By Shawn Kennedy, AJN interim editor-in-chief

After I last wrote to you from the NTI (the American Association of Critical-Care Nurses’ annual National Teaching Institute and Critical Care Exposition), I headed back to the exhibit hall to check out the helicopter and the Army’s mobile operating tent. But I didn’t get to either one, because I met a young critical care nurse from a regional hospital in Missouri. We chatted about her workplace, and it was obvious that she was very proud of the work she and her colleagues did. When I asked her, “What’s your biggest issue?”, she said that it was probably staffing. I expected her to cite the shortage and the difficulty of finding qualified critical care nurses. But that wasn’t what she meant—rather she was talking about  bare-bones staffing because of tight budgets. Her hospital routinely switches between two tactics: it sends nurses home when the patient census is low (when this happens, the nurses are paid only $2 an hour to be on call, but must still use a vacation day to retain full-time benefits, a tactic that rapidly depletes their vacation time); or, when the patient census is higher, the hospital imposes mandatory overtime, creating havoc in nurses’ schedules, finances, and personal lives. And people wonder why there’s a nursing shortage! […]