Latest Likes For herring_RN

herring_RN Guide 65,709 Views

Joined Mar 14, '04 - from 'California, USA'. herring_RN is a retired registered nurse. She has '>40 years' year(s) of experience and specializes in 'Critical care, tele, Medical-Surgical'. Posts: 16,788 (72% Liked) Likes: 32,863

Sorted By Last Like Received (Max 500)
  • May 20

    Quote from SobreRN
    And we had an ally in democratic governor Gray Davis at the time.
    He was the only candidate of any party willing to promise to sign the bill if it passed.
    So hundreds of us worked on his campaign.

    Our major elected hero was non LA County Supervisor Sheila Kuehl.
    This is from the bio on her Supervisor's page regarding her time as a state senator:
    She authored 171 bills that were signed into law, including legislation to establish paid family leave, establish nurse to patient ratios in hospitals; protect the Santa Monica Mountains and prohibit discrimination on the basis of gender and disability in the workplace and sexual orientation in education.
    She fought to establish true universal health insurance in California.

    Meet Supervisor Sheila Kuehl

  • May 20

    A great positive step is the ANA sponsoring a very public event in our nation's capitol. The announcement has already been posted here:
    http://allnurses.com/nursing-activis...n-1098146.html

    The 2017 Rally for Nurse-Patient Ratios , will take place on May 5th 11a-4p at the Capitol Building, in Washington, DC.
    nursestakedc

  • May 20

    Quote from RNOTODAY
    Because hospitals have lobbyists, many many of them with unlimited $$$ behind them.
    california did because, well California should be considered its own country, plus the CNA-- their union, is the best and most powerful in the country
    I believe other states can do it too. It took us a long time in California.
    In 1995 we voted at our CNA Convention by 92 percent to leave the American Nurses Association (ANA) because the national organization was not yet ready to insist on safe staffing with minimum ratios.
    We adopted a program to reallocate resources to organize RNs, strengthen contracts, confront hospital industry attack on RN jobs and practice, and enact legislative and workplace protections.
    https://donate.nationalnursesunited....ganize/101.pdf

  • May 20

    Quote from SobreRN
    @ hppygr8ful, I remember it well and it was not Schwatrzenegger who signed staffing ratios into law 1999, it was Democratic governor Gray Davis.
    Governor Arnold Schwarzenegger tried to eliminate the safe staffing ratios for med-surg and emergency departments with executive action. We had to take him to court. He was defeated three times before he gave up.
    Schwarzenegger Abandons Court Fight Against Nurses
    Gov. Arnold Schwarzenegger has given up a yearlong legal battle with the state's nurses union, among his most ardent critics, over a state law that requires more nurses in hospitals...
    ... A judge in Sacramento ruled in March that Mr. Schwarzenegger, a Republican, had acted illegally, but the governor's office appealed the decision. Late Thursday, the state attorney general's office withdrew the appeal on Mr. Schwarzenegger's behalf, state officials said on Friday....
    http://www.nytimes.com/2005/11/12/us...st-nurses.html

  • May 12

    Management thinks nurses are an expense.
    Fact is that patients are hospitalized because they need nursing care.
    As soon as they no longer need nursing care they are discharged.
    All other care is available as an outpatient.

    The "product" of a hospital is nursing care.

  • May 10

    Quote from NurseSpeedy
    Mandated numbers would be a nice start but it will never take into account the workload of a specific assignment. My facility does a pretty good job of not going over a given number of patients per nurse (we are always full). However, even if you discharge all the patients that you started with in the morning, expect to be reassigned those beds with transfers or admits as soon as the room is clean.

