Nurses HAVE the Solutions......

  1. "RN Solutions to the Nursing Care Crisis

    ~THE GROWING SHORTAGE OF NURSES AT THE BEDSIDE~

    Health care employers are reporting difficulties in recruiting and retaining registered nurse and other health care staff.

    Nurses are reporting that they are assigned too many patients to deliver optimal nursing care and adequately supervise support staff.

    Patients are hiring sitters to assist them in hospitals with short-handed and overworked staff.

    The public is becoming aware of short staffing in hospitals, nursing homes, home care, schools, correctional institutions, assisted living facilities, and every other health care delivery environment. Its sounding like a crisis, and, if not addressed properly, it will be a public health disaster.

    REASONS FOR THE IMMEDIATE CRISIS ~

    The current shortage of nurses in direct care was manufactured by healthcare employers who systematically downsized nurse staffing over the past ten years. During widespread restructuring in the mid-1990s, employers forced experienced and highly paid nurses out of the workplace through layoffs, early retirement buy-outs, and attrition. In an effort to compete for managed care contracts, they focused on the bottom line without assessing the
    impact on patient care.

    If employers expected that there would be new graduates to fill these positions, they
    were wrong. As word spread about downsizing of nursing staff, nursing school enrollments dropped precipitously.

    In addition, working conditions worsened for the nurses who remained on staff, forcing many frustrated and exhausted RNs to leave direct care. In the current crisis in direct care, employers indeed find it difficult to recruit and retain nurse staff a situation attributable to the intolerable working environment they created.

    HOW TO BUILD THE NURSING WORKFORCE ~

    #1 Improve workplace conditions and..........."
    http://www.nysna.org/PGA/LEG/solutions.htm


    •  
  2. 13 Comments

  3. by   natalie
    jt-
    Check it out: http://www.nurses.com/content/news/a...atestHeadlines

    Also did you see what the Michigan Board of Nursing did? Astounding news, really. I tried to find the current language of our Board and was unable to find anything succinct. It's difficult to read through the legal nurse practice acts for New York.
    http://www.nurses.com/content/news/a...atestHeadlines

  4. by   -jt
    [QUOTE]Originally posted by natalie:
    [B]jt-
    Check it out: http://www.nurses.com/content/news/article.asp?DocID={E1 6D9337-1A20-11D5-A770-00D0B7694F32}&Bucket=HomeLatestHeadlines
    Also did you see what the Michigan Board of Nursing did? Astounding news, really. I tried to find the current language of our Board and was unable to find anything succinct. It's difficult to read through the legal nurse practice acts for New York.
    [Q]


    Yes! I saw both. I'll be in Albany from tomorrow working with the legislators on that piece along with the others. Michigans board made a bold decision. Congrats to them for seeing the light! Did you see what our board of nursing said about this topic a a couple of months ago? It was in either Statewide or Report as a letter from the director of the NY State Board of Nursing? She had the nerve to send a long letter (or was it a guest article?) to the NYSNA newspaper that the state board has a fine working relationship with the NYSNA.... but then she wrote that "it doesnt take being at the hospitals for me to know that there is a shortage of some kind going on" can you believe it??? A "shortage of some kind"???? Thats what our state board of nursing calls it. Obviously she doesnt have as good a working relationship with our state association as she thinks or she would know damn well what kind of shortage it is. She may think she has a good working relationship but if she can make that comment then she hasnt been listening! To top it off, she goes on to say that many nurses call her office to say they have been ordered to remain at work for mandatory ot but need to leave at the end of their shift & if they do, is it pt abandonment? She adds that yes,it is abandonment. And its a difficult situation but the nurse has to stay if ordered & if she leaves, she can be charged with abandonment. Then she explains why & how & just what the obligations of nurses are to their patients, etc.
    Amazing. While state boards & state associations (including ours) all over the country & the ANA are all saying refusing M.ot is NOT pt abandonment, our state board thinks it is. So thats where our state board of nursing stands - in direct conflict with the position our state nurses association has taken - which is:

    ~NYSNA advocates zero tolerance for mandatory overtime.~
    ~Licensure regulations need to change to ensure that nurses WILL NOT BE CHARGED WITH PATIENT ABANDONMENT for refusing mandatory overtime.~ http://www.nysna.org/PGA/LEG/POINTS/staffing2001

    that was NYSNA's message to the state board of nursing in NY. How long do you think it will take them to get it??
  5. by   oramar
    Yes, this is a big step in the right direction. However, there is a long way to go. Thank you very much for all the good links. I love surfing the net for any information I can find on nursing. I especially love the ease of just logging on and finding someone has done all the work for me.

