Very poor retention of staff RNs. Most units are staffed by agency. CNO continues to place agency/travel RN scheduling preference over full time staff. Agency nurses not held to same standard of staff, are often late with attitudes and openly on cellphone not working on shift/taking multiple breaks and expecting staff to do their work. Patient care suffers. Directors of departments are essentially “yes men” with CNO micromanaging all decisions. Very high turnover rate for staff RNs and unit directors. Poor communication between house supervisors and management regarding daily staffing. Despite being fully staffed with agency and state nurses full time staff are denied earned PTO. Mandatory overtime. Staff nurses are expected to orient agency/state RNs and preceptor new staff and students without compensation. Inadequate orientation before working the floor then staff scrambling to teach employees 4 different systems for charting, reviewing labs/physician documentation, 2 different systems that do not fully communicate to input and review orders with multiple logins and passwords. New employees are not trained nor do they have access to order entry leaving the staff to do extra work of these nurses. Staff arrive to units without being placed into the med access cabinet or patient charting access once again leaving staff scrambling to obtain access so these nurses can function independently. Mix of paper and electronic orders and charting with systems not fully communicating leaving gray area for orders like labs and medications to get missed on the regular. For example serial H/H on a bleeding patient not being put in the system not communicated correctly to oncoming nurse and being missed until almost 12 hours later. Very dangerous all around due to multiple systems and mix of mostly transient and new staff. As staff you are expected to be unit secretary, food and nutrition services, housekeeping and tech. Upper management does not have staff nurses best interest in mind not patient safety.
