Should nurses strike? - page 8
Should nurses strike? Would you cross the picket line?:confused:... Read More
Jun 25, '03Originally posted by spacenurse
What about impossible rather than 'near impossible'?
Check the link for what thousands of the other 99% of us who need to eat, sleep, and can only be in one place at a time have been doing on our time off.
I am twice your age, worked for 46 years so far, raised two kids who are fine adults, cooked, cleaned, and did the laundry.
I have been injured in accidents, survived cancer, and do volunteer work. I have spent one hundred thousand hours at direct patient care.
I am Not supernurse. Am I abandoning my patients when I say I am too tired after a 12 hour night shift without sitting down, eating, or urinating? Must I stay another 4? More if management in the office asks?
I cannot titrate several medications mcg/Kg/min to the BP, PA, PCWP, PVRI, SVRI, while timing the IABP, suctioning, stripping the chest tube tubing, checking the glucose, titrating the insulin drip, trying to wean the patient from the ventilator, doing Q 15 adjustments of the CRRT, explaining , comforting, and keeping the patient in bed, assisting the family and patient cope, ordering labs, communicating with the physician (rather have OUR critical care NP) feeding the patient, bathing, AND getting the next admit from the ER. Which patient do I leave? Do I assess the new patient while gambling with the original patients life? (What IS the K+?)
Do I hope the new patient is OK? Do I assume someone not assigned and just as busy will help?
When something happens am I abandoning future patients when I lose my license for failing to act as a patient advocate. Remember this is my 20th hour. I am due back in four hours.
The 99% group can only be in one place at a time.
Without the 99% you are one illness or accident away from having no nurse.
We are human.
Perfection aside, the face of healthcare is changing...on many levels. The expectations of today's nurses are changing. You can fight change all you want, just do it without striking and when your not working your shift.
Jun 25, '03Just TRYING to explain that patients die because MANAGEMENT would rather have a strike then show those who do the ONLY work the patient is admitted to a hospital for the respect of negotiation with them. When they say, "My way (unsafe staffing and mandatory overtime) or you can strike" what is the choice?
For profit chains routinely buy all the hospitals in an area and close 40%. Patients then die on route to the nearest ER passing a former hospital. Did THEY abandon the patients?Last edit by pickledpepperRN on Jun 25, '03
Jun 25, '03Originally posted by spacenurse
Seems someone is.
Jun 25, '03Originally posted by bender73
Alright, look, my response was a bit harsh but I am tired of seeing and hearing about pickets, protests, etc.. I'll try to explain my answer of "No" better.
I am a Nurse Practitioner that admits and follows patients at a large city hospital. The attitude of a lot of nurses is poor and is likely reflective of a large percentage of the nursing community.
Yes, I am a nurse. I am an NP and my function at this hospital is 99.9% that of an MD.
My argument is that every time I turn around there is some RN gripe. I work hard and have tremendous pressure. My decisions/orders are not directly supervised by an MD and I don't just carry 3-4 patients...at times it could be 6 or more. I have to constantly answer pages by RNs and run to the ER to write orders on patients. The work can be very stressful and like the residents there, I don't get paid as much as the attendings.
My point being that, like the residents and other NPs, I suck it up. I do my job. What do RNs want? Heck, you have PCAs to help out. Some jobs are simply just demanding...accept it and do your best. It might be hard, but do your job.
Physicians (even the ones in their 50s or 60s) can put in 60+ hours a week and $150,000/yr is not a ton of money with $200,000 in student loans, kids, etc.. They don't strike against the hospital or group practice...its part of the job. NPs don't typically strike. It always seems to be the RNs.
If your short-staffed then you just have to work harder. If I am paged to the ER to admit more patients than I can get done in my shift then I have to stay later...and I am on salary so I don't get overtime!!! ITS PART OF MY JOB SO I DO IT. I might get annoyed but I don't run outside and picket.
RNs, not all of them, need to learn to accept the fact that this is the healthcare system today. Its fast-paced and requires a lot of work.
What exactly do RNs want? An easy day with a few patients? Longer lunches? Coffee breaks? Cigarette breaks? More and more money? I am salary and I don't even get any set breaks. ER docs and NPs work their tails off and eat between patients...and end up staying longer than their shift...all while maybe carrying 10 patients at once and making critical decisions. Do they strike? No.
Its an attitude that is getting out of hand. I can understand some of the gripes RNs have. I really do. But there has got to be a point where enough is enough.
Feel free to flame away at me because I am sure I will get flack. I am in no way saying all nurses are like this. Moreover, I can indeed see some issues that need to be addressed in the system. However, people are losing sight of what it means to do a job. Sometimes that job is just very hard and demanding...and requires one to go the extra mile without running outside to picket or blaming management. All that does is possibly degrade the perception people might have of a nurse.
*It is not my intention to generalize all nurses and this is just my opinion.
Jun 25, '03Originally posted by RNPD
Several points about nurses and strikes:
1) No one forces nurses to strike, including the union. It is an individual decision made by the union members, not the union reps.