    [This message has been edited by oramar (edited March 18, 2001).]
  6. by   Mijourney
    Originally posted by -jt:
    "RN Solutions to the Nursing Care Crisis

    ~THE GROWING SHORTAGE OF NURSES AT THE BEDSIDE~

    Health care employers are reporting difficulties in recruiting and retaining registered nurse and other health care staff.

    Nurses are reporting that they are assigned too many patients to deliver optimal nursing care and adequately supervise support staff.

    Patients are hiring sitters to assist them in hospitals with short-handed and overworked staff.

    The public is becoming aware of short staffing in hospitals, nursing homes, home care, schools, correctional institutions, assisted living facilities, and every other health care delivery environment. Its sounding like a crisis, and, if not addressed properly, it will be a public health disaster.

    REASONS FOR THE IMMEDIATE CRISIS ~

    The current shortage of nurses in direct care was manufactured by healthcare employers who systematically downsized nurse staffing over the past ten years. During widespread restructuring in the mid-1990s, employers forced experienced and highly paid nurses out of the workplace through layoffs, early retirement buy-outs, and attrition. In an effort to compete for managed care contracts, they focused on the bottom line without assessing the
    impact on patient care.

    If employers expected that there would be new graduates to fill these positions, they
    were wrong. As word spread about downsizing of nursing staff, nursing school enrollments dropped precipitously.

    In addition, working conditions worsened for the nurses who remained on staff, forcing many frustrated and exhausted RNs to leave direct care. In the current crisis in direct care, employers indeed find it difficult to recruit and retain nurse staff a situation attributable to the intolerable working environment they created.

    HOW TO BUILD THE NURSING WORKFORCE ~

    #1 Improve workplace conditions and..........."
    http://www.nysna.org/PGA/LEG/solutions.htm

    -jt, I like the fact that you, oramar, and natalie keep me grounded about nursing when you regularly bring attention to interesting and relevant articles. There are others who have presented interesting, relevant articles once in a while. Thank you all.
  7. by   natalie
    Another nursing issue that scares the hell out of me is the upcoming US Supreme Court decision re: RN's as supervisors. I think they'll be handing down their decision in June. I can't imagine a ruling that we have had the autonomy, power, and decision-making capacity to be banned from collective bargaining. But, then again, given the political climate...

    It would have a huge impact on northern nurses.
  8. by   -jt
    Originally posted by natalie:
    Another nursing issue that scares the hell out of me is the upcoming US Supreme Court decision re: RN's as supervisors. I think they'll be handing down their decision in June. I can't imagine a ruling that we have had the autonomy, power, and decision-making capacity to be banned from collective bargaining. But, then again, given the political climate...

    It would have a huge impact on northern nurses.

    to put it bluntly - it will kill us. In addition, they may be leaning to including LPNS in this as supervisors too because they direct UAPs in nursing homes. The whole case is causing rattled nerves here because of whats the Justices have been saying at the hearings so far.......
    "This is the first time the court has tackled the issue of nurse supervisors since it affirmed a lower-court ruling in 1994 that said nursing home licensed practical nurses were supervisors because they oversaw nursing assistants.....Justice Antonin Scalia saying that if a nurse can assign where others work, ``I don't know why that isn't supervisory.......''
    for the full article see: http://www.modernhealthcare.com/curr...ished=20010226



    ........

  9. by   RNPD
    .....Justice Antonin Scalia saying that if a nurse can assign where others work, ``I don't know why that isn't supervisory.......''

    ----------------------------------------

    Why it isn't supervisory? because to be a supervisor a valuable component is missing in the "supervisory" work that an RN or LPN does, when simply "assigning" work. And that is the ability to sanction those you are supervising if their performance is not up to par. When was the last time you saw a staff nurse with the ability to write up insubordination or errors? NEVER, that is the (true) SUPERVISOR's job-and most times, even when we report a problem or complaint, it is dismissed. To be a true supervisor, you must have the power to enforce your assignments. We do not.
  10. by   -jt
    [QUOTE]she goes on to say that many nurses call her office to say they have been ordered to remain at work for mandatory ot but need to leave at the end of their shift & if they do, is it pt abandonment? She adds that yes,it is abandonment. And its a difficult situation but the nurse has to stay if ordered & if she leaves, she can be charged with abandonment. Then she explains why & how & just what the obligations of nurses are to their patients, etc.
    Amazing. While state boards & state associations (including ours) all over the country & the ANA are all saying refusing M.ot is NOT pt abandonment, our state board thinks it is. [Q]