    Also, just because a patient meets criteria for a specific floor does not mean that a given number of patients would be safe. I've had days where everything went haywire and I couldn't keep up even within our given number, not getting out until almost three hours after my 12 was supposed to be finished. I didn't even chart until after giving report. It's impossible to say that a certain number will provide safety. I definitely could see administration using it as a way to justify that there is enough staff if there was a law. IVs/inserting and maintaining tubes/pain med frequency/confused patients that are constantly trying to get out of bed-better not fall/declining patient status/phone calls/doctors/families-the list goes on and it's impossible to determine prior to the beginning of a shift what will happen since there is no crystal ball seeing into the next 12 hours. I've had the exact same group one day when everything will go okay for the most part and then the next day it's a total crap shoot. The only thing that would have helped would be another nurse to jump in to give meds and do tasks-but I have rarely seen a facility that will bring on another nurse who doesn't have a patient load assigned.
    The California regulations attempt to address this in several ways.
    One is to require additional staff to meet the needs of each patient.
    ... In addition to the requirements of subsection (a), the hospital shall implement a patient classification system as defined in Section 70053.2 above for determining nursing care needs of individual patients that reflects the assessment, made by a registered nurse as specified at subsection 70215(a)(1), of patient requirements and provides for shift-by-shift staffing based on those requirements.
    The ratios specified in subsection (a) shall constitute the minimum number of registered nurses, licensed vocational nurses, and in the case of psychiatric units, psychiatric technicians, who shall be assigned to direct patient care.
    Additional staff in excess of these prescribed ratios, including non-licensed staff, shall be assigned in accordance with the hospital's documented patient classification system for determining nursing care requirements, considering factors that include the severity of the illness, the need for specialized equipment and technology, the complexity of clinical judgment needed to design, implement, and evaluate the patient care plan, the ability for self-care, and the licensure of the personnel required for care. The system developed by the hospital shall include, but not be limited to, the following elements
    1) Individual patient care requirements.
    (2) The patient care delivery system.
    (3) Generally accepted standards of nursing practice, as well as elements reflective of the unique nature of the hospital's patient population...
    View Document - California Code of Regulations
    Also the charge nurse is not to be counted in the ratio. At my hospital charge nurses are often very helpful.
    Charge nurses are allowed to take over a nurses assignment during a break, but my hospital eventually hired nurses for break relief. Often they work for five or six hours in the middle of a 12 hour shift. Often the break relief nurse will stay to admit one or more patients.
    From Title 22 of the California Code of Regulations:
    Nurse Administrators, Nurse Supervisors, Nurse Managers, and Charge Nurses, and other licensed nurses shall be included in the calculation of the licensed nurse-to-patient ratio only when those licensed nurses are engaged in providing direct patient care.
    When a Nurse Administrator, Nurse Supervisor, Nurse Manager, Charge Nurse or other licensed nurse is engaged in activities other than direct patient care, that nurse shall not be included in the ratio.
    Nurse Administrators, Nurse Supervisors, Nurse Managers, and Charge Nurses who have demonstrated current competence to the hospital in providing care on a particular unit may relieve licensed nurses during breaks, meals, and other routine, expected absences from the unit.
    View Document - California Code of Regulations
    Please watch the short video. You will understand that nurse's working conditions and patient lives and comfort are worth the years of hard work we put in. New York nurses are doing it now.
    State by state, and the country by country safe staffing will someday be the standard expected for those who need nursing care.

  • May 9

    Quote from Neats
    I am a Management RN who has worked as management before becoming an RN. I care about patient safety but am able to look at the whole picture and have information available to me that line staff more than likely do not. I have worked in union and non-union environments.
    Developing a staffing model is an art if you will. Most people think only "bean counters" decide how much staff we get.
    When I do develop a staffing model I get input from staff. I have provided schedules (no names on it) and times we need higher coverage than others. I have also provided an empty schedule (no times with the caveat of some must have criteria i.e. there must be coverage 24/7)...this one I get my best results and a very creative schedule that with some tweaking success for staff.

    I agree with what is written here and patient safety but I really do not think a class action lawsuit is the answer. What I think is the ANA, and any other health profession association band together and submit a Problem, Solution and discussion formation to our Nation leadership. Invite your local congress senator, mayor, governor to your facility for the day at a time when they are feeding, passing medication, putting in bed for a afternoon rest... you know the busy times. I know from being in Long Term Care to have staffing ratios and the reimbursement that goes with it would make a difference in so many lives however I would want this to be made in a thoughtful way because be careful what you wish for once we get government input then our administrative costs', documentation, and everything else we do is so much more than what we bargained for to begin with. I want to see staff busy not overloaded in an unsafe way, I do not want to see staff sitting around because there is nothing to do.

