California Nurses sue governor - page 7

Sacramento -- Two weeks after branding them "special interests" and bragging he can "kick their butt," Gov. Arnold Schwarzenegger was sued Tuesday by California's largest nursing union as it moved to... Read More

  1. by   kathi yudin
    we should be spending money to get nurses into nursing.. training instructors so that schools don't need to be closed.. offer rewards for staying at a job for a specific amount of time.. work to get nurses.. then.. work for the much needed safer ratio's..


    Quote from NurseGuy_in_06
    Anything that spotlights the need for more US nurses is a good thing. How else could the need for more nurses get this much attention?
  2. by   kathi yudin
    i can't defend other nursing homes.. only mine.. however.. i can tell you that that does not happen where i am..!!.. we hardly use bedpans..residnts go to the toilet and or use diapers if they are incontinent..if a facility sends a resident in that condition.. the facility should be reported!!.. i can speak from my residents.. we sent one that had one st. 2.. the hospital reported us stating she had 3 stage 4's!!.. she didn't!!.. documentation proved that!!!.. the hospital.. a large one in southern oranage county with a supposedly good reputation.. sent her back with 5 stage 2's and 3's!!!!... right now.. our census is 93.. we have <5% with decubs!!!.. not bad for a place where the majority of our residents are end stage dementia with chronic illnesses and low albumins!!!.. that .. is a credit to an excellent staff!!!

    Quote from stevierae
    kathi--

    Please write complete sentences, WITH PROPER PUNCTUATION, if you want us to be able to follow your train of thought.

    Now, would you like me to tell you how many direct to the operating room from the emergency room admissions we have had for nursing home patients who were left on a bedpan--some as long as 8 hours--and not checked on? Not a pretty sight--that is, the impression of a bedpan, cut deeply within an elderly person's skin...nor are the subsequent daily I&Ds and the ongoing battle to prevent infection and possible sepsis...
  3. by   kathi yudin
    once a resident goes to a nursing home.. they have multiple illnesses mostly chronic which may lower their ability to fight off disease... it is not the working conditions that keep nurses from nursing.. it is the lack of classrooms.. the the retiring of the baby boomers!!


  4. by   lossforimagination
    Quote from kathi yudin
    we should be spending money to get nurses into nursing.. training instructors so that schools don't need to be closed.. offer rewards for staying at a job for a specific amount of time.. work to get nurses.. then.. work for the much needed safer ratio's..
    Your facility sounds like a reasonable place to work, unfortunately few hospitals are. I don't have first hand knowledge about nursing homes; I stay away from them because my understanding is they are even worse than hospitals.

    I think it's rather pointless to spend money trying to get people into nursing when new grads are quitting the nursing field within a year or 2 of graduation. They are quitting for the same reasons the seasoned nurses are......unsafe and too stressful working conditions and the lousy treatment of nurses. People don't want to be abused just to make a living. You can't pay a lot of nurses enough to put up with it. Even those saintly people for whom nursing is a calling get stressed out to the point their health is affected and have to quit.

    Throwing a lot of new grads at the situation isn't going to solve the problem. You certainly can't replace the experience and knowledge base of seasoned nurses with new grads. (And sooner or later the new grads decide they aren't going to put up with the abuse and quit)
  5. by   alintanurse
    Quote from lossforimagination
    Your facility sounds like a reasonable place to work, unfortunately few hospitals are. I don't have first hand knowledge about nursing homes; I stay away from them because my understanding is they are even worse than hospitals.

    I think it's rather pointless to spend money trying to get people into nursing when new grads are quitting the nursing field within a year or 2 of graduation. They are quitting for the same reasons the seasoned nurses are......unsafe and too stressful working conditions and the lousy treatment of nurses. People don't want to be abused just to make a living. You can't pay a lot of nurses enough to put up with it. Even those saintly people for whom nursing is a calling get stressed out to the point their health is affected and have to quit.

