When will nurses advocate for themselves?

[Eschell2971]

Ask any bedside nurse what is one of the most challenging parts of his or her job, and I'll bet you the 12-hour shift will be one of the top 3 answers. Ask any nurse who has left bedside care and I'll bet you, "It's hard on your body," or "it breaks you down," will be in the top 3 answer choices.

So, my question is, "When will nurses advocate for themselves?" Yes, I know the research among nurses who provide direct care is mixed. Most of the research shows that some nurses like the 12-hour shifts because they have 3 or more days off in a row. Other research shows how nurses are not happy campers when it comes to the professional autonomy they DON'T have and scheduling is one of the reasons. Still, even more, research documents the occupational injuries, medical mistakes, and even death to nurses after working 12-hours shifts, including when overtime is factored into the equation.

We can't have it both ways or can we? The the12-hour shift is by and large a function of the reduced or projected shortfall of nurses and/or a function of the employer being able to get the most bang out of its buck of nurses-basically, 2 shifts for the price of 3 shifts. Physically, our bodies know that working 12 hours, often without a reasonable break, is not a good thing for our body functions. Mentally, 12 hours straight is emotionally draining. At the end of the day (or night), nurses are so mentally fatigued they literally can't think straight. And, professionally, there is a cost, too. Nurses make more mistakes, especially medication errors, not to mention communication errors or missed opportunities for interprofessional communication about patient care. Sadly, nurses have been killed in car accidents when driving home, especially after working a 12-hour night shift.

How much is enough? In our highly technological age, there must be a way to have adequate staffing for inpatients while reducing the physical and mental taxation on professional nurses. What about flexible scheduling, where nurses choose to work either 6, 8, or 12 hours, as they choose if they fulfill X number of hours bi-weekly or per month? What about not admitting everyone that comes to the emergency room with symptoms that are not life-threatening, but, can be managed at home? What about discharging patients at night, if necessary, once their inpatient goals and trends are in the right direction? What about statutory mandates for nurse-patient ratios and do away with the staffing grid games that are common in many hospitals?

Better yet, how about nurses advocating for themselves, their own health, and the healthy lifestyles that we promote for our patients? I understand advocating is a risk and no one wants to be singled out as a rabble-rouser, but, I fear that nothing is going to change until patients and nurses are seriously hurt and/or the risk threshold is too high for the hospital administration to ignore. I still ask how or why prominent nursing organizations allowed this to happen. Where was the professional advocating on behalf of the nurse members of these organizations?

It's sad to admit, but, the bottom-line seems to be the same as it is in many issues: Follow the money! As a nurse, this makes me angry, but, truth is truth and clarity are what's important. I encourage nurses everywhere to take a risk, advocate for US, and let's present a united front for our profession, our own health and welfare. Nurses want to go home to their families at the end of the day, too!.

[nursel56]

My recollection is that nurses wanted the 12 hr shift option. At the time, it was also an effort to attract job-seekers to the hospital. They briefly offered 4 10s as well. Sounds hellish for the poor soul who had to schedule that.

[xoemmylouox, ASN, RN]

I work nights and I love my 12 hour shifts. I could not do 5 - 8 hour shifts every week though. I've done it in other positions which I worked days and got weekends and holidays off, but to do it in the acute care setting, no thank you. I know 12 hours are tough for some though. I think having a mix of 8's and 12's would be good for a unit. It could make scheduling more difficult, but if a unit is desperate enough you'll do what you have to do. If 12 hr shifts disappear from the acute care setting so will I.

[brillohead, ADN, RN]

If I were going to advocate for something, I'd advocate for staffing ratios, as I'm MUCH more concerned with staffing ratios than I am about 12-hour shifts.

I like the continuity of care for the patient that the 12-hour shift allows, in addition to the additional time off for the nurse. If I had to come into the hospital and deal with the soul-sucking patient assignments five days a week, I would cut someone. Seriously.

The almighty Press-Ganey scores have killed nursing.... it's not my job to make you HAPPY, it's my job to make you HEALTHY, for crying out loud!!!

RN does not stand for Refreshments and Narcotics, for the love of all that is holy!!!

The CHF patient who doesn't take their Lasix "because it makes me pee too much"...

The COPD patient who gets a simple cold and ends up hospitalized for a week because they're still smoking a pack per day...

