covid came up - and he said, "Thank God it's over". Of course I told him that it was not over, that lots of people are still being hospitalized with it.

That's part of the current problem, right there. Lots of people, not necessarily politically driven or anti vax or anti mask, just simply think that the epidemic is over! These are people who don't read newspapers or listen to news (not even Fox); they just go by word of mouth.

Right?

So many of us want it over with, we don't care if it isn't done?

That's the biggest obstacle!