    I urge my healthcare profession to carefully think before acting so that any changes are sound and not cost prohibitive.

    Bring a solution that includes higher reimbursement form CMS in writing with thousands of signatures not only from nurses but other healthcare staff and patients would be prudent and may work with public pressure in a coordinated, formal and professional way would be refreshing and certainly remembered in that we directed our own path and hopefully worked.

    Lastly people often think the companies reap the rewards for profit at the expense of staff, although this may seem true at times I can say in the Long Term care setting profit is not more than 3 percent at most so already they are operating bare bones.
    Nurses have led the successful achievement of safe staffing ratios in acute care.

    I think for long term care facilities it will take politically active and organized residents who are able along with staff and especially family members of residents and patients.

  • May 9

    Quote from Neats
    I am a Management RN who has worked as management before becoming an RN. I care about patient safety but am able to look at the whole picture and have information available to me that line staff more than likely do not. I have worked in union and non-union environments.
    Developing a staffing model is an art if you will. Most people think only "bean counters" decide how much staff we get.
    When I do develop a staffing model I get input from staff. I have provided schedules (no names on it) and times we need higher coverage than others. I have also provided an empty schedule (no times with the caveat of some must have criteria i.e. there must be coverage 24/7)...this one I get my best results and a very creative schedule that with some tweaking success for staff.

    I agree with what is written here and patient safety but I really do not think a class action lawsuit is the answer. What I think is the ANA, and any other health profession association band together and submit a Problem, Solution and discussion formation to our Nation leadership. Invite your local congress senator, mayor, governor to your facility for the day at a time when they are feeding, passing medication, putting in bed for a afternoon rest... you know the busy times. I know from being in Long Term Care to have staffing ratios and the reimbursement that goes with it would make a difference in so many lives however I would want this to be made in a thoughtful way because be careful what you wish for once we get government input then our administrative costs', documentation, and everything else we do is so much more than what we bargained for to begin with. I want to see staff busy not overloaded in an unsafe way, I do not want to see staff sitting around because there is nothing to do.

    I urge my healthcare profession to carefully think before acting so that any changes are sound and not cost prohibitive.

    Bring a solution that includes higher reimbursement form CMS in writing with thousands of signatures not only from nurses but other healthcare staff and patients would be prudent and may work with public pressure in a coordinated, formal and professional way would be refreshing and certainly remembered in that we directed our own path and hopefully worked.

    Lastly people often think the companies reap the rewards for profit at the expense of staff, although this may seem true at times I can say in the Long Term care setting profit is not more than 3 percent at most so already they are operating bare bones.
    Nurses have led the successful achievement of safe staffing ratios in acute care.

    I think for long term care facilities it will take politically active and organized residents who are able along with staff and especially family members of residents and patients.

  • May 6

    A great positive step is the ANA sponsoring a very public event in our nation's capitol. The announcement has already been posted here:
    http://allnurses.com/nursing-activis...n-1098146.html

    The 2017 Rally for Nurse-Patient Ratios , will take place on May 5th 11a-4p at the Capitol Building, in Washington, DC.
    nursestakedc

  • May 5

    Quote from anonymurse

    There ARE unions for nurses in LA--at the VAMCs in Shreveport, Alexandria, and NO.
    Quote from Chisca
    Toothless tigers. Their contract forbids them from striking.
    Rep. Takano, Sen. Brown Introduce Bill to Help VA Attract and Retain Talented Medical Professionals
    Washington, D.C. – Today, Rep. Mark Takano (D-Calif.) and Senator Sherrod Brown (D-Ohio) introduced the VA Employee Fairness Act to support the goal of building a talented workforce to care for America’s veterans. The bill would create a better environment for attracting and retaining physicians, nurses, and other healthcare workers by restoring collective bargaining rights to medical professionals at the Department of Veterans Affairs.

