"Failure to Rescue" - A product of the nursing shortage?

  1. 5
    I wonder if this common "mistake" is actually a result of too few nurses stretched thin "failing" to be able to pick up on subtle signs of patient failure"...

    http://www.msnbc.msn.com/id/24002334

    They can't expect nurses to be miracle workers, esp when they have too much charting and too many patients.
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  5. 29
    "The ratio of nurses to patients is one measure of how well a hospital might control its failure to rescue rate, Clarke said. Just as important, however, is the education and experience of the nurses and whether they have the resources available to do their jobs."

    I think another part of the problem is the exodus of seasoned, experienced RNs from the bedside, leaving many hospital med-surg units largely staffed with poorly prepared novice RNs with little supervision or mentoring. This is something I've mentioned in many of the discussions here about the "nursing shortage" -- the answer to experienced nurses leaving the field in droves is usually presented (in public conversations about the issue) as making it possible for schools to crank out larger and larger numbers of new grads, quicker and quicker (rather than talking about changing hospital employment conditions to make it more appealing for the experienced RNs to stay) -- but what will the consequences be, over time, of having hospitals staffed largely by inexperienced new grads? I guess this MSNBC article could be considered one possible answer to that question ...
  6. 12
    I agree - seasoned nurses have the expertise to detect when a patient could be failing, or that a status change has occurred that does not bode well.

    Speaking of not boding well... if the experienced nurses are leaving the bedside due to bad working conditions, that does not bode well for new nurses, who will be even less able to tolerate those conditions due to 1) lack of mentors and 2) the normal stresses of being a newbie.

    Not to mention the increasing acuity of patients, 12-hour shifts, high patient:nurse ratios, more demanding families, hospitals too focused on $ and presentation, etc., etc.

    These are systemic problems rooted in the changing health care system. No easy answers; but I wish Congress could be braver about addressing health care reform such that hospitals/LTC would focus on RETAINING nurses, reducing charting requirements, and assigning fewer patients to a nurse.
    Last edit by marie-francoise on Apr 8, '08
  7. 0
    Quote from marie-francoise
    Speaking of not boding well... if the experienced nurses are leaving the bedside due to bad working conditions, that does not bode well for new nurses, who will be even less able to tolerate those conditions due to 1) lack of mentors and 2) the normal stresses of being a newbie.

    Not to mention the increasing acuity of patients, 12-hour shifts, high patient:nurse ratios, more demanding families, hospitals too focused on $ and presentation, etc., etc.

    These are systemic problems rooted in the changing health care system. No easy answers; but I wish Congress could be braver about addressing health care reform such that hospitals/LTC would focus on RETAINING nurses, reducing charting requirements, and assigning fewer patients to a nurse.
    I agree completely.
  8. 1
    When I was working at a local hospital in chicago. I see the nurses' frustration with the new technology... computer charting. It takes them twice as long as paper charting. Most of the time the computer freezes and when that happens the whole unit goes to he__. Not only that, if you don't have a particular med. in your drawer i have to pick it up from pharmacy. When that happens, I am sitting there waiting for the medication for almost 30 minutes or more. And please don't ever have only one nurse aide working on the unit. That really guarantees a bad day for everyone. There is no easy fix for the crisis we are about to face. My only suggestion is to talk with your state representative, and hopefully they will listen to what you have to say. If you really feel the problem is important, anyway.
    calliesue likes this.
  9. 2
    We have a team ( an ICu nurse, and resp. therapist), who can respond if we feel a patient is going bad ( VS, Resp problems, etc.). They can help us further assess the patient and provide acute care. We of course call the doctor and they usually talk to them also. Most of the time the patient is moved to the ICU or other unit for closer monitoring. I have called on this "team" a few times. I agree though that it is shame that "seasoned nurses" are leaving the profession due to long shifts and unsafe patient care, understaffing etc.
    calliesue and wooh like this.
  10. 12
    Quote from Ruffles 1
    We have a team ( an ICu nurse, and resp. therapist), who can respond if we feel a patient is going bad ( VS, Resp problems, etc.). They can help us further assess the patient and provide acute care. We of course call the doctor and they usually talk to them also. Most of the time the patient is moved to the ICU or other unit for closer monitoring. I have called on this "team" a few times. I agree though that it is shame that "seasoned nurses" are leaving the profession due to long shifts and unsafe patient care, understaffing etc.
    More and more facilities are instituting Rapid Response Teams. However, again, they can only help if the bedside nurse is able to recognize that the client is getting into trouble and calls for them.
  11. 4
    Sadly most often they only way places see the light of day is for the "right " person to die of have a error occur to them due to these issues. Then the crappola hits the fan.

    I keep saying the only way any facility will ever get enough nurses is to open up the wallet and spend the cash. Pay us what we are worth, buy us the best equipment money can buy, pay 100% for CE, BSN if we so desire, certifications if we choose. Pay for our insurance and give use daycare if we need it and all shift included, sick and well children too. If some facility were to do that I could almost bet they would rarely have any instances of "failure to rescue"or what ever you wanna call it this week.

    Rj
    flygirl43, calliesue, VickyRN, and 1 other like this.
  12. 1
    Quote from elkpark
    More and more facilities are instituting Rapid Response Teams. However, again, they can only help if the bedside nurse is able to recognize that the client is getting into trouble and calls for them.
    Yeah, we sometimes here the RR team being called and then 2-3 mins later its a code blue to the same room. So yeah that is an issue.
    calliesue likes this.
  13. 1
    Quote from marie-francoise
    I wonder if this common "mistake" is actually a result of too few nurses stretched thin "failing" to be able to pick up on subtle signs of patient failure"...

    http://www.msnbc.msn.com/id/24002334

    They can't expect nurses to be miracle workers, esp when they have too much charting and too many patients.
    I think the condition H system is a good idea and the last two places I worked had H team. However, I have to tell you that in one hospital you got nearly a full code team for a condition H, at the other you got either a ICU nurse or stepdown nurse and either a ER doc or House officer. The person writing this speaks about "building an intensive care unit around the patient in a few minutes". That is expecting a lot, even the hospital which had a big condition H team could hardly manage that and the one that sent one nurse and one doctor was no where near such a thing. YOU CAN ONLY HAVE AN INTENSIVE CARE AROUND A PATIENT WHEN THEY ARE IN INTENSIVE CARE! Both hospitals of which I am speaking had shortages of intensive care beds and both had situations where codes where called and the patient could not be moved for a long time. Also, the nurses that came to the condition H were nurses that were pulled from the bedside of patients they were caring for and that is not exactly a safe situation. I don't know where these researchers get their ideas sometimes. I think that a lot of places will set somesort of minimal team up just like the place that sent one nurse and one doc just so they can brag they got a H team when the reality is far from the idea.
    calliesue likes this.


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