Nurses, CNAs, Techs, if you could affect change, what would it be?

[wildboo]

Attention all nurses, CNAs and Techs out there! I could really use your help for a project I'm doing about how we as staff can affect change, and how changes made by people (like managers, CEOs, VPs etc) affect the staff below them.

In a perfect world (your NCLEX General, if you will) what things would you like to see? For example, does it make to crazy that every bedrail requires an engineering degree to use? Fracture pans only make changing the sheets inevtivatable? Is there a piece of equipment that you will use only as a last resort because it is such a nightmare? What would you change/add/subtract and why?

Here are some examples of how employees affect change: When Boeing was designing their 777, they asked all kinds of crew members to help in the design. One thing that's differerent in that plane than the one's before it is the toilet seat. The flight attendants noted that on landing, the toilet seat always slammed down. So, on this new design, the seats are on hydraulics so when the plane pitches forward, the seat slowly goes down so as not to make noise.

For those of you in peds: If you've ever used an IV house, you might know it was designed by a St. Louis nurse who originally made the little "houses" out of medicine cups she cut in half. That's how the idea started.

From management: Fed Ex management designed forms for all of their curriers. Great form that tore on the left hand side. Only problem? All of the equipment was designed to make it so the form would be easiest to tear from the RIGHT hand side. No one bothered to actually ask the people who had to use it!

So, what would YOU change in your department, big or small? I would love to hear your ideas!

[NPvampire, MSN, RN, APRN]

I would like to see--instead of managers always evaluating us and firing for petty, insane reasons--CNAs, LPN, and RN evaluate each other and the managers. If 100% of the staff is poorly evaluating them, AND more than 1 person per month have quit citing that manager or employee, then the problem employee shapes up or hits the road!!

I think the greatest invention ever is the IV "balls." If yall haven't seen them, you hook them up to an IV cath, unclamp, and wholia! They are preset and prefilled by the pharmacy to do their thing at the correct speed and time regardless of position and free of any electronics. I've only seen them in home health but they are fantastic!!!

[Forever Sunshine, ASN, RN]

Rooms with more space. Hallways with more space. (LTC nurses know what I mean when the med cart, 20 residents in w/c's and 4 CNAs are all in a traffic jam).

[mehitabela]

I would make management understand that a LTC unit in the hospital gets a much more acute brand of "resident" than a regular LTC, and then have it staffed appropriately. It simply is not safe for two RNs to each have a ten patient assignment, no aid, and a unit secretary when in addition to normal ADLs and meds we have heparin drips, blood to hang, tons of IV meds, and patients that have external fixators, chest tubes, new trachs, etcetera. On a recent shift we coded two patients! Yet for financial reasons the hospital insists on calling us a nursing home and making up our grid as such!