Hospital Cannot Require RNs to Remove Button Stating Demand for 'Safe Staffing' - page 3

Hospital Cannot Require RNs to Remove Button Stating Demand for 'Safe Staffing' Labor Relations Week Apirl 14, 2005 A Washington state hospital's requirement that nurses remove a union... Read More

  1. by   SmilingBluEyes
    Thoughtful posts, StevieRae. Not sure I am for wearing buttons at work, yet. But you give me much food for thought. I am on the fence on this one. I see both sides.
  2. by   pickledpepperRN
    I wear a button, "Patients are my special interest"
  3. by   VivaLasViejas
    Quote from SmilingBluEyes
    Thoughtful posts, StevieRae. Not sure I am for wearing buttons at work, yet. But you give me much food for thought. I am on the fence on this one. I see both sides.
    Me too. Stevierae, you've made some excellent points, and I'm glad to see the beginnings of a movement here in my state (Oregon) to implement staffing ratios.......my hospital currently does it informally and voluntarily, but I know most don't, and I'm for anything that makes things safer for both patients and staff. Good luck with your presentation, and let us know how it goes!
  4. by   pickledpepperRN
    Quote from stevierae
    www.cms.gov
    [url] www.apic.org

    If we all get involved as the patient advocates we took an oath to be, soon mandatory RN to patient safe staffing ratios will be mandated nationwide.
    Ratios AND infection control - YES!

    I'm going to sleep now. When i wake up I will study these sites.

    Thank you!
    Let us know if we can be of help from another state.
  5. by   stevierae
    Quote from spacenurse
    Ratios AND infection control - YES!

    I'm going to sleep now. When i wake up I will study these sites.

    Thank you!
    Let us know if we can be of help from another state.

    I forgot to mention that there is currently a bill in the works for CA to be one of the states that will mandate infection rate reporting by hospitals. However, guess who doesn't want it to be passed, although I do not know his rationale?
    Arnold. Are we surprised?

    When will he understand that nurses are not ones who can be eaily intimidated?

    If you are a CA nurse, and you want to check on violations, complaints, fines, citations etc. at ALFs, SNFs, etc. or are simply shopping around for potential nursing homes for an elderly family member, here's an easy way to do it:

    Call the Department of Aging at 916-322-3887. Speak to anyone there, and give them the name of the facility you are interest in. They can look it up for you, and will tell you whatever they have on that facilty.

    If you prefer to do the detective work on your own, or for future reference or simple curiosity, go to this site:

    www.ccrd.ca.gov

    Type in the name of the facility. You may need to also type in the county.

    The license number of the facility will come up. Make note of it.

    If the facility is in San Francisco county, (tha'ts just the one I am most familiar with, since I work there) call this number in San Bruno once you have the license number of the facility:

    650-266-8800

    They will fill you in on violations, complaints, etc. You can also come into the office and look at the file. The San Bruno facility is at 851 Traeger Avenue, Suite 360.

    Every facility also has an ombudsman, or several. They are also good resources.

    For nurses/consumers in other states, every state has a Department of Aging, or something similar--and all nursing homes have ombudsmen you can contact.
    Last edit by stevierae on Apr 21, '05
  6. by   pickledpepperRN
    Boy did I find out a lot!
    Like you said - Why do some not choose to report?

    I think ther will be some explaining to do.

    Thank you!
  7. by   lindarn
    Quote from stevierae
    I agree. It's BECAUSE we wore buttons (there were also billboards everywhere) that said "Every patient deserves a Registered Nurse" in CA that patients, who are also savvy consumers who shop around, investigate hospital politics, infection control standards, (and the info (available online) about how many hospital acquired infections have been reported--as well as how this hospital compares to other hospitals in state of the art and up to date delivery of care for conditions such as stroke, MI and pneumonia,) complaints, JCAHO