Has anyone really broke down the numbers?

Nurses General Nursing

Published

I am getting ready to close in on my 2-year anniversary as a licensed RN and read so many stories about how hospitals do not staff based on acuity, how staffing is pushed to the maximum limits and how hospitals claim they have bugeting issues with payroll.

If anyone, would like to make a fortune...I mean, a serious fortune, they would come up with a National Nurses Union and unionize every licensed nurse in the country and force these corporate hospital CEO's to cut back on their second homes in Barbados and their $120K Mercedes and make sure that patients got their care they deserved rather than PRETENDING that they do.

I'll be the first to admit...I am a NICU nurse and I am very blessed to work in a unit that is based on acuity. For that reason, I would quit nursing if they ever tried to transfer me to another department and work at Walmart...because not another department in our hospital does.

I float to the Pediatrics department as well and one night I was given 6 patients.....5 is typical. These are kids with chronic conditions, mostly, that come in and out of the hospital and I was hanging IV drug after IV drug of meds I had never heard of....the charting is different from my department and it was all I could do to keep up. Do you think that any of those kids got quality care that night? Heck no they didn't...it is sad that "alive and well" becomes the standard of which you rate your patients when you leave your shift....not that you did anything to improve the situation.

On average, the nurses at our hospital make about $22 per hour. Let's say you have a patient room of $2,000 per day and 5 patients. That is only $4.40 cents per hour, budgeted to take care of each one of those kids in direct care.

A clerical..probably getting $10 per hour..but she is the clerical for the whole unit for each shift, which usually equals about 30 to 35 kids.

One CNA...for the whole unit.

Respiratory Therapy..billed as specific treatment, along with radiology, etc..., so their labor is built in when the service is rendered.

Now, I understand, that I am not factoring in managers, case workers, housekeeping, security, etc.

But still...it makes you wonder.

There IS a National Nurses union- National Nurses United- an offshoot of the California Nurses Association. Look them up on the internet.

They have achieved staffing ratios in California, and far better working conditions, pay, benefits, and pensions, in VERY anti union states, like Texas, Florida, Nevada. worplace safety, and protection to be able to advocate for your patient.

Look them up, and contact them. Take the plunge and help organize your hospital. To quote from an old Star Trek episode, "every revolution starts with one voice".

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

Specializes in pediatrics, public health.
So nurses who work in hospitals with unions never have to float? I guess I don't see why someone who works in the NICU floating to a general peds unit is exploiting the nurses if 5 or 6 is the norm for all nurses there. When I worked at a peds hospital I worked everywhere, the longer you are there the more familiar those typical diagnoses for that unit become, as well as the unit's unique documentation requirements.

At the unionized peds hospital in CA where I worked, the max ratio was 4:1 on the acute floors, 3:1 in the PICU and 2:1 in the NICU. Critical care nurses were floated first to other critical care units and acute care nurses to other acute units. Occasionally it was necessary for critical care nurses to float to acute units and vice versa. NICU nurses who floated to acute units were supposed to be given an all-baby assignment whenever possible, and generally our charge nurse would try to give them the easiest pts, especially if there weren't enough babies for them. When acute care nurses needed to be floated to a critical care unit, they were given the easiest possible assignment, and were assigned a "mentor" nurse to look over their shoulder and help them. The small number of times I was floated to the PICU or NICU this is exactly what happened.

Prior to becoming a nurse I was lukewarm towards unions, but I feel very strongly that I never want to work as a nurse anywhere that isn't unionized, and I thank God that I work in the only state that has patient ratios -- I am sure that I could never work as a nurse in any of the other 49 states until and unless ratio laws are implemented elsewhere!

Specializes in Med/Surg, LTC/Geriatric.

I was neutral in terms of unions before becoming a nurse. Now that I belong to one, I am very happy to have it!

There are pros and cons, but I feel that the pros far outweigh the cons and I am happy to have them backing me.

I read some of the stuff here about horrible staff ratios, low pay, constant worry about being reprimanded and fired for certain infractions that boggles my mind. Being written up for calling in sick mor than 2 times in 6 months, not getting any raises for over 2 years etc.

Very happy to belong to a union.

Specializes in M/S, Travel Nursing, Pulmonary.
Then here is the thing....

Statistics show that the majority of nurses feel that the workplace needs to be improved, that they are given unsafe assignments, many more planning to leave the profession, leave bedside nursing within 5 years of school, etc.

