I fully expect that RN burn out will gain momentum in the next few years due to the increased pressure felt by our nurses. Rn's continue to leave the profession, recruitment is tight and hospitals have to tighten their budgets to reflect the current economical crisis. Whilst we all acknowledge that our priority is high quality patient care, we have to question what cost?
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Where I used to work, 8 nurses have left in the recent months and not 1 nurse has been employed to fill in the gap. The work load has increased, expectations remain the same and the clients are getting sicker.
We all know despite the current nursing job freeze and the effects this is having on our new nursing graduates, we do face in our near and distant future a increased nursing shortage with the 'baby boomers' getting older, generations are living longer and RN's who are in their 60's and 70's working because they cannot afford to retire.
Is Primary Nursing Care being seen by some as the new way forward? If you said yes then you would be correct, there is current a new wave of thinking that we must revert to the old in order to move forward to the future. We must always think first and foremost about pt satisfaction, because financially this means pts will return to our facility time and time again, and will recommend the hospital to others, which in turn increases our revenue. In recent surveys at my hospital patients said what helped to improve their stay in hospital was lots of interaction with their RN. The least satisfied Pt's were the ones who said they hadn't seen enough of their nurse and some could not even remember the name of any RN's who had cared for them.
What happened recently in my hospital, they closed 6 beds because there were not enough nurses but then they open up 3 beds because ER was full as there were no more beds in the hospital. Did the floor get another nurse no they had to flex up. This added pressure and stress on the already overworked RN now they have 1 more pt which means 3 more daily assessments and all the work which comes with a new admission that I don't need to explain at this time.
So somebody came up with a brilliant idea to do Primary Nursing Care where all pts will be more actively involved with their RN. The aim of this is that RN's will spend 70% of their working day at the Pt's bedside, the goal increased pt satisfaction. Is this ambitious? Who can say it is early in the experiment, and RN's are going through the typical problems change brings.
It is important to stress at this time that management did not get any floor RN's on board before commencing this trial and the only documentation the RN saw was a piece of paper which stated their new role. There was however a meeting once a week for a month, and staff were encourage to attend one session this allowed the staff to hear what was happening and an opportunity to ask questions.
They are still waiting to see the patients satisfaction levels to see if this way forward was the right way to go. Sometimes I think health care management are just fumbling in the dark and are so far removed from the shop floor they are unable to think critically. Management just don't seem to comprehend what is happening, the tools they use to measure are old and antiquated and need to be revamped by asking the regular nursing staff to be more on board. Maybe primary nursing care is the way forward all I know is it didn't work in the 80's and 90's so why should it work now?
The disadvantage of involving the floor nurses is again cost. Cost of what cost of time, self, responsibility, education, the list is endless.
Primary nursing is a method of nursing practice which emphasizes continuity of care by having one nurse (often teamed with a nursing assistant) provide complete care for a small group of inpatients within a nursing unit of a hospital. The "primary nurse" is responsible for coordinating all aspects of care for the same group of patients throughout their stay in a given area.
This is distinguished from the practice of team nursing or functional nursing by dividing duties by patient rather than by function (I.e. passing medications, doing treatments, etc.)