    Throwing a lot of new grads at the situation isn't going to solve the problem. You certainly can't replace the experience and knowledge base of seasoned nurses with new grads. (And sooner or later the new grads decide they aren't going to put up with the abuse and quit)
    Unfortunately ,you are all too right in your evaluation of the nursing situation. Many of the people that I graduated with are no longer in nursing. Too many people have the idea that nurses are so "well paid" that it is part of our job to put up with the abuse. I've heard that statement from so many people and it makes me sick!
  6. by   stevierae
    Quote from kathi yudin
    through compliance with obra and title 22 safe effective care is able to be given.. as stated at another time..
    I just left a facility where I was doing chart audits to try to bring them into compliance with JCAHO, but they were hopeless. I hope they get shut down--I reported them to CNA and the BRN. The nursing administrator-- a traveler-- kept trying to cite "Title 22" and "licensed nurses" as a way of justifying using LVNs instead of RNs to fulfill the RN to patient safe staffing ratios--she thought that it was fine to use LVNs in their place. It's NOT.

    I told her the truth, that she did not want to hear--Title 22 is only a very, very small part of safe staffing--AB 394, mandated in Jan. 2004, overrides Title 22 in the case of any disagreement--and the CA Nurse Practice Act overrides them both. LVNs are not allowed to assess. Period. End of story. Read their nurse practice act--I don't care WHAT their job description says at your facility.

    So, you bring in coffee and treats twice a week--so what? I'll bet if you took a poll your staff would much prefer a raise so that they can buy their OWN coffee, treats or whatever. I find your actions somewhat patronizing, and I'll bet they do, too.

    But, kathi, I fear you are too closed minded to listen to reason or facts, so I give up. You will do whatever you want to do, the same way middle management in all hospitals does, until the staff finally complains that they simply are not getting throough to you--that you want to keep them at bay and buy them off by throwing coffee, treats, and parties at them every once in an while--just like the facilities that offer "Ice cream socials" and lollipops during Nurse Appreciation Week (dum-dums, mind you!) that say "Our nurses can't be licked!" and "I'm a sucker for a great nurse!"--that was the brainchild of the last middle manager I worked with--before they finally got rid of her, and realized just how useless middle management was at our hospital.
    Last edit by stevierae on Jan 10, '05
  7. by   caroladybelle
    Quote from kathi yudin
    this is a subject near and dear to me as i am middle management and director of nursing at a skilled nursing facility in newport beach.. while work situation may be a factor in the nursing shortage.. it is not the precipitating factor.. we are faced with a shortage because.. 1) baby boomers are retiring and aging .. 2).. there are waiting lists to get into nursing schools.. there are not enough instructors to train all that want to go into nursing... hospitals are discharging their patients earlier and earlier to nursing homes who get sicker and sicker residents..now.. let me tell you about working conditions where i work.

    so.. despite the fact that each nurse has 32 residents to pass meds to and be in charge of.. it is possible to give safe.. effective and efficient care!!!.. it takes time management and a desire and love for what you do!!!.. would i like to have more nurses??.. of course!!!!.. however.. there aren't enough out there.. as for other working conditions
    Alright, we have Kathi in middle management that says working conditions are not a factor in the shortage, that she gives lots of perks and somehow cannot retain staff. She thinks that an LVN to give meds on 32 patients is satisfactory, despite the increasing acute care situation in Nursing homes. That the shortage is due to the baby boomers retiring. She makes no mention of what has happened to all the nonbaby boomers that have graduated over the decades and are no longer in Nursing. But she is sure that the shortage is not due to unreasonable working conditions/heavy work loads.

    The we have a bulk of the respondents on this thread, that actually are floor nurses, not management...that are complaining about the working conditions and unreasonable work loads. And we have data that indicates that there are more than enough nurses out there to eradicate the shortage, but that they have gone on to other careers/jobs, because they can't stand nursing anymore.