    While VA employees have had collectively bargain rights since 1991, health care providers are exempted from collective bargaining on matters of professional conduct or competence, peer-review, or changes to employee compensation. As a result, they are prevented from raising grievances about staffing shortages that undermine patient care or negotiating for competitive pay that will attract health care workers to the VA. The VA Employee Fairness Act removes this exemption, and grants front line health care providers their full collective bargaining rights...

    ... “Registered nurses are on the front lines of patient care for our nation’s veterans – in fact, they serve as the first line of defense for patients in the V.A.,” said Jean Ross, RN, Co-President of National Nurses United. “Without full collective bargaining rights, V.A. nurses have been limited in their ability to speak out about working conditions that impact the quality and safety of patient care, such as safe staffing.

    “The restoration of their full collective bargaining rights is necessary for registered nurses to serve as effective advocates for their patients,”...
    Press | Press Releases | Newsroom | U.S. Congressman Mark Takano of California's 41st District

  • May 2

    A great positive step is the ANA sponsoring a very public event in our nation's capitol. The announcement has already been posted here:
    http://allnurses.com/nursing-activis...n-1098146.html

    The 2017 Rally for Nurse-Patient Ratios , will take place on May 5th 11a-4p at the Capitol Building, in Washington, DC.
    nursestakedc

  • May 2

    I am very glad to see this public event by the ANA for ratios!

    #Nurses Take DC for Nurse : Patient Ratios Now!
    California has mandated Safe Nurse Patient Ratios.
    It is time for nurses to stand together, support each other, and demanded that Washington hear the voices of the largest workforce in the united states- nurses.

    This legislation for national nurse to patient ratios has been stalled in the legislative process by big money and associations that do not care about our profession.
    We must let Washington know that no amount of money can drown out the passion of a fed up nurse.

    nursestakedc

  • Apr 28

    For First Time Ever, Majority of House Dems Support 'Medicare-for-All' Bill
    A record-breaking 104 House Democrats are co-sponsoring a Medicare-for-All bill

    As President Donald Trump and the GOP attempt once again to repeal and replace the
    The bill, H.R. 676, known as the "Expanded & Improved Medicare for All Act," has been introduced into Congress repeatedly by Rep. John Conyers (D-Mich.).
    It has now received support from more than half of the Democratic caucus, a record for the party...
    For First Time Ever, Majority of House Dems Support 'Medicare-for-All' Bill | Common Dreams

  • Apr 28

    Economic case for ‘Medicare for All’ compelling
    Our system carries huge administrative costs because health care providers must deal with a myriad of different provider plans, each with its own panel of other approved providers, rules and copays, etc.

    The result is for every doctor in the USA, there are eight workers in administrative and non-medically productive roles; in contrast, other Western countries have a miniscule fraction in non-medically productive support personnel and can afford superior coverage for their entire populations.

    We spend approximately $3.5 trillion a year on our complex mix of public and private coverage, each with different rules and excessive administrative departments.
    Duke University employs 900 insurance clerks, said to be more than they have nurses.

    Our very complex $3.5-trillion system has overhead and administrative expense of over 33 percent; Canada's system has 12 percent and Taiwan's is even less. Simply eliminating that waste within our system would save an estimated $630 billion a year...
    Bellamy and Clay: Economic case for ‘Medicare for All’ compelling

  • Apr 28

    Economic case for ‘Medicare for All’ compelling
    Our system carries huge administrative costs because health care providers must deal with a myriad of different provider plans, each with its own panel of other approved providers, rules and copays, etc.

    The result is for every doctor in the USA, there are eight workers in administrative and non-medically productive roles; in contrast, other Western countries have a miniscule fraction in non-medically productive support personnel and can afford superior coverage for their entire populations.

    We spend approximately $3.5 trillion a year on our complex mix of public and private coverage, each with different rules and excessive administrative departments.
    Duke University employs 900 insurance clerks, said to be more than they have nurses.

    Our very complex $3.5-trillion system has overhead and administrative expense of over 33 percent; Canada's system has 12 percent and Taiwan's is even less. Simply eliminating that waste within our system would save an estimated $630 billion a year...
    Bellamy and Clay: Economic case for ‘Medicare for All’ compelling


close