How Nurses Can Advocate Against Short Staffing While Staying Employed

How Nurses Can Advocate Against Short Staffing While Staying Employed

Nurse Staffing and You

With one out of two nurses reporting inadequate time with patients, you’ll probably experience some form of short nurse staffing during your career. Even though research indicates that short staffing increases the chance of patient complications and medical errors, you may find that your facility still fails to employ enough nurses. Rather than risking burnout or delivering poor care to your patients, it’s important that you know how to ask for the extra help you need without placing your job in jeopardy.

Nurse Staffing Requirements Under the Law

Federal regulations require that medical facilities that participate in Medicare have adequate nurse staffing. The regulation does not specify specific staffing ratios, so thirteen states have passed laws that require facilities to publicly disclose staffing-to-patient ratios or have staffing committees that determine nurse staffing levels. Only California has a required ratio of nurse to patients while Massachusetts has a required level of nurse staffing for Intensive Care Units only.

Some states may not specify appropriate staffing levels but they may protect nurses who advocate for their patients. For example, the Texas Nursing Protection Act doesn’t allow employers to retaliate against you if you report them to a regulatory body because you have safety concerns related to poor staffing levels.

Advocating for Adequate Staffing Levels

Due to the lack of state-mandated staffing levels, your best option for increasing staffing is to advocate for management to provide better coverage. When asking for better coverage, your request should be clear and cite specific examples. If your facility has a nurse-driven staffing committee, you should discuss your specific on-the-job concerns with management that can refer this information to the committee.

American Nurse Today suggests you use the SBAR (Situation, Background, Assessment, Response) technique to discuss staffing shortfalls with management. Always start with your immediate supervisor; most medical facilities are hierarchical structures that strongly rely on the chain of command. It’s also important that you assess any response you receive and decide who you should speak to next to get an acceptable response.

Also consider joining professional organizations that advocate for legal protections for nursing and other regulations. If you belong to a union, make sure that your union is respectfully working with your employer to address short staffing issues.

As the Baby Boomer generation continues to age, short nurse staffing will continue to be a problem you’ll have to address. In addition to advocating for your patients with management, make sure that you’re consistently updating your own training and work habits to be the most effective nurse for your patients. That way you’ll be in the best possible position as a nursing advocate and a professional.

What is the Nurse Practitioner Scope of Practice?

What is the Nurse Practitioner Scope of Practice?

Through state laws and regulations, some states limit how a Nurse Practitioner (NP) can interact and deliver care for patients. The limitations are what defines the scope of practice. We understand that keeping up with the changes can be challenging, so we created this page to give an overview of scope of practice information for Nurse Practitioners.

Our Locum Tenens division, Medestar, created a handy state-by-state guide to review the laws. This is especially useful for nurse practitioners who are looking to relocate for jobs and need to know the laws in their new state.

California Scope of Practice

The sunshine state is not so warm to the idea of Nurse Practitioners having full scope of practice. California has some of the most restrictive laws.

  • Restricted practice authority; must have policies in place that follow standards of the state Medical Board 
  • May prescribe drugs and devices provided it is authorized through the protocols in the collaborative agreement; Schedule II-III require physician involvement and care plan
  • NPs are recognized in state policy as primary care providers
  • Regulatory Structure: Restricted Practice
  • Regulatory Agency: Board of Registered Nursing
  • Licensure Requirements: RN license and a graduate degree.
  • Nurse Practice Act

Texas Scope of Practice

If your job search sends to you to the Lonestar state, your partnership with the physicians in your practice will be important. Texas like California has restricted practice authority.

  • Restricted practice authority; written protocol required with a physician
  • NP may prescribe as outlined in the written protocol
  • NPs are recognized in state policy as primary care providers
  • Regulatory Agency: Board of Nursing
  • Licensure Requirements: RN license, graduate degree, and national certification.
  • Nurse Practice Act

Want to learn about more states?

Visit Medestar’s Full NP Scope of Practice guide here.

PRESS RELEASE: THMED Acquires CV Staff Solutions

PRESS RELEASE: THMED Acquires CV Staff Solutions

THMED, a nationwide leader in permanent and temporary healthcare recruitment, completed a strategic acquisition of Colorado-based CV Staff Solutions, a niche healthcare staffing solutions company. No financial terms were disclosed.

PRESS RELEASE Dallas, April 15, 2019 – THMED, a New Capital Partners (NCP) portfolio company, today announces that it is has acquired CV Staff Solutions, a specialty inpatient locums and perfusion staffing company. The acquisition accelerates THMED’s vision of providing more access to qualified medical professionals for current and new clients and expands CV Staff Solutions services on a national scale.

Founded in 2014, CV Staff Solutions specializes in optimizing the inpatient cardiovascular service line efficiency through long term coverage arrangements. CV Staff Solution’s roster of highly qualified cardiovascular surgeons, cardiologists, perfusionists, and other cardiovascular specialists offer continuity of care and help stabilize a financially critical service line to hospitals. CV Staff Solutions has been successful in recruiting and retaining providers, as well as clients, because of their personalized approach, understanding of the clinical needs, and deep network in the space.

Dr. John R. Mehall, CEO and founder of CV Staff Solutions, said, “We are thrilled to partner with and join THMED. We will be able to leverage THMED’s infrastructure, experience and expertise to bring our services to more hospitals around the country. THMED’s extensive team of recruiters will enable us to serve clients across a broader spectrum of subspecialties.”

John Martin, CEO and founder of THMED, added, “The CV Staff Solutions team has consistently delivered medical staff augmentation solutions that resonate with locum providers as well as client hospitals. We are elated to partner with them and look forward to expanding their service delivery model. Our partnership increases value for clients in a high-demand, ever- changing market.”