So...that is a lot of unhappy people that do not like the way we are TREATED...however, I am sure most of us like the work we do.

Corporations...have had decades to do things the right way.

So to those that do not think a National Nurses Union is possible...I think for every one that wouldn't join would a nurse that would no longer have the right to complain..especially when an alternative is given.

I agree with you on a lot of levels, but convincing nurses to band together under one name is..........well, may as well be trying to prove water is not wet.

Its not in the personality of the majority of nurses to "go with the flow" or to be told how to feel about certain issues. Take the issues at my hospital for instance. The union (does not include nurses) voted itself a raise last year despite many pleads from the admin. to allow salaries to be frozen. The vote to decline to let salaries to be frozen was very close. Many dietary and CNAs were unhappy with the union's attitudes. Yet, on the other hand, the higher paid dept's (maintenance and a few others) got their way.

Now put nurses in the position of the CNAs and dietary. They feel the hospital should be allowed to freeze wages for one fiscal year (while promising no lay-offs for that year) and the rest of the union tells them they have to stand with them while they say otherwise. Not gonna happen. A great many of the nurses would be in the managers/admin. office proclaiming their independence from the union...........hence it don't work.

In short, nurses as individuals value...........individuality too much to be in a well functioning union. Look at a great many of the threads/topics on this site. There is not a single thing we agree upon. Heck, there is even a thread where the actions of a hospice nurse who was sleeping with a married dying pt. were defended. We can't even agree on the basic moral principals of our trade. How are we going to band together on financial issues or decide when is the right/wrong time to strike?

TBH, although I do see the value in unions, that is the issue that keeps me from being a supporter. I look around, see how many of my coworkers and other nurses act/behave and think to myself "If I were in a union with this person, they'd have a vote on how I choose to act/treat admin etc.... Not good."

I agree with you on a lot of levels, but convincing nurses to band together under one name is..........well, may as well be trying to prove water is not wet.

Its not in the personality of the majority of nurses to "go with the flow" or to be told how to feel about certain issues. Take the issues at my hospital for instance. The union (does not include nurses) voted itself a raise last year despite many pleads from the admin. to allow salaries to be frozen. The vote to decline to let salaries to be frozen was very close. Many dietary and CNAs were unhappy with the union's attitudes. Yet, on the other hand, the higher paid dept's (maintenance and a few others) got their way.

Now put nurses in the position of the CNAs and dietary. They feel the hospital should be allowed to freeze wages for one fiscal year (while promising no lay-offs for that year) and the rest of the union tells them they have to stand with them while they say otherwise. Not gonna happen. A great many of the nurses would be in the managers/admin. office proclaiming their independence from the union...........hence it don't work.

In short, nurses as individuals value...........individuality too much to be in a well functioning union. Look at a great many of the threads/topics on this site. There is not a single thing we agree upon. Heck, there is even a thread where the actions of a hospice nurse who was sleeping with a married dying pt. were defended. We can't even agree on the basic moral principals of our trade. How are we going to band together on financial issues or decide when is the right/wrong time to strike?

TBH, although I do see the value in unions, that is the issue that keeps me from being a supporter. I look around, see how many of my coworkers and other nurses act/behave and think to myself "If I were in a union with this person, they'd have a vote on how I choose to act/treat admin etc.... Not good."

The mentality change that needs to take place in nursing, needs to start with the selection process for nursing school. There has to be a way, in the pretest and psychological testing, that potential nursing students take, to screen out the "martyr marys", and look for qualities that suggest unity, strength, assertiveness, etc. You get the point.

Also, the individuals who are teaching nurses, and the curriculum, needs to be upgraded to include, the historyof unions, and how they have in the past improved workplace pay, conditions, how they have made a difference, Employment law, Administrative law, Insurance law. These classes will teach nurses what their rights are in the workplace, the concept of "strength in numbers", and the cases that prove the points of these. Ex- nurse unjustly fired, and successfully sued hospital/employer for $$$$.

Also, the sacrifices that unions made in the past that we now are reaping the rewards of- 40 hour workweek, Overtime laws, child labor laws. If our past union members, had not sacrificed what they did, we would ALL be in alot worse shape than we are now. The difference in a union work place, and a non union (right to work- for less), workplace.

