The solution to nursing problems

teamrn · Oct 18, 2002

I've read some great ideas in the above posts. However, where was everyone at this year's Million Nurse March on Washington, at the Capitol Mall? I and others talked it up alot on this and other message boards, but when push came to shove, only the organizers showed up.:imbar

Seems that we nurses are great at complaining, but when it comes to solving the problem, we retreat. Think about it, if the shoe fits;)

montroyal · Oct 18, 2002

Originally posted by Youda
A nurse cannot just walk off the floor without a relief. It is illegal to do that by every Nurse Practice Act I know of. That nurse would lose her license, plain and simple. While I'm all for change and speaking up, I'm not inclined to sacrifice my license to do it.

In most states it is illegal to work more than 16 hours at a time.Not only that, it is unsafe for the patients. No Board of Nursing would charge a nurse for patient abandenment if the nurse refused to work any hours he/she felt would be unsafe for the patients. Keep in mind, the hospitals are the ones who agree to accept and care for the patients. It is their responsibility to ensure that the facility is staffed. If they can not meet this obligation, it is their responsibility to transfer the patient to a facility that can.

Unfortunately, the hospitals are the ones who are pushing this idea into a reality. Management refuses to accept safe nurse to patient ratio's. To them,this is strictly a bussiness with the eyes on the bottom line. I believe that someday a one day strike will happen. It is preventable, but the hospitals refuse to believe nurses will ever take that strong of a stand to protect the patients we care for.

The other day, I work a four hour shift in the ICU. One of my patients had an order written by a Pharm D for vicodene elix. The Pharm D wrote it for 10ml with the elix having 500mg Hydrocodone/ 333mg tylenol per 10ml. Thats 100 times the normal dose of hydrocodone. The nurse that was caring for the patient was new and inexperienced. She never questioned the order and she did two chart reviews after the order was written. Thank God she never gave the med, but it goes to show, management just wants a warm body. Something must be done to ensure our patients safety.

Youda · Oct 18, 2002

>>>>

I'm a strong believer that is something is going wrong, you have to figure out the problem, and then find solutions to that problem (not unlike nursing!).

With all respect, and understanding your frustration, I think it is a mistake to blame people for not showing up and make the conclusion that nurses are willing to complain, but not take some action.

So, what could have gone wrong? Let me offer a few suggestions from my point of view.

First, I never heard about it. Never. This means that there is a communication problem somewhere. That doesn't necessarily mean that the organizers failed to publicize well, but that you didn't reach all nurses.

Secondly, for me to travel to Washington D.C., I would travel around 2,500 miles one-way. This would involve a huge expense and at least a one week "vacation" to attend (assuming I knew about the event). Any nurse west of me, would have farther to travel, so the financial impact would have been a greater burden when you add up mileage, motels, food, etc., just to get there.

So, what's a solution to overcome these obstacles?

You have a pre-march ralley of some sort to get all the media covering it. That way you get free publicity and it gets the word out to the nurses who otherwise haven't been aware of the march.

Secondly, you have multiple marches across the country at the state capitols as well as at Washington. That way nurses can participate who otherwise wouldn't be able to travel so far.

Thirdly, for those nurses who are working that day, you have an alternate method of participating. Such as a central website where they could log-on and give their support. Or a letter/postcard that they could mail to their legislature or Washington that they could sign and mail.

My point is simply that you all figure that if someone doesn't show up, they don't care. WRONG. They is plenty of caring and support out here. Please don't confuse support with ability to attend a function.

sanakruz, ADN · Oct 18, 2002

I would do this, Can it really get off the ground? Would this cause patients deaths? Let the mds work the bedside!!!

sanakruz, ADN · Oct 18, 2002

Youda Youve hit on something- Coordinated marches all over the US and Canada We could take out newspaper ads alerting all when "WE'RE COMING!!"

Youda · Oct 18, 2002

Oh, I like that! We're Coming!

If the marches were presented as "public service" or "educational" then you could get free newspaper ads, too!

outbackannie · Oct 18, 2002

Very good, Youda! Sounds like you implemented your nursing diagnostic skill once again.

For me to attend a march in Washington, D.C. would be an extreme hardship on my family. They come first. That doesn't mean I don't care about how nurses are treated.