    So I went to the legislative lobby day in Albany this w/e, Natalie & the next one is April 17th. I totally recommend it. Youd love it! It was free for CNP officers, non-members could also participate & members expenses were re-imbursable. Lots of RNs were there from Niagra Falls area, Erie, Buffalo, Syracuse, Downstate, etc. from all over the state. It was a great day & I was amazed at how the legislators dropped everything to talk with us when we stopped by their offices in the morning. Also, we held a luncheon for them & they all came, sat at round tables with their RNs from their own districts, had a relaxed lunch & talked about the issues with their own constituents - us.

    Addressing us as speakers were the majority & minority leaders of both the Assembly & the Senate, state comptroller Carl McCall, surgeon general Dr. Antonia Novello, the director of the office professions (which the state board of nursing reports to), the health commissioner, and a letter was read from the attorney general who was in NYC at the time. Every single one of them supported all the bills we want passed & the ones we wrote. We have a sponsor for all of them. The legislators from our areas sitting at our tables were so knowledgeable & passionate about these issues & asking for our help in making them laws & they were really interested in what we had to say. I cant tell you how many times we heard "my wife is a nurse" "my mother was a school-nurse" "my grandma was a nurse midwife" "my sister is a nurse practicioner","I was in the hospital 10 yrs ago & my nurse Mary Jones saved my life",(he even still remembered her name) "nurses are the lifeblood of healthcare", etc.

    They spent a lot of time with us & I dont think it was the free food that kept them there. They took notes, phone numbers, asked real pertinent questions & made a committment to work with us on everyone of those issues in the other thread.

    We had packets made up for them explaining which bills we wanted them to support & vote for & why. They loved how easy it was for them to see the info right at a glance. It was all very professionaly done.

    Each of them from both parties gave committments to sponsor, support & pass the laws we needed. Some things may be harder to achieve than others because a few of the Republicans kept saying the problem was our aging & lack of recruiting minorities & providing financial assistance to them for school. The Democrats were more on target reminding them that "no matter how much money you give people, if the working conditions arent improved, there still will be a shortage. And people will still be saying 'I wont work at that facility no matter how much they pay me' ". Obviously, they have been learning from us! lol.

    I was amazed at the knowledge of & committment they had to all our issues. They were really well informed by us over these past few months & this was a very interesting way to network with them. It was very relaxed, & we treated each other as though we all new each other for years. Funny to see elected officials are just regular people.

    In the afternoon, we went to watch the Assembly in session & they surprised us by bringing our whistleblower bill to the floor that day in honor of our presence there. And they voted unanimously to pass it! The Senate promised to day the same. And both Republican & Democrat leaders made a committment to having their groups working with us to get the Govenor to sign it this time. I was surprised at the amount of respect they had for all of us (thats something we arent used to as staff RNs!) & the way they treated us as knowledgeable, important professionals whose help they need.

    As for the Board of Nursing, at the dinner on Sunday night, the ANA rep Suzanne Whitaker made a presentation of the exciting, progressive plan of the ANA to push the employer-friendly/worker-hostile Bush administration into action by fighting the same fight in every state simultaneously while the feds drag their feet. Once the states have certain legislations, it will be very difficult for the federal goverment to deny us any longer because they make decisions based on what the states have done. So every SNA has been asked to do what we are doing & work towards those issues that are listed in the other thread. Also, she said loud & clear that the ANA's opinion is that mismanagment by insufficiently staffing is not a reason to order mandatory oT & any nurse who refuses mandatory OT is not abandoning pts. I stood up & told her what our state board of Nursing had written in the paper on that. She disagreed with them & thats why we have this initiative to pass a law in every state that says NO nurse being ordered to stay M.OT will be charged with abandonment if she refuses. A nurse who is also on the board of nursing stood up to correct me & say that what they mean is that each case is on an individual basis & if the RN proves that short-staffing was the reason for the M. ot, she would not be charged but she has to have that hearing to prove herself. But why should we have to prove our innocence??? NYSNA & ANA's do not think we should! Their bill on M.ot would rectify the requirements of the state board so that we dont even have to have a hearing or prove anything.

    Legally, refusing M.OT would not be subject to any hearing in any case - unless a disater had ben declared by the city, state, or federal govt. Every state is being asked to sponsor this legislation to change State Board of Nursing rules to prevent the RN from being charged with abandonment & Rns do not have to be a member of their SNA to influence their elected officials in passing this law in their state.