Student nurses need to be taught how important they, and other nurses are, what we bring to the workplace, positive patient outcomes, how We improve the hospitals financial bottom line, how to develop a nursing cost center with our own budget. No more of the, you are a dime a dozen, you are unimportant, you are lucky to be here, blah blah blah. Rolling our professional practice into the room rate, housekeeping, laundry and the complimentary roll of toilet paper. Medical Students, Law, and Dental Students all have an uphill battle to get accepted into their respective professional schools. Yet they are not subjected to the negative classroom atmosphere, that student nurses are. They feel good about themselves and their classmates.

In Law School, it is routine to form study groups, to evaluate their class work, help each other out to analyze the law. If you have not see, "Legally Blonde", with Reese Witherspoon, it is a must see. It shows the Law students in the Law Library, every night ,weekends, studying together, working together for a common goal -to understand the law, pass Law School, and graduate to become succesful lawyers. Nurses could learn alot from this.

While they are in law school, and the interns and residents what we work with, are all coming together to plan on practicing together after they are out on their own, they form their own practice groups, etc. They LOOK for opportunities to join together, not hate each other, and backstab by tattling like 4 year olds.

Yet you don't here of them being told, that they are a dime a dozen, are lucky to be here, so you can kiss my behind, and take a lot of crap, because I want to treat you that way. Backstab other students, etc.

What can nurses do to prevent that awful student experience? It is up to nurses to improve what is going on. A National Nurses union, such as the National Nurses United, is a step in the right direction. Each and every one of us, could do something to improve the nursing profession ,if we only tried, and were encouraged to do so from the get go. Law students work with practicing lawyers in the community. Lawyers feel it is their duty to pass the torch to new Lawyers, and students.

Most importantly, nurses need to look at their fellow students for the potential joining up after graduation, and first two years of employment, and form "practice groups", incorporate and sell their services back to the hospital. Most importantly, to learn to join and work together for their common good.

These are not dirty words. This should be the future of nursing. Other health care professions, (PT, OT, ST, CRNA's), all have the ability to start individual companies to serve the public. They make a fortune! This is true employment independants.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

Specializes in NICU, Post-partum.
The mentality change that needs to take place in nursing, needs to start with the selection process for nursing school. There has to be a way, in the pretest and psychological testing, that potential nursing students take, to screen out the "martyr marys", and look for qualities that suggest unity, strength, assertiveness, etc. You get the point.

Also, the individuals who are teaching nurses, and the curriculum, needs to be upgraded to include, the historyof unions, and how they have in the past improved workplace pay, conditions, how they have made a difference, Employment law, Administrative law, Insurance law. These classes will teach nurses what their rights are in the workplace, the concept of "strength in numbers", and the cases that prove the points of these. Ex- nurse unjustly fired, and successfully sued hospital/employer for $$$$.

Also, the sacrifices that unions made in the past that we now are reaping the rewards of- 40 hour workweek, Overtime laws, child labor laws. If our past union members, had not sacrificed what they did, we would ALL be in alot worse shape than we are now. The difference in a union work place, and a non union (right to work- for less), workplace.

Student nurses need to be taught how important they, and other nurses are, what we bring to the workplace, positive patient outcomes, how We improve the hospitals financial bottom line, how to develop a nursing cost center with our own budget. No more of the, you are a dime a dozen, you are unimportant, you are lucky to be here, blah blah blah. Rolling our professional practice into the room rate, housekeeping, laundry and the complimentary roll of toilet paper. Medical Students, Law, and Dental Students all have an uphill battle to get accepted into their respective professional schools. Yet they are not subjected to the negative classroom atmosphere, that student nurses are. They feel good about themselves and their classmates.

In Law School, it is routine to form study groups, to evaluate their class work, help each other out to analyze the law. If you have not see, "Legally Blonde", with Reese Witherspoon, it is a must see. It shows the Law students in the Law Library, every night ,weekends, studying together, working together for a common goal -to understand the law, pass Law School, and graduate to become succesful lawyers. Nurses could learn alot from this.

While they are in law school, and the interns and residents what we work with, are all coming together to plan on practicing together after they are out on their own, they form their own practice groups, etc. They LOOK for opportunities to join together, not hate each other, and backstab by tattling like 4 year olds.

Yet you don't here of them being told, that they are a dime a dozen, are lucky to be here, so you can kiss my behind, and take a lot of crap, because I want to treat you that way. Backstab other students, etc.