    Sorry, Kathi, but we tend to give the staff nurses the authority here. Too many of us work for managers that understaff and yet expect that a few bennies will cover for us risking our licenses.
  8. by   lossforimagination
    Quote from alintanurse
    Unfortunately ,you are all too right in your evaluation of the nursing situation. Many of the people that I graduated with are no longer in nursing. Too many people have the idea that nurses are so "well paid" that it is part of our job to put up with the abuse. I've heard that statement from so many people and it makes me sick!
    Well paid? Not so for a staff nurse in this area.....is $20 - $25/hour "well paid"? Ok, maybe agency nurses get about $30/hr.... no doubt plumbers or electricians make more. At any rate, for a lot of people, no amount would ever be enough to have to put up with it all.
  9. by   alintanurse
    Quote from lossforimagination
    Well paid? Not so for a staff nurse in this area.....is $20 - $25/hour "well paid"? Ok, maybe agency nurses get about $30/hr.... no doubt plumbers or electricians make more. At any rate, for a lot of people, no amount would ever be enough to have to put up with it all.
    Exactly! that why I now tell those people that think nurses are "making the bucks" that the nursing profession is open to them as well,all they have to do is go for it-then they can cruise down easy street too!! Usually they have nothing more to say.
  10. by   pickledpepperRN
    http://www.calnurses.org/?Action=Category&id=251

    Email and Call the Governor

    Call 916-445-2841, extension 7 during business hours and leave a message saying: "I am a Registered Nurse from (City) and I am offended by your remarks about nurses and I oppose your attack on the safe staffing ratio law."
    Email him at governor@governor.ca.gov and cc CNA at press@calnurses.org
    Please let us know if we an use your letter publicly.

    More info:
    http://files.calnurse.org/assets/Talking_Points.pdf
    http://files.calnurse.org/assets/Letters.pdf
    http://files.calnurse.org/assets/Lawsuit.pdf
    http://www.calnurses.org/?Action=Content&id=544

    Hospitals use tax dollars (Medicare) and insurance money (your policy dollars) that is supposed to pay for nurses and patient care!
    http://files.calnurse.org/assets/121...A_AD_Alert.pdf
  11. by   SmilingBluEyes
    Quote from stevierae
    I just left a facility where I was doing chart audits to try to bring them into compliance with JCAHO, but they were hopeless. I hope they get shut down--I reported them to CNA and the BRN. The nursing administrator-- a traveler-- kept trying to cite "Title 22" and "licensed nurses" as a way of justifying using LVNs instead of RNs to fulfill the RN to patient safe staffing ratios--she thought that it was fine to use LVNs in their place. It's NOT.

    I told her the truth, that she did not want to hear--Title 22 is only a very, very small part of safe staffing--AB 394, mandated in Jan. 2004, overrides Title 22 in the case of any disagreement--and the CA Nurse Practice Act overrides them both. LVNs are not allowed to assess. Period. End of story. Read their nurse practice act--I don't care WHAT their job description says at your facility.

    So, you bring in coffee and treats twice a week--so what? I'll bet if you took a poll your staff would much prefer a raise so that they can buy their OWN coffee, treats or whatever. I find your actions somewhat patronizing, and I'll bet they do, too.

    But, kathi, I fear you are too closed minded to listen to reason or facts, so I give up. You will do whatever you want to do, the same way middle management in all hospitals does, until the staff finally complains that they simply are not getting throough to you--that you want to keep them at bay and buy them off by throwing coffee, treats, and parties at them every once in an while--just like the facilities that offer "Ice cream socials" and lollipops during Nurse Appreciation Week (dum-dums, mind you!) that say "Our nurses can't be licked!" and "I'm a sucker for a great nurse!"--that was the brainchild of the last middle manager I worked with--before they finally got rid of her, and realized just how useless middle management was at our hospital.

    I continue to be amazed at how well-informed you are. You really know your way around nursing practice and laws. Thanks for all your valuable informative posts.
  12. by   SmilingBluEyes
    As well, as you, Spacenurse. You are fountain of information.
  13. by   stevierae
    i encourage all ca rns--in fact, all rns who are concerned about safe staffing, optimal patient care and better working conditions for nurses--to respond to this anonymous "guest" editorial that appeared in the orange county (ca) register and a ca high desert newspaper called desert dispatch.

    the author also makes a point of trashing cna.
    the editorial can be viewed via this link:

    http://www.desertdispatch.com/2004/110450326333914.html

    my own response to the editorial appears below. there is a form on the site on which you can register and email a response.