My philosophy is if you don't want to be a doormat, don't lie down! I've had to tell a few MD's and Administration that they are out of line. I've never had repercussions from doing so.

rncountry · Oct 18, 2002

Actually as one of the original organizers of the Million Nurse March everything Youda said to do was the original plan. The plan was to have a march not only in Washington DC, but in state capitals at the same time. There is a website, http://*************************** if you go there it is nearly impossible to be able to figure out what was actually occuring. It was one the issues that caused much friction. Couldn't get the webmaster to be answer emails or even phone calls so we could work out ways to make the site more informative and relevent. It seemed to myself and one of the other organizers that the webmaster was more interested in making money for himself and a friend who would be printing T-Shirts, then he was in actually getting things organized. Then the paperwork for 501©3 nonprofit status was never filed correctly with the IRS, and despite numerous requests for copies of it myself and the other organizer never received them. In order to do what we needed in to do in terms of the amount of money to be raised we needed nonprofit status or we would be liable for a fair amount of taxes, not to mention having to file the tax papers correctly. I spoke with attorney's and CPA's on this and was told exactly what needed to be done, but couldn't get it done because the paperwork had been filed by the person who was doing the website, in his name. I had done hours and hours of work to contact other nurses who could help organize the state rallies, had names, numbers, email address as well as their mailing addresses. I had many, many of these. Interviews were done, and published as well. Things were rolling along bumpy but rolling. When we could not get the financial information we requested and couldn't however myself and the other person opted out. I don't ever want to do something that could piss off the IRS, nor do I want to be involved with something that I felt could be a problem and cause harm to my reputation.

When myself and the other organizer pulled out many others opted out too. We had been their contacts, we had been the ones putting the work into it and to me the whole thing basicly fell apart. The original scope of the march was lost, the mission statement was scraped, and then changed a couple times. One of the problems that we had was that the webmaster wanted to include resp. therapists, xray etc... anyone who had something to do with patients, and we felt that the idea was a march for nurses about nurses and our problems, not the whole damn healthcare system.

Christ I had access to a reporter for the Times, who lost interest in it when the two people who was the driving force behind it, left.

I wonder if the posts on the subject are still around on this site? I was a very angry person over the way this all went, it was a great idea, had a great many people who were willing to make it work, shortly before we pulled out we had people from the SEIU who were showing a great deal of interest in it, and were willing to do some funding, we had someone else who could write grants so we could ask other groups who support healthcare issues to do grants to support us. We had plans on how to keep the group going so that we became a resource for nurses who had been retailated against, for information on bedside issues for the media, all sorts of great ideas and groups that we could have likely pulled in. It was a shame the way things happened. I ended up apologizing many times to many people over it, and the way they were treated because they had warned me about the character of the man doing the website and how they felt he was in it for the money, and I had roared back at them. Instead they were right. It was not until there was an interview and many posts on the internet regarding the issue that the webmaster took off the ads and attempts to sell all sorts of things whose major money was not going to go to the march fund, but into the pocket of his friend.

What I have written here is only a little of the whole thing, and I don't care if someone doesn't believe me or anything else. I was there, and I know.

So were was I when the "Million Nurse March" took place? Don't even remember, because no one knew it was still going to happen.

The only person who managed to pull off a march and make it a media event was Karen O'Hara from PA. Our own Karen here.

teamrn, I don't know who you are, and I hope you are not too offended with what I have written. The march should have been something, but it wasn't because it wasn't properly funded. Nurses were not notified, that takes alot of money. How is it that the organizers did not know there would be no turnout? How very unfortunate it went the way it did.

-jt · Oct 18, 2002

Just look at all the work that went into this, all the resources ready, all the organizations lined up to help, & all the media set. Then ....... pffffffff! How ready are they all going to be next time when we come knocking on the door for their help & support?

Cant you just hear them all ---

"sighhhhh...its nurses... again"(yawn)

fuggedaboddit.

I went to the Nurses March in DC in 1995. It was a great day - truly energizing & inspiring for the 35,000 nurses and healthcare personnel who participated. There was a lot of support from the community in DC who watched us, but when it was over, what big changes were there? It was tremendously advertized. Nursing leaders, organizations promoted it. State nurses assoc, RN unions, & healthcare unions got their people there - rented buses, paid travel costs, gave out Tshirts, buttons, bumper stickers, flyers, etc and still there were only 35,000 - not even all RNs - out of 2.7 million RNs in the country. At the time we didnt have mandatory ot for RNs, instead, we were having massive layoffs of RNs - downsizing & restructuring down to skeletal staffs, losing our jobs & being replaced with UAPs. The causes were different, but the situation was just as bad then for RNs & though RNs came from across the nation Alaska to Florida, the majority still didnt come. We had a terrific march for a day, but since then things have gotten worse. I wont go so far as to say it was money wasted because it did wake up a lot of nurses to get more involved in nursing politics & activism, rejuvenated us, and brought those of us who there together, but I think thats all it did.