2) Striking is a last resort, and only occurs when management pushes for a strike. Yes that is correct. If admin would negotiate instead of dictate, nurses would not strike. We are willing to strike only for safer staffing however, even with decent raises on the table. The 6 month nurses' strike at Nyack hopital will attest to that. So it isn't all about money-although it is impossible to attract nursing staff to poorly paid facilities.
3) Nurses do not abandon patients when they strike. Hospitals choose to ignore the 10 day notice and carry on business as usual. They hire scabs and manage to find millions of dollars to pay their contracts, although they can't manage to find enough money to give their staff a raise, or to continue the benefits they already have and insist on givebacks. And, BTW, nurse to patient ratios are always much better for the scabs. And plenty of ancillary staff is available as well. So patients actually receive more attention during a strike, although the replacements often give substandard care. Many unfortunately are willing to work wherever they are placed regardless of experience or expertise, as long as they get that paycheck. They also put their patients in harm's way by working excessive and exhausting hours. (BTW, if I was willing to work those excessive hours, I would get just about the same paycheck as the scabs. The hourly rate isn't really that high once hours worked & OT is factored in.)
4) patients ARE in danger due to short staffing. Dr Linda Aiken at The University of PA recently proved this and her research was published in JAMA in Oct '02. For every patient over 4 that a staff nurse cares for, each patient has a 7% greater risk of dying after routine surgery. This is related to "failure to rescue". It was seen quite poignantly at Mount Sinai in NY when a man in his 50s who was quite healthy, donated a part of his liver to his dying brother. The overworked RNs and RESIDENT (take note here bender) missed the subtle signs of an impending crash due to overwork, high patient loads and exhaustion. Had they reacted quicker, that man would be alive today. Mount Sinai was cited and fined by the DOH for inadequate staff. Mt Sinai's respnse-they announced a layoff of RNs 6 months later (Pending). The reponse of most hospitals to this published research?-most staff nurses today continue to care for between 8 and 10 patients on the day shift-more on off shifts. Therefore, RNs have a moral and legal responsibility to advocate for safe staffing and to refuse to work in a situation that puts their patients and themselves in danger.
5) The answer isn't if we don't like it get out. That is proven by the fact that hundreds of thousands of RNs have done just that-leading to one of the worst nursing shortages in history-and it is projected to worsen to the point that 800,000 RN positions in this counrty in 2020 are expected to be vacant. Who will care for the patients then? UAPs-which is exactly what the hospitals are praying for. They can then pay them a lot less, all the while whining "but there aren't any RNs available!".
6) So what is the answer? Since the hospitals have done such a lousy job, and nurses can't seem to find their collective voice (due unfortunately to the martyr syndrome, the selfish syndrome, and too many other syndromes to mention ), it is time for federally mandated legislation to save American patients-who will one day be US! It is time that nursing is repsected by allowing us more autonomy in caring for our patients-by not allowing patient care to be driven by greed. Bender, I suggest you read "Code Green-Money Driven Hospitals and the Dismantling of Nursing" by Dana Beth Weinberg, PhD. Also try this article by Weinberg & Suzanne Gordon-a non-nurse nursing advocate; "Cutbacks in nursing are harming patients". It appeared last week in the Boston Globe. here is a web addy
I suggest that those of you who seem to care but really don't seem to get it need to educate yourselves. Start with the above; both are very good. Others like tom I simply have no use for, and no amount of education will help someone like him.
As for should nurses strike and would I cross a picket line? After reading what I wrote do you still need to ask?
Jun 25, '03Look bender, the point is simple-when nurses are faced with unsafe, impossible situations that put their patients and their licenses in jeopardy, they have few choices:
1) they can stay and "make the best of it". This is sure to result in patient morbidity and mortality and increased costs to the facility, not to mention the nurse's personal and professional life and the poor patient. This has been proven by Dr Aiken and endorsed by the AMA thru JAMA.
2) they can leave and seek better conditions-which if you read any studies (try some nursing journals) are not easily found. Something like 85% of nurses polled in a recent scientific survey stated that conditions at their hospitals were dangerous to patient and nurse. Few planned to be at the bedside in 5 years.
3) they can leave nursing altogether. This has been done en masse, as over 800,000 American RNs who are not working as RNs can attest to.
4) they can stay and try to make a difference by whatever means necessary, including at times striking-after exhausting all other possibilites. No abandonment can occur because hospitals have the choice to stop accepting patients and discharge others during the 10 day notice. Patients too ill to be transferred or who arrive at the ER anyway needing critical care, will be cared for by the NURSES WHO ARE ON STRIKE if needed, as long as the hospital requests their expertise. If hospitals decide to try business as usual, it is the HOSPITAL that is failing the patient, not the nurses. BTW abandonment is a legal term-you need to look it up.