What can nurses do to prevent that awful student experience? It is up to nurses to improve what is going on. A National Nurses union, such as the National Nurses United, is a step in the right direction. Each and every one of us, could do something to improve the nursing profession ,if we only tried, and were encouraged to do so from the get go. Law students work with practicing lawyers in the community. Lawyers feel it is their duty to pass the torch to new Lawyers, and students.

Most importantly, nurses need to look at their fellow students for the potential joining up after graduation, and first two years of employment, and form "practice groups", incorporate and sell their services back to the hospital. Most importantly, to learn to join and work together for their common good.

These are not dirty words. This should be the future of nursing. Other health care professions, (PT, OT, ST, CRNA's), all have the ability to start individual companies to serve the public. They make a fortune! This is true employment independants.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

...what I wouldn't give you take you out for a drink and a big steak right now.

Well said!

Specializes in Rodeo Nursing (Neuro).

I work at a facility in a state which is not a right-to-work state. Nurses are not unionized, but some ancillary classifications, including my previous position, are. In my previous position, it was possible to be employed without joining the union, as long as one paid the union a service fee equivalent to members' dues. So, member or not, you had to pay the union for the privelege of working there.

Conditions at my facility are not ideal, but they aren't bad. The union I belonged to was a parasite that skimmed off a chunk of my modest wages every month, and since I was willing to work for my pay, all it ever got me was the right to do my work and that of any coworker who wasn't willing to work for their pay.

Specializes in Peds/outpatient FP,derm,allergy/private duty.
NICU is her normal area, the general floor is not. Being pulled is never easy, even for an IcU nurse. You yourself stated that it takes time to learn, so why would you expect that this pull should have been easy for her? Maybe it was the first pull, not the 101st.

Not sure why you quoted my post above this response because nowhere in it did I say anything about an individual or how easy or hard floating to another unit should be. My comment was referring to whether or not union contracts normally include prohibitions about nurses floating to other units, and what my experience had been. If my words lacked clarity and the OP thought there was anything negative about her personally in my reply, I would hope she would ask me what I meant.

To repeat. I never said being pulled is easy. In fact, I dreaded it, and some of the charge nurses were screeching b-words to me when my presence in their domain was something I didn't choose, but due to unforeseen staffing/census issues.

The other ridiculous thing in nursing, pharmacists who send the wrong drugs are not held accountable. Doctors who order the wrong dose of drugs are not held accountable. The nurse is.

The whole thing is a set up. Yet the majority of nurses refuse to organize. Madness.

Oh, how many times have I said this very thing.... Madness, indeed!

Specializes in NICU, Post-partum.
The other ridiculous thing in nursing, pharmacists who send the wrong drugs are not held accountable. Doctors who order the wrong dose of drugs are not held accountable. The nurse is.

The whole thing is a set up. Yet the majority of nurses refuse to organize. Madness.

I got into a heated argument with a senior nurse about two months ago on this very issue regarding IV drugs mixed by pharmacy. We had an incident regarding an infant recently (the details are too specific to post) that got the wrong drugs by pharmacy and it was a borderline life-threatening event if it wasn't for a nurse paying close attention...the same nurse that hung it.

She had the attitude of, "If you hang it and it is wrong, then you are responsible" and voiced very loudly that the nurse that hung the IV was probably going to be hauled into court, be sanctioned by the BON, etc. She was one of those senior nurses that liked to try to scare the more inexperienced ones with these fantasy stories with gross exaggerations.

I presented the argument, "Not necessarily....my job is to verify the original order matches the LABEL placed on the IV bag by pharmacy. The bag is a clear liquid...I have no idea nor any control what is INSIDE the bag..that is where the liability rests with pharmacy...verifying that the bag matches the order, is mine."

She pitched a fit that I was wrong...and I knew I was 100% correct.

I even told her, "Think about what you are saying..I would have to have a chemistry kit at bedside in order to accurately verify what is INSIDE the bag..there is NO WAY you can do that..do you even realize how ridiculous your position is? Verification of the label is my responsibility, not what is inside of it."

Keep in mind this SAME NURSE teaches this crap to new orientation students...and none of it is accurate...so we have a few newer nurses that are paranoid to hang IV drugs now because they think that even if they verify the order/med label and pharmacy mixes it wrong, that they are still going to lose their license.

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