I dont have the energy to start something like this from scratch. If Im going to expend all that efort, Im putting into my already-established state & national organizations to help get more positive long term effects & to make our voice stronger. Just think how far all the money that is needed to spend on one march for one day could go if we had it to apply to things like more lobbying for the nurses workplace conditions/recruitment/retention laws that are sitting in Congress right this very minute.

James Huffman · Oct 19, 2002

Originally posted by psychnurse.com
I would do this, Can it really get off the ground? Would this cause patients deaths? Let the mds work the bedside!!!

Would this cause patients' deaths? Count on it. If we don't think there would be very serious repercussions from such an action, then we must have a very low view of the importance of the work nurses do.

Physicians work the bedside? That's not their job. They are not nurses. We are, and we have a responsibility to carry out our area of professional practice.

Jim Huffman, RN

http://www.NetworkforNurses.com

Youda · Oct 19, 2002

-jt and rncountry, I am really impressed by the dedication you both have shown to the nursing profession. I can't imagine the amount of time and work you both did to organize something like that. I belong to a national group (non-nursing) and getting a few thousand people to agree on anything is almost impossible. We've had similar problems with non-profit IRS stuff, in fact it took several months of debate (not all of it very pleasant) before we actually got it done.

One thing that has worked in that group is to break tasks down into committees, and work strictly on a Roberts Rules of Order. The committees are each given a task to accomplish, and that keeps any one person or group from needing to do it all.

In that group, we've also had to take meticulous care to avoid anyone profiting from monies. There is always someone who tries to profit, and rncountry, your experience (sad to say) was almost predictable.

Yes, you all had some failures. You also had some success. Do the failures now prevent nurses from speaking up? Isn't it possible to take the failures and learn from them?

Back in the last centruy (cough), one of my first political involvements was as a delegate to a state convention for the passage of the ERA ammendment. As women, we were pretty green to the concept of politics. If you remember that time, opposition was intense, especially from some of the churches and religious groups. We gained some victories, we lost some. But, the messages weren't lost. Things like equal pay for equal work, battered women, single mothers, discrimination, etc. Back in the 70's, those were new concepts. Some would say we didn't get very far in the last 30 years. But, I think we did. The ERA didn't become part of the constitution, but we won public support and awareness.

Now the big push is healthcare. As nurses, we don't have to start from scratch to try to educate the public. They are already aware that there is a problem. They are not aware of how it affects nurses, though. What I'm saying is that the momentum is already here. Let's use it.

Failures in political activity are just as frequent as success. But, if you're really dedicated to your ideals and message, you learn from those failures so you can be more effective next time. And, you keep hammering away, because change doesn't occur instantaneously. It takes hard work and many years to accomplish.

I'd hate to think where woman's rights would be if Susan B. Anthony or or Elizabeth Stanton had ever given up because her attempts didn't win them their highest expectations for change. Fact is, if they had given up, you wouldn't even have the right to vote yet.

So, this is a plea not to give up. Learn from the past and what didn't work. Find new solutions and approaches.

"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it's the only thing that ever has." Margaret Mead

rncountry · Oct 19, 2002

That last quote Youda is interesting, it was the tag line for the Million Nurse March when it first started.

Also had an interesting experience at work yesterday. We had a new patient admitted, and I went to see them fairly quickly. She had a chemical burn on her neck and her lips from an IV infusion of Vanco that had not infused, instead it had run out of the tubing onto her neck and lips, had a vascath with infusion port in her neck. This had occured on a med-surg floor with a nurse who had 9 patients, not my place. I introduced myself to the patient and her son as the wound and infection control nurse. The first thing out of the son's mouth was "What are your patient to staff ratio's?" I have never had a patient or family member ask me that. I explained that our facility had a policy that day nurses did not take more than five and nights no more than six, and that assignments are made according to patient acuity. He nodded and said that is what the case manager at the prior facility had told him but he wanted to make sure they weren't lying to him. This man is absolutely furious that his mother ended up with this burn. He is not angry with the nurse, he is angry with the facility for asking the nurse to take care of so many patients, and is seriously thinking of suing. We had a long conversation regarding the nursing shortage and causes.

I wonder if people will start asking this question more frequently. I have another patient right now that had dopamine infusion go sub Q in his right arm. The damage is deep and extends nearly the full length of the inside of his right arm. He will never make it through a surgery and am not sure what eventually can be done for it. The problem happened again on a med-surg floor. Different hospital. Must be I have been off a regular med-surg floor too long because when I worked one we would not have done a dopamine drip there, that would have been done in ICU.

I hope that eventually the public will start asking pertainent questions about how nurses can do the job and take care of their loved one, on a regular basis.