Bender you stated previously that you based your opinions on your own observations and a survey of the opinions of your co-workers. I think you must admit that is quite a narrow viewpoint and hardly scientific, and can not possibly be representative of the true state of nursing today. I think you need to do some journal reading (nursing not medical) and other research of well thought out nursing studies. Because while you may be an RN, you obviously think and feel like a doctor, since your work is 99.9% the same as an MD. If your opinions on nursing are not based on nursing related research, how they they possibly be valid?
I choose to stay and fight for my patients and their right to safe and compassionate nursing care. You are right-the face of healthcare IS changing-that doesn't mean the change is for the better. I for one, intend to continue working to IMPROVE nursing care by any means possible-I do it for my children and my children's children-but most of all I do it for my patients who deserve nothing less.Last edit by RNPD on Jun 25, '03
Jun 25, '03originally posted by bender73 [quote] I am a Nurse Practitioner that admits and follows patients at a large city hospital. The attitude of a lot of nurses is poor and is likely reflective of a large percentage of the nursing community............ My argument is that every time I turn around there is some RN gripe......... I don't just carry 3-4 patients...at times it could be 6 or more [quote/]
bender do you really think that you can look at the nurse in "a large city hospital" and then base your opinion of all nurses on this small sample? Hardly scientific. Not to mention that since conditions in "large city hospitals" tend to be horrendous, it is no wonder nurses have an attitude. In spite of this they continue to find nurses who will work there-this attests to the true love of patients of so many nurses. I think you have quite limited nursing experience and this leads to your narrowminded viewpoint. Did you even read the articles I and others suggested?
BTW, are you suggesting that the average floor nurse carries "3-4 patients"? If so I think you need to check out the nurse to patient ratio at your facility. Do you even have any idea of how many patients each floor nurse cares for on each shift? I would like you to post those numbers here, so I can get an idea of what they are dealing with.
Jun 25, '03This just stretches credulity; next bender will be telling us that s/he was the "5th Beatle."
I give up on this "debate"...bender doesn't even want to ID himself/herself with the nursing profession (99.9% of function being that of an MD).
Best of luck to you in your professional pursuits, bender (with the way the profession is going, luck is what you'll need).
Jun 25, '03Originally posted by RNPD
legal term-you need to look it up.
I choose to stay and fight for my patients and their right to safe and compassionate nursing care. You are right-the face of healthcare IS changing-that doesn't mean the change is for the better. I for one, intend to continue working to IMPROVE nursing care by any means possible-I do it for my children and my children's children-but most of all I do it for my patients who deserve nothing less.
We don't just "suck it up".
We are willing to WORK FOR CHANGE. For the future of us all!
TEN DAYS is reasonable notice.
"For patient abandonment to occur, the nurse must: Have first accepted the patient
assignment , thus establishing a nurse-patient relationship, and then severed that nurse -patient relationship
without giving reasonable notice to the appropriate person (e.g., supervisor, patient) so that arrangement can
be made for continuation of nursing care by others. Refusal to accept an assignment or a nurse patient
relationship is not considered patient abandonment by the BRN."
Jun 25, '03I have read all of these posts and I just want to point out that bender is enjoying getting a rise out of the other posters here and is deflecting all reasonable questions about patient safety and instead focusing in on how to prolong arguement. This debate is not what I had hoped. I am very interested in the long term effects of union vs. no union. Being as short sighted as to accept that right now my luck in finding a job that has a 6:1 ratio in an intermediate care unit in neuroscience with great pay and benefits does not mean that I will always be faced with a patient care ratio that is acceptable. My primary concern will always be the safety of my patient. The primary concern of for-profit hospitals is questionable. Right now, hospitals have to bend to get staffed enough to comply with state and other credentialing regulations. I would like to find ways to permanently ensure good patient nurse ratios while we have some strength. I do not know if unions are best for this. I think unions are, generally speaking, better for the nurse than for the patient, although it is true that both can go hand in hand, especially if the unions are careful. I am not against unions. I feel I don't know enough. And this debate has not helped me at all. I know that California now has laws about patient staff ratios. Does anyone here know what those ratios are and how those laws came to be?
And I think that while nurses can, figuring out a way to ensure that nurses will always be paid a salary that is commesurate with our experience and training is an excellent thing to do now, as well. While the rest of the world is toppling in economic crisis, the nurses have a unique position. They are being recruited. Wined and Dined. It would be great if we could use this time to do some good for future nurses, and for future patients.
Jun 25, '03I'm sorry this discussion didn't go in the direction you needed.
Nurses are being wined and dined for recruitment; the problem is that hospitals don't put that effort into retention, which causes nurses to leave, staffing to become poor, etc.
I wish someone could come up with a solution.Last edit by fab4fan on Jun 25, '03
Jun 25, '03"someone"
well I think it's us. I just don't feel educated enough to even know where to start researching. My best guess is to look at how patient RN laws were passed. Do you know where to look or do you know if states other than California have done so? Was the union a part of that? Unions aren't strong or even visible here in Texas as far as I can tell.
Jun 25, '03I said "someone" not to toss responsibility off onto another person...geez!
It seems that the things I did were not that helpful, so maybe "someone" smarter than I can come up with a better way.