    There were petitions distributed by the ANA that all RNs in the US can sign, member or not, to have the federal laws we need passed - that includes federal legislations for safe staffing, elimination of mandatory ot & the above board of nursing changes,federal whistleblower law, workplace violence/safety legislation, and funding for expansion of nursing programs & loans. You can get it from the website & also download a copy of the poster for nurses week. It has a red circle & line thru a picture of a pretty nurses day cake & it says for nurses week we want safe staffing, no mandatory ot & to be able to provide quality care! Anyone can use it - even non-members.

    All in all it was a thrilling day. You would have been proud. Go in April if you can. You'll see how much your efforts everyday really do count.
  11. by   -jt
    When was the last time you saw a staff nurse with the ability to write up insubordination or errors? NEVER, that is the (true)
    [/B]
    Thats very true & thats what the NLRB's argument is being based on. That & the fact that LPNs & RNs do not have the ability to hire & fire. But if you read the article, you'll see that the justices were annoyed at the NLRBs focus on what they called "general details". Very scary!

  12. by   RNPD
    ...A nurse who is also on the board of nursing stood up to correct me & say that what they mean (by considering refusal of mandatory ot as pt abandonment) is that each case is on an individual basis & if the RN proves that short-staffing was the reason for the M. ot, she would not be charged but she has to have that hearing to prove herself.

    -----------------------------

    Does the NYS BORN realize that we live in the 21st century in the USA? Did they ever hear the credo on which the US legal system is based? "INNOCENT until PROVEN guilty". The onus should be on the HEALTH CARE FACILITY to prove that patient abandonment occurred, not the other way around. After all, loss of licensure IS a legal issue!
  13. by   natalie
    jt-
    Wow and thanks for all that info! Our work schedule was already posted for April and am working on the 17th. Is there another to follow? I would need to know over a month in advance to get the time off. Would love to attend one.

    (Taking a week off and heading to Virginia today.)
  14. by   -jt
    [QUOTE]Originally posted by natalie:
    [B]jt-
    am working on the 17th. Is there another to follow? I would need to know over a month in advance to get the time off. Would love to attend one.


    they should give you the time as an Ed. day. CEUs are being given. Anyway, the one after April as far as I know is in DC on June 26th. RNs from all over the country are going & what we just did will be done with the Federal representatives from every state. It should be a pretty big event.

    Once the states have certain legislations, it will be very difficult for the federal goverment to deny us any longer because they make decisions based on what the states have done. So every SNA has been asked to do what we are doing & work towards those issues that are listed in the in previous posts in this thread. We will get around Bush & obtain "national" legislation by going thru state by state across the country & leaving the feds holding their hats.

    We need legislation to change the rules of the state board of nursing about mandatory OT instead of waiting for them to see the light on their own. If we had the law we proposed, legally, refusing M.OT would not be subject to ANY hearing in any case - unless a disaster had been declared by the city, state, or federal govt.

    Every state is being asked to push their legislators for this law to change State Board of Nursing rules to prevent the RN from being charged with abandonment. RNs do not have to be a member of their SNA to influence their elected officials in passing this law or any of the other issues on the nursing agenda in their state.
    Its as simple as writing a letter or making a phone call.

    There were petitions distributed by the ANA that all RNs in the US can sign, member or not, to have the federal laws we need passed. The petitions will be presented en mass at the lobby event in DC on June 26th.

    You can get it from the website & also download a copy of the poster for nurses week. It has a red circle & line thru a picture of a pretty nurses day cake & it says for nurses week we want safe staffing, no mandatory OT & to be able to provide quality care! Anyone can use it - even non-members.

    To NY RNs: Go to Albany on April 17th if you can. You'll see how much your efforts everyday really do count.

    To all of you in other states, these lobby days will be taking place with every SNA & non-members can participate in this. It doesnt matter. All that matters is that you are a nurse & you can make change happen in your state. Check with your association for the details & find out from them the agenda, the bill numbers & the talking points.

    The associations legislative offices will have printed up all the info you need to give to your representatives. Make appointments with your elected officials to discuss the issues on those days that dozens or hundreds of other RNs will also be there doing the same. You dont have to be a member to work together with the SNA in your state for the good of all your pts & fellow RNs. I cannot tell you enough how effective this event was. Every RN
    should experience this at least once in her career.

    have fun!


close