Dear Hospital Management,

My birthday is coming up in May, and I thought I'd let you know ahead of time what I'd like so you can get working on it.

I would like my unit to be appropriately staffed all the time. I don't want it to be an unexpected surprise when we have two CNAs on the floor, or when I get my 15-minute breaks.

Last night we were dangerously understaffed considering the complexity of our patients. We had all twenty-six beds filled. Three of our patients are worth *at least* the work of two our three patients themselves. We've been good. We are doing our PCHs as diligently as we can.

For a full house, we are supposed to have a Charge, two Resources, and two CNAs on the floor. There was one Resource and one CNA.

This is just plain wrong.

One of my patients last night has CDiff, is incontinent, and has a Stage II pressure ulcer on his coccyx. I cleaned him 5 times in my 8 hour shift. Each time I had to spend *at least* 20 minutes just trying to find someone, anyone, to help me clean him up. That much feces near that severe of an open wound for that long is just *screaming* to brew a massive infection. On top of that, this pt's wife is *very* involved in her husband's hospital stay, and not in the good way. This guy is doing his best for a TTJ and we just keep putting in new corpaks (Don't even get me started on the corpak adventure. Let's just say that after as many X-rays he got, I wouldn't be surprised if he started glowing in the dark.) and turning him every 2 hours and doing dialysis and putting restraints on so he doesn't pull things off.

I spent at least four hours of my eight-hour shift just on him, nevermind my other three patients (two of whom were mentioned in my adventurous last post) who thank god didn't do anything exciting.

So much time could've been saved if there'd been more help around. I had to rush to check on bed alarms because there was no one else. And bed alarms are only effective if there's someone to hear and react, much like the tree falling in the wood.

I know we're going through a lot right now, what with our realignment nonsense. I know you don't want to hire any new outside people until you figure out where all of us inside are going. But just because you're planning for the future doesn't mean you can ignore the present. When you are in the hospital, the present is all you have. If you don't take care of it, you don't have a future to worry about.

So, Management, if you have any shred of love for your faithful employees, you'll give me this one little thing I'm asking for. You still have two months to get it together.

Thanks for your time,

PurpleRN