    you can also email the publisher and each department's editor personally from the site, once you register. i would also copy in cna, to let them know you support them in the good fight.

    my own response:

    i wonder who the "guest" who wrote that editorial is? notice that the paper is one from the ca desert--which has hospitals that think they do not have to play by the rules.

    i am betting it was written by some upper or middle management nursing manager or one of her minions up at some hospital in the ca desert, concerned only about putting fat bonuses in their own pockets.

    or, it may have been some hospital ceo out in that same vast ca desert (some of the little hospitals up in the ca desert are notorious for thinking they can bend the rules; utilizing lvns as part of the staffing ratios which very specifically call for rns and ignoring the need to staff with even more rns when patient acuities (which they do not bother with) call for it, citing "title 22," but conveniently ignoring the provisions of ab 394 and our own ca brn.)

    there is a reason most of those desert facilities are now staffed mostly with travelers--even the charge rns and administration are travelers, and there are consultants frantically working behind the scenes to somehow keep them afloat and avoid fines and shutdowns. the staffs simply became mad as hell and refused to take it anymore. has anyone read about mlk in los angeles? now staffed primarily by travelers, with all kinds of outside consultants and committees frantically working behind the scenes? these facilities are mlks in the making.

    at many of these desert facilities, there are no aides--they were let go as a cost-saving measure--so, not only do the few rns have to deal with sicker patients, (not being allowed to assign acuity levels, they cannot demand extra rn staff) they must take on an increased patient loads as they are responsible for every action carried out by an lvn--and do the work traditionally carried out by nursing assistants.

    lvns cannot assess, at least not in ca--despite what nursing management and administration--particularly the temporary "consulting" managers and administration, who are from out of state and don't have a clue about the history behind ab 394-- would like to bully them into believing. most staff lvns realize this, so, unwilling to put their own licenses on the line, they leave, too.

    i do understand that arnold is simply trying to delay the 1:5 med surg ratios at this time. i don't work med-surg, but 1:6 seems reasonable for the time being--as long as those med-surg units are strictly adult units (once they become mixed with sick peds patients, the ratios and acuities--and the mixture of rns, not all of whom can care for sick peds patients-- need to be adjusted accordingly) and as long as there are aides and housekeeping staff so that the rns can concentrate on optimal patient care, and as long as the rns can speak up and demand that additional rns be made available--that's what registry (agency) is for--when acuity levels demand increased rn to patient ratios.
    staffing is a management dilemma. let's hold them accountable!!!!

    we--my fellow cna rns and i--have fought for these safer rn to patient ratios since the early '80s, striking when needed. gray davis, the governor in the '90s, signed ab 394 into law in around '96, and mandated that all hospitals come into compliance by january 2004. they have had years to come into compliance--this is not something that was sprung on them overnight.

    this is my concern. if arnold wants to play with the med-surg staffing levels--then what's next? the l& d staffing levels? the icu staffing levels? instead of 1:2 in icu, he'll decide that 1:3 is fine and dandy? heck, why not 1:4?

    i've already seen it in the ca desert--1 rn to 4 sick patients, 1 of them on a ventilator with a propofol drip that anesthesia said he would not/could be held responsible for, since implementing it was the rn's suggestion; fighting pulmonary edema secondary to fluid overload, since there was no ability or equipment to monitor cvp; (not even an old fashioned iv pole mounted water manometer) 1 patient who required frequent arterial sticks for abgs because there was no equipment to set up and monitor an arterial line, who possibly suffered an intra-op stroke and was seizing and bleeding internally.

    the single rn had all she could do to keep one alive; she had to ask the unit clerk--all of 23 years old--to "keep an eye" on the vent patient so that she could tend to the seizing patient and get her medevaced out to a hospital that could handle her.

    management's response when this rn asked for help? sent an lvn back there. when said lvn "helped" by spiking a unit of blood wrong--said blood promptly went all over the floor, bed, ceiling and patient--management promptly turned on her heel and left. if one pretends not to see a problem, the problem doesn't exist, right? denial is a wonderful thing.

    that's one opinion from an rn who works in ca.
    Last edit by stevierae on Jan 14, '05

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