About CV Staff Solutions: CV Staff Solutions is a niche healthcare staffing provider based in Colorado Springs, Colorado. The company focuses on providing cardiovascular surgeons, cardiologists and non-physician providers, including perfusionists, to inpatient care facilities. CV Staff Solutions helps clients address ever-changing healthcare staffing challenges while at the same time offering medical professionals the opportunity to supplement their existing salary and gain flexibility over their schedules. For more information, please visit

About THMED: THMED is a leading healthcare staffing firm focused on locum tenens and permanent placement. Celebrating its 10th year of business and recognized amongst the best for company growth, THMED provides its clients with a complete staffing solution that relies on
the latest technology, proven search strategies, and expert consultation. Focused on helping its clients provide quality health care to their communities THMED’s consultants serve hospitals, medical groups and other healthcare facilities across the United States. For more information, please visit us at

About New Capital Partners: New Capital Partners (NCP) is a private equity firm headquartered in Birmingham, Ala. NCP makes investments in niche, tech-enabled services companies in the healthcare, financial and business services industries. Because of the firm’s extensive operational experience, the firm seeks to gain significant value in portfolio companies by focusing on one core goal: building great companies. For more information, please visit

7 Tips for Staying Healthy While Travel Nursing

7 Tips for Staying Healthy While Travel Nursing

We all know the temptation to indulge in delicious foods while in a new place. When on a short assignment, it might be easy to slip into a pattern of eating more than you would at home, ordering that high-calorie Starbucks, or trying all of the local cuisines. But just because you’re away from home, you do not have to be away from your normal health and wellness routine. Here are 7 tips for staying healthy while travel nursing.

      1. Start your day with water

Before doing anything else for the day, drink a full, 8 oz. of water. This will hydrate your body and satisfy your appetite so that you don’t overeat at breakfast. But also…

       2. Do NOT skip breakfast

There’s nothing worse than going into work with hunger pains. You’re sluggish, cranky, and will likely binge on something unhealthy later to calm the cravings. You can avoid facing this problem by simply eating a balanced breakfast before leaving for the day. It’s important to eat a meal with healthy fat, protein, and carbohydrates in order to keep you fuller longer. Things like avocado toast with an egg on top or oatmeal with fruit can curb your appetite and keep you satisfied till lunch. Check out this website for healthy breakfast ideas.

       3. Do a hunger check

Most of the time, when you’re craving pizza or thinking about downing a bag of chips, you aren’t hungry… you’re just bored. Try to distract yourself, drink a glass of water, and reevaluate in twenty minutes. If you’re still hungry, likely the craving will have gone away, and you can make a healthy decision on a snack to eat to tide you over until your next meal.

       4. Treat yourself…. But not too much

You’re in an exciting new place! It’s important that you embrace this experience. So, while working on a thirteen-week assignment in Maui or even just a couple weeks in rural Minnesota, allow yourself planned treats from a couple of new places. This will help satisfy you while also maintaining a balanced diet.

       5. Remember, a few weeks makes a difference

Whether your assignment is just for a few weeks or for 13-weeks, what you do during that time will make a difference to your health. You might slip into vacation mindset and overindulge, planning to get back to your routine when you return home. But your body can undergo a lot of change over the course of your travel assignment, and it’s important to stick to your eating routine from home as much as possible.

       6. Don’t count on finding a gym

If the gym is your usual spot for getting in your workout, try to discover a new fitness hobby. Maybe you’re on assignment in California and can try surfing or swimming. Or you’re in beautiful Gainesville, Florida and can hike every day to get in that cardio. Whatever the case, find something fun to do while away so that you can keep your body healthy while trying something new as well.

       7. Release stress

Stress causes more damage to our bodies than we realize. According to the American Psychological Association, health is the third most common source of stress. Trying to count calories, get in daily workouts, lose those couple of pounds… It gets overwhelming. Your mental health can really take a toll. An easy way to check for tension in your body is to do a quick check on your face, your hands, and your shoulders. Are you tensing any of them? Let it go, and take a deep breath. Yes, clean eating is important, as is fitness. But stress can have physical consequences, causing weight gain, appetite fluctuation, overeating, etc. So, let go of the stress, and make health an enjoyable journey rather than a box to check.

As a nurse, what you do is important. You save lives and help promote health wherever you are traveling. Remember to take care of yourself, too.

What are the Different Types of Dental Practices?

What are the Different Types of Dental Practices?

There is a significant expansion of dental practice models in the country as the demand for dentists grows. The average person would assume that all dental practices are privately-owned by the dentist who works there but that is not always true. Here is an explanation of the different types of dental practices.

Dentist Owned and Operated Group Practice

This can be an individual dentist or a group of dentists who wholly own their practice and run all the administrative and business aspects of the practice. Typically, these are considered practices who are not affiliated with any DSO. Dentist-owned practices can also have multiple locations.

Dental Service Organizations (DSOs)

Some people get into healthcare wanting to practice independently but may want assistance with the actual management of their practice. This is where a service or support organization comes in. According to the Association of Dental Service Organizations, these groups ” contract with dental practices to provide critical business management and support including non-clinical operations.” You might also hear these relationships referred to as “corporate dentistry.”

A DSO may provide services including employee relations, practice technology, and financial management. By law, they can not manage the clinical decisions in the practice, those must be made by a licensed professional dentist. This article does a great job explaining the impact of DSOs on the dentistry industry.

Non-Profit or Community Health Practices

According to the California Dental Association, working at a non-profit or community health practice usually means “charitable, educational or quasi-governmental organization that often focuses on providing treatment for disadvantaged populations or training health care professionals.” Often times, there are benefits like loan forgiveness when accepting positions with these types of practices.

If you need help to find a dentist practice for you, please reach out to THMED and we will connect you to consultant to discuss new opportunity options. Email us at