"The Many Sides of a Nursing Shortage" - page 2
April 23, 2002, by Ryan Alessi The many sides of a nursing shortage Amid the beeps and blips of medical machines, Kara Coullard calmly takes a needle and injects it into her elderly patient's... Read More
May 12, '02ps
recently in NYC, a pt died after donating part of his liver. The state shut down the program citing "poor staffing practices". A first year intern with 12 days experience on the unit had been left to medically care for 34 transplant pts as the only MD there. There were nurses there also - 1 for every 7 of these pts when in similar units at other hospitals in this state the ratio for these pts is 1:1. At this hospital, not only was the RN to PT ratio too much, all of them were new nurses too. The state did not cite the nurses for negligence. It blamed the hospital for its staffing practices which put the pts, the nurses & the intern in a situation where mistakes were bound to happen.
May 13, '02Thanks -jt, that is the best summary of that incident I have read, I finally got it straight in my head. I have been reading bits and pieces of that situation and could not quite put it all together.
May 14, '02My pleasure - but that story doesnt end there....
for its "poor staffing" which the state said led to "abysmal third world aftercare", the hospital was fined the max - $48,000 - (thats less than the starting salary of a new grad ADN) - At this very same time, instead of recruiting to provide better pt ratios or improve pt care staffing, the hospital LAID OFF 450 hospital support services workers and ELIMINATED many vacant RN positions. The hospital response to the state regarding improving staffing is that they will no longer allow 1st yr interns to be left on their own & are hiring more PAs.
May 14, '02I work on a understaffed tele floor with transplants and radical necks to boot. Plain tylenol for immediate post op pain as ridiculous doesn't require much thinking, I'm sorry. Just my very humble opinion.
May 14, '02That nurse was FLOATED into that unit. The stress alone can impair her thinking. Thats why floating is restricted in our contracts. Its not a safe staffing tool.
Who knows if she was ever on that unit before, had any kind of orientation, how many pts she was trying to care for, if she even had any help, what kind of stress level she was under or what else was going on.
Who knows what any of us may miss while working in the same situation when ordinarily it would be something we wouldnt even have had to think about. But float to an unfamiliar area or try to work with unmanageable pt loads & under those kinds of conditions, the nurse is trying to think of a million things at once, is stressed & worried about making mistakes, and sometimes so overwhlemed that she cant think of or notice even the "simplest" of things. Thats why these staffing practices are being so hotly protested by nurses all over the country. Being overwhlemed does something to the brain & leaves us vulnerable to make mistakes we otherwise would not be making.
Its so disheartening to see how nurses are so ready to pass judgement & lynch each other even while knowing what they are all going thru daily right now in hospitals & nursing homes. Far be it for any of us to judge another nurses thinking ability without knowing what else she was facing in the situation she was forced into. We ourselves may someday be in the same kind of situation, may make a "stupid" mistake because of it, and may be needing support from our peers too.
May 14, '02Exactly Jt. Thanks for being supportive of nurses and working to better the working conditions for all nurses.
May 14, '02your welcome.
We are in a profession where we are accustomed to assess & evaluate by asking a lot of questions before we draw conclusions for a diagnosis - we should do more of that when it comes to drawing conclusions about our peers.Last edit by -jt on May 14, '02