slave labor - page 7

I work in a medium sized er. Busy place. Usually am charge rn & triage rn (if not triage, I take on full assignment-4 pts., sometimes more if we are using hall beds). It is almost impossible to be... Read More

  1. by   pmcd8243
    These Federal laws supercede any local lawe in reguard to pay. If you do not get a lunch break at least get payed for it. The Nancy Nurse act is why nurses are treated so badly in the first place. http://www.dol.gov/esa/regs/compliance/whd/whdfs53.pdf
  2. by   fakebee
    When I read that NicoleRN07 doesn't worry about whether her shift is
    short 1 or 3 nurses, she just works harder to make up for it I was saddened beyond words. The major reason was because short staffing is the single biggest threat to patient safety and it's also managements easiest way to save money at the patients expense. If your management routinely short staffs you and you don't document the near disasters and substandard care given because of it, no nurse can call themselves a true patient advocate. My management has decided that a 3:1 pt nurse ratio in ICU is acceptable on nights because "we just can't get any help." That's not acceptable to me, so you better believe that until I find another critical care unit that believes in proper staffing for pt safety I am documenting up the whazoo whenever I or anyone is forced to take an unsafe assignment and that includes my conversations with my unit charge nurse, the house supervisor, my unit director, the DON, and the state board of nursing. I wish I could just quit but the area hospitals have all decided that having 3 pts is acceptable on a routine basis and I have to work to pay the bills. As much as I love nursing, I hate to see what it has become and I fear it's only going to get worse unless we stand up for ourselves and our pts! Right now I wouldn't recommend bedside nursing to anyone. That kills me because I think it's the most important job in nursing, and in the right circumstances, the most rewarding...
  3. by   RNtigerEMT
    Just a note to all those who think working without breaks/lunch breaks helps the other staff. I was working on a very busy cardiac med-surg unit 12 hr shifts. Due to staff shortages(caused by massive layoffs per management) i was routinely working 5-6 12 hr shifts a week, with lunch breaks the exception, pt load of up to 8 pts of my own and overseeing an LPN with 7-8 pts. Definately unsafe conditions. As a result of allowing myself to be used that way, I ended up a pt on my own floor. They lost the use of a reliable RN for one week. After that little scare, I went back to my hired hrs of 3 12 hr shifts per week. I did occasionaly pick up extra shifts, but wouldn'y allow them to work me to death anymore. I did get wrote up for missing work, even though I had collapsed on the floor during work hrs. I no longer work at that facility, more layoffs. You cannot do excellent pt care if you cannot take care of yourself.
  4. by   digidog1
    Quote from NicoleRN07
    I work in a very busy Level III trauma center, where we see approximately 180-220 patients per day. It is rare that any of us get an entire break. That, unfortunately is just part of working in the ER. You can't always stop to take a break, so when you can....enjoy it! Try Protein Bars....you can eat them while running down the hall, and you'll stay full.
    My dear, if you're working in a level III trauma center you are NOT seeing 180-220 pts. a day!! You surely mean a level I trauma center. You are lucky to see 10 pts. a day in a level III!! Make sure you have your facts right before you get on that soapbox! It can be really slippery up there!!
  5. by   tencat
    Quote from NicoleRN07
    AND YES, I AM A WORKAHOLIC!! I am proud to call myself a nurse. My needs may not always be met, but it is my job to make sure my patients needs are!
    Honey, if one's needs aren't met, there is NO WAY that one is giving the best possible care he/she can give and adequately meeting the needs of the patient. The less one takes care of one's self, the more prone he/she is to making a serious mistake as the shift wears on. Management counts on our 'dedication' to the job to coerce us into thinking that we should have no needs that need to be met on the job. It is not wrong to take ten minutes to pee and eat something. It is wrong to expect that all nurses should work through fatigue and discomfort for the 'good of the patient' which usually with management is double speak for 'good of the company's bottom line'.
  6. by   schroeders_piano
    Quote from digidog1
    My dear, if you're working in a level III trauma center you are NOT seeing 180-220 pts. a day!! You surely mean a level I trauma center. You are lucky to see 10 pts. a day in a level III!! Make sure you have your facts right before you get on that soapbox! It can be really slippery up there!!
    Just because it is a Level III does not mean it is not a busy ER. I worked in a ER with no trauma rating and we saw around 100 patients a day as did the bigger ERs around us. Maybe you need to get your facts straight before you get on that soapbox. I hear it can be slippery up there!
  7. by   middlekane
    Quote from NicoleRN07
    I'm not saying that you should never get a break....believe you me, I enjoy my 30 minutes as much as the next person, all I'm saying is that in the world of nursing, things happen that can not be controlled, and there is not time to take your lunch break, nor is it appropriate. When I am in charge, I always make sure that my staff gets to at least get a few minutes to sit down and regroup, but, when I have 20 people waiting to be seen, 10 to be triaged, 21 already in the back, with a pile of orders that need to be carried out, then NO, we will not have a break until things are at least partially caught up. My needs and the needs of my coworkers are important, but, we can not simply slow down the process of treating patients in the ER while we get our breaks in. Complaining to higher management is going to do no good, because you guys are right, they don't care, but honestly, they can not control the situations that we encounter day to day that sometimes prevent us from getting our breaks. Of course, they could hire more nurses, but really, is that going to make a difference? If you have high volume and high acuity patients, then you need an extra hand or two, and you're just going to have one more nurse who didn't get a break that shift. Nursing is not like most jobs where you get to a stopping point and can leisurely take a lunch, most days there is no stopping point. Sure, you can have a float nurse care for your patients while you break, but when you have an AMI patient who is unstable, are you really going to feel comfortable reporting off to another nurse and going to eat? I know I'm not......I know if I were the patient, then I wouldn't want my nurse to leave me with a different nurse who knew only what was given to her in report so she could go eat. That, in my opinion is selfish, and uncaring. We should never put our needs ahead of our patients, especially when our need is the need to eat, and our patient needs life saving measures.
    If I were an acute MI, I would want a nurse that was with it. That was able to concentrate and wasn't thinking about her need to pee or her desperate need to eat because her blood sugar is 60. So yes, I would prefer having her switch off and have someone else take care of me while she grabbed a quick bite (doesn't need to be 30 minutes) and came back. The most selfish thing one can do is to believe that we are inhuman and that we can simply rise above physiological needs without affecting patient care. We might think that we can, but we are just like everybody else. We don't think clearly when we are hungry, exhausted, have to pee, or are in pain. It affects patient care adversely when we do so.
  8. by   digidog1
    I'm sorry, I don't think I mentioned ANYTHING about a small er not being busy, but was rather pointing out the distinction between a Level I and a Level III trauma center which the author of the quote was incorrect about. And though it is possible that you see over 100 pts. a day it is NOT the norm for small rural ers that fall under that level III or no designation status that I am speaking about. I am quite clear on the FACTS as I have worked in many facets of nursing and in many large and small hospitals all over the country. How old are you? 25? . Talk to me in 15 years when you have a little more experience under your belt sweetie.
    Quote from schroeders_piano
    Just because it is a Level III does not mean it is not a busy ER. I worked in a ER with no trauma rating and we saw around 100 patients a day as did the bigger ERs around us. Maybe you need to get your facts straight before you get on that soapbox. I hear it can be slippery up there!
  9. by   caroladybelle
    Could we get back to discussing the topic and not having urine fights about level I vs II busyness?

