What I Would Love To Send to My Hospital's Inpatient DON - page 4

by Lev <3 | 20,284 Views | 41 Comments

This is what needs to be instituted to keep your nurses and patients happy: Mandated nurse to patient ratios The suggested ratios are: 1:5 Acute care, 1:4-5 Observation 1:4-5 Surgical acute, 1:4 Heart Care Unit, 1:3... Read More


  1. 4
    Quote from brandy1017
    I agree it is ridiculous to expect the doctors and nurses to put in orders, what are the secretaries for then! Also errors are happening and things are getting missed because we are not trained as secretaries and frankly don't have the time. I don't blame the dr's for being upset, they have enough to do already and work such long hours why push secretarial tasks on them?
    Really, it doesn't take any longer to type it in a computer than to write it in the chart. And it's legible. And hasn't had a minimally trained person in the middle screwing it up. (Like I sometimes did when I was a unit secretary back in the day.) It's not like the MDs have to write it in the chart and THEN put it in the computer.
  2. 0
    Quote from wooh
    Really, it doesn't take any longer to type it in a computer than to write it in the chart. And it's legible. And hasn't had a minimally trained person in the middle screwing it up. (Like I sometimes did when I was a unit secretary back in the day.) It's not like the MDs have to write it in the chart and THEN put it in the computer.
    YES! I have flubbed up a few orders as a unit secretary. (EEG instead of ECG, BMP instead of BNP etc.). I wouldn't have put those orders in wrong if I understood more about the patients dx and condition. The nurses are more likely to catch those kinds of errors because they know what labs should be ordered, etc. Our doc's screwed orders up royally when we went to CPOE, if I were the nurse, I feel like I'd rather just put it all in myself so I'll know its done right.
  3. 0
    The place I work has made it easier. They doctors have access to a new Electronic Medical Record where the nurses do not get to access it. The doctors are responsible for their orders. We can not see the orders in the new system since we even were denied read only access also. They wanted to say money. It is insulting and limiting, but also a way to make the Physician be responsible.
  4. 2
    Treating staff well only makes good marketing sense. We have 2 hospitals in my town. The other 1 is laying people off. We have to have overflow units. Rehab, where I work is going to be expanding from 24 beds to 40. In this major remodel we are being asked by the architecture firm what we want and need to do our jobs effectively and to serve our patients. Then the plans are adjusted accordingly.

    So far the only changes I haven't seen are the jacuzzi, plasma screen TV and wet bar for staff.
    bluenurse85 and brianbooth like this.
  5. 4
    Quote from she57
    The place I work has made it easier. They doctors have access to a new Electronic Medical Record where the nurses do not get to access it. The doctors are responsible for their orders. We can not see the orders in the new system since we even were denied read only access also. They wanted to say money. It is insulting and limiting, but also a way to make the Physician be responsible.
    How exactly do you know what the orders are if you can't even read them? That's mind boggling.
  6. 1
    Quote from Rayacj
    I feels that what happens is these nurses who move in to management positions forget what it was like to be a nurse. I think that for you to be able to call yourself a Registered Nurse you should have to perform clinical duties. It saddens me that these so called nurses get bonuses and kick backs by making their fellow nurses suffer. They forgot what it was like to care for very sick patients. It also saddens me that only California has a state law for pt/nurse ratios. We are one of largest work forces out there and getting larger everyday, but we have yet to get a national law on the books to protect us. It is sickening.
    They don't forget. They decide to keep their jobs by enforcing rules that come from higher up or that make their budget numbers look better. Can't really blame them for protecting themselves. Protecting staff or patients isn't necessarily going to help their own situations. Survival.
    adventure780 likes this.
  7. 5
    I'm going to chime in here!

    My hospital doesn't even begin to have a reasonable ratio. When I started off I had seven patients a piece most nights we everybody else similarly staffed. In other words all my patients couldn't walk, had iv's (sometimes multiple) had dressing changes and or feeding tubes and/or trachs.

    Needless to say it was pass a pill, great you swallowed it now run to the next person... Same for dressing changes and other tasks. In addition , because I worked night shift I had a huge paperwork pile of stuff that needed to be done for the next day, like check all the MARs and make sure they were correct, double check all orders for (seven) patients were entered correctly etc.

    Now the unit I work we still have five-six patients a night (sometimes seven) and several discharges and admits. A bathroom break is hard to come by (one nurse jokes we should all get foleys with leg bags or wear kotex.)

    We eat while charting because otherwise there is no time (did I mention I'm the fastest one handed typist around). And I get to work about half and hour early and still wind up working a thirteen-fourteen hour shift.

    Things I'd love:

    1. Max of five patients.
    2. No vistors during the first two hours of shift (so I can pass meds and do assessments in peace)
    3. A way to lock the unit doors to keep unwanted visitors out.
    4. Doing away with the high-school type popularity contest. You shouldn't have to feel like you have to basically brown nose the egotistical head nurses and admin or your head could be on a chopping block.
    5. Speaking software for charting...give me a mic and while I'm conducting my assessments I can have someone typing them up.
    6. Have other units treat those that float better...We have a choice to float and the help we give should be appreciated not belittled.

    There I'm off my soapbox....

    Nice job to the OP by the way
  8. 1
    awesome points, someone hoovering over you as you work whether it's visitors or admins, just makes our jobs harder, if you can't fix , don't make it harder for floor nurses
    Lev <3 likes this.
  9. 0
    Quote from KimberlyRN89
    My facility uses Cerner, and recently the physicians have come on board and now they are responsible for putting in their own orders. It's not going so well :-( Mainly a lot of them are grumbling that they should not have to do it. One even went so far and said "What are the secretaries for?" Sigh.
    Haha I am a secretary right now and dang if I do not hear this on a constant basis! Lazy ol doctors! Once I teach them how easy it is, they are better at being "okay" with putting them in.
  10. 0
    You all must work in larger hospitals. I work in a small hospital that, because they are trying to save pennies,will call one of the 3 nurses off low census when there is only 5/6 patients. During the week days this is one thing. But nights and weekends when there is no other nurses to pull from desks, it gets very stressful . What if there is a code? I should also explain that one of the nurses is stationed in the er and at times has no ems with them. I understand wanting to save money , but at what cost? I get sick of hearing they can't staff for the what ifs. I do not think patients and their families would appreciate knowing this was going on.


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