The ESRD patient who skips a week of dialysis "because I didn't feel good" and now they're in the hospital for a week...

The drug-seeker...

The DM patient who never checks their glucose and is on an insulin drip getting hourly titration...

The Medicaid patient who calls 911 for an ambulance to bring them in for toe pain...

If I had to look at these people (whose medical bills are being paid for by MY tax dollars in 99% of the cases) for five days out of every single week, I'd be gone from nursing in under a year. Only working six shifts every two weeks is the only thing keeping me sane.

You can pry my 12-hour shifts out of my cold, dead hands...

[allstressedout1]

But my question is who really gets to do 3 12s a week. For the summer on our 6 week schedule we will be required to do 3 12 hour shifts a week and pick up 4 call days. So many weeks we will be working 4 -12s. If we are on call we are required to be there in 30 minutes so call days are not days you can use as you wish. Then open forums are mandatory, most inservices are mandatory, unit meetings. Pretty much 75-80 % of your days off you will recieve text messages needing someone to take call or work etc. If no one says ok, then expect extra call days the next schedule. A full 30 minute lunch, off unit never happens. You answer phone calls, moniter alarms, answer questions etc while you eat for 10 minutes at most. Self schedule but can only pick days that are open. Then 3 weeks later schedule call days so any stretch or long weekend is usually messed up. How is it other places?

[ThePrincessBride, MSN, RN, NP]

But my question is who really gets to do 3 12s a week. For the summer on our 6 week schedule we will be required to do 3 12 hour shifts a week and pick up 4 call days. So many weeks we will be working 4 -12s. If we are on call we are required to be there in 30 minutes so call days are not days you can use as you wish. Then open forums are mandatory, most inservices are mandatory, unit meetings. Pretty much 75-80 % of your days off you will recieve text messages needing someone to take call or work etc. If no one says ok, then expect extra call days the next schedule. A full 30 minute lunch, off unit never happens. You answer phone calls, moniter alarms, answer questions etc while you eat for 10 minutes at most. Self schedule but can only pick days that are open. Then 3 weeks later schedule call days so any stretch or long weekend is usually messed up. How is it other places?

Are you an OR nurse? Most bedside nurses don't take call unless they are put on call d/t low census.

I work 3 12s at my FT gig. Because I am money-hungry, I usually work 44-48 hours per week (3 12s and one 8 or 4 12s.)

[Everline]

Three days or five days, I want lower ratios. Let's do something about that problem, please.

[brillohead, ADN, RN]

I only *have* to do six 12s per two-week pay period.

Many times I *choose* to pick up extra shifts for the overtime (anything over 72/pay period is paid at OT rate at my facility... some places only pay OT over 80 hours/two weeks).

I'm only ever "on call" if I was scheduled to work but census is low. It's rare that I get a phone call on a day off. If they need more people, they'll post it on a private Facebook group rather than sitting down and calling everyone in the book.

[applesxoranges, BSN, RN]

A bigger complaint for me is that hospitals do not give nurses lunches routinely or provide a safe mechanism for someone to cover them for breaks. I am very much of the camp "punch no lunch if you do not get one." People will accept donating 2000+ to their employers each year, which is what you do if you do not take lunch breaks and have them deducted from your paycheck.

[Avid reader]

Never! When women stand up for themselves, they are described by the B****h word. In this country we are not only programmed to be aware of what others think of us, our self esteem is wrapped up in how we look. How can we possibly take our selves seriously when we always judging others. When instead of being able to be ourselves, we first have to run the expression of our thought through so many limiting cycles that it comes out almost as a tertiary expression. I love how Scandinavians and most Brits say as they feel bluntly, because in their cultures, content is more important. They still couch, but less so and outward appearance is not pertinent to what's been said.

If Elizabeth Warren can be shushed, do you understand the lack of respect or disdain McConnell and his cronies have for women and by extension right leaning men? This behavior is constantly apparent in normal life and women need to stand up for each if we are to make any inroads. STOP the gossiping and ******** about each other and pay more attention to your own lives instead of being concerned about others.

More so than ever women need empowerment. Grabbing genitals, rating women on scales, ogling pre pubescent girls, how could anyone not follow that train of behavior and not see the carnage that would follow especially re our rights and dignity? You voted for him, own up to making the mistake and make the changes before we are banished back into the kitchen. If you are unable to understand that I actually do not mean that literally, then continue washing your wife beaters.