    There are PMs for having turf wars.
  10. by   RedERRN
    Quote from digidog1
    I'm sorry, I don't think I mentioned ANYTHING about a small er not being busy, but was rather pointing out the distinction between a Level I and a Level III trauma center which the author of the quote was incorrect about. And though it is possible that you see over 100 pts. a day it is NOT the norm for small rural ers that fall under that level III or no designation status that I am speaking about. I am quite clear on the FACTS as I have worked in many facets of nursing and in many large and small hospitals all over the country. How old are you? 25? . Talk to me in 15 years when you have a little more experience under your belt sweetie.
    Wow. This is a perfect example of "eating your young." Great job, digidog!
  11. by   chip193
    Quote from digidog1
    My dear, if you're working in a level III trauma center you are NOT seeing 180-220 pts. a day!! You surely mean a level I trauma center. You are lucky to see 10 pts. a day in a level III!! Make sure you have your facts right before you get on that soapbox! It can be really slippery up there!!
    Trauma designation has nothing to do with other complaints. What good is a Trauma Center if you're having an MI?

    One of the busier ERs in the area is at the top-rated heart hospital in the state. They are not a trauma hospital (and it's actually kind of funny to see the reaction of the staff when a shoot or stab shaows up through triage!), do not want to be a trauma hospital, and unless things change at the top, will never be a trauma hospital (the Level I Center is a mere 2.2 miles down the street). But, they see 75-80K patients a year - right at the 180-220/day that the OP noted.

    Chip
  12. by   kalbo3
    I would also look into another job. Who is going to be the first one in your department to kill a patient or lose their license because of fatigue or stress? You must take care of yourself before you can take care of others. Food for thought.
  13. by   BULLYDAWGRN
    I work in a level III and partime in level II here in Ms. I know for a fact we see about 35,000 pts a yr, and the level II is more 35-40,000 per yr. The trauma center designation levels here in Ms have nothing to do with the number of pt's you see, but more with the medical care capabilities of the facility. As far as the original post, I think it's going to be hard to change administrations view of staffing. There has been times I've had to go without a meal or a break but thank god it's not everyday. There are times you have to have a break or just a walk outside to get away from all the crap..

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