[nursegoodlove]

In our one ECU the management sometimes resort to a "contingency plan" when they cannot (or say they can't) replace an RN. On a day or eve. shift - that means one RN may have to look after 50 patients (and these pts have "racks" of meds.) & at night......they will allow one RN to look after 100 patients (on two floors - going up and down via an elevator). They "try" to bring in an LPN to help give meds. but because there is such a shortage of LPNs - they often end up with nurse aides. So - the RN is left to give all the meds, prns, tube feeds, deal with the sick, dying, those that have fallen (one floor alone has 10 bed alarms), maintain any IVs running,etc. These pts. are varied: frail, elderly, chronic, multiple system failures, some quads, para, ms (younger folk - who are just as vulnerable as the elderly).
The worry here is that "when" (as it is just a matter of when) something goes awry - it will be the sole responsibility of that RN to pick up the pieces and take the fall. Some of these patients run at full codes.
Is this as insane to you as it is to me?
I don't know how that nurse will live with herself when that "when" happens. Nurses tend to take those kinds of things rather personally & I rather doubt that the management/admin. that put them in that situation will give any support.
Some nurses fill out professional responsibility forms that protest the unsafe conditions - they are the smart ones - but, there are those who are ESL or "superwoman" mentality that put up with this.
Does this happen to anyone else? Does anyone ever refuse to do it (which is what "should" happen)?

[MisterArnold]

Any hospital, nusing home, rehab, etc. that allows this to happen needs to reported ASAP to the State. They are in violation and could have their license yanked.

[nursegoodlove]

Hi MisterArnold,
Unfortunately, this was reported to local MLA (Memeber of Legislative Assembly) & the hierarchy of management/admin. & nothing done. It then made it to the front page of the local paper as well as a major paper (The Province).
Needless to say, the attention "slowed" things down for awhile but, the practice still continues.

[sjoe]

Any questions about their being a "nursing shortage" in Canada as well.

Amusing that "management" does not schedule itself to work on the floor when it is unable/unwilling to do its own job, which includes finding adequate staffing. It does not put itself at risk, nor does it work any harder under these conditions, and goes home at the regular time. So, it has no reason to change the present "contingency" policy.

Obviously your government, "higher" management, and the public are not willing to help out. Time for a union, IMHO.

[gwenith]

Keep up the pressure - do you have a union??? Is there an accreditation facility overseeing your facility? What is the legislation relating to "Duty of Care"?

My thoughts and best wishes go out to anyone caught in a situation like that but my only advise is to keep the pressure up and keep looking for different avenues.

[nursegoodlove]

Thank you for the replies sjoe & gwenith. Yes, the "nursing shortage" is alive & well in Canada. Our govt. is also in the throws of "pink slipping" virtually hundreds of RNs as I speak & replacing them with LPNs. I guess that's one way to take care of the shortage? We have had a Bill 29 legislated on us (in the dead of the night) that has opened the door wide up to contracting out, gutting of our contracts - "legislative vandalism" (yes, we are unionized) and privatizing our universal healthcare. We are going the american way - while the americans are "trying" to come our way! We have an extreme right wing, anti-union, big business loving govt. Very seriously, everything from our LTC facilities to ERs, surgical, etc. are open for auction.
Interesting you point out that management do not roll up their sleeves to help out in these horrid situations. During our job action 2 years ago - they even refused to check charts for fear of jeopardizing their licenses. What do they think they are doing to these nurses in our LTC with this type of "contingency plan"? What's that saying - "all animals are equal but some animals are more equal than others (Orwell)."
There is accreditation but, I believe they only appear once every three years & it is unpredicted when they show & it is in and out very quickly. See no evil, hear no evil.
I am not sure about legislation/policy on "duty of care" but I thank you for bringing it up and am going to ask the union about that!
Once again, I do appreciate the feedback. This is a very frightening event.

[janfrn]

Holy cow! I can't wait for my parents to move out of BC. We really don't hear much over here in Alberta (and of course we're up to our ears in fertilizer ourselves right now over our contract... see "Is this any way to retain nurses?" in the Political Activism forum) about what's happening on the other side of the hill. I'm appalled, frankly, that this is being condoned in Canada. Maybe someone needs to ask the management (if they're nurses) if they really believe their licenses are safe when they knowingly put other nurses in the position of having to defend theirs. Take it to the families of your patients. They are all voters. Make noise. Have your families make noise. If you're careful, you can get your message out in a factual manner without breaching any rules, and the squeaky wheel eventually gets the grease. Even a partial victory is better than status quo.

{{{{{{{{{{nursegoodlove}}}}}}}}}}

Hugs from the frozen hinterland!

[maxy2006]

Nursegoodlove,

This is fabulous information for my union vs. nonunion lecture! Especially how Canada is trying to go the American way and vice versa. Not so fabulous for you it sounds, though. What exactly is the Bill 29? How is your union supposed to be helping in this situation (I can't pretend to know a whole lot about unions, but I'm trying to figure it out!). If you could even explain a little more about how this affects patient care. I realize the affects are pretty obvious, but if you could get some time to cite some specific examples, that would be great!

[ktwlpn]

Originally posted by nursegoodlove
What do they think they are doing to these nurses in our LTC with this type of "contingency plan"?

And what are they doing to these residents with this kind of staffing? Maybe the families can call attention to this matter-I would raise the roof if my loved one was a victim of this "contingency plan"....

[nursegoodlove]

maxy2006, Bill 29 is a bill that was legislated by our provincial govt. It is called the "health & social services delivery improvement act". The main aims of the bill (for the govt.) were to: "allocate staff where needed"(up to 50 kilometers or more), erode one contract for all nurses, eliminate successorship rights for unions & lessen employment security. Allows contracting out/privatization of public health services, cut costs (wages, benefits), no consultation with staff re: downsizing/closures & displacements, allows the transfer of services/programs, make you work multi-sites. All nrsg. work in LTC& community can be contracted out to private, for-profit business. In acute care, all out-pt. clinics, day surgery, ambulatory care, kidney dialysis, emergency wards...can be contracted out. If work is contracted out - you can lose your wage/sick time/seniority/vacation entitlements/your pension/benefits/union membership & rights.
The unions are taking the case to the supreme court.
It affects pt. care because "a nurse is not just a nurse" - when you talk about floating RNs btwn. sites or floors - which is a risk for the pt.s(i.e.: you would not want a pediatric nurse being forced to work in ICU - totally different specialities and, if you are unfamiliar with a unit/where equipment is being kept/routines/procedures/policies...there are risks). There is also the issue of not having continuity of staff - which could be a problem with follow-up on the pt. Going private means people will have to pay for care out of their pockets & that could mean that people that do not have have the financial means - do not get the care needed.
Hope this helps & good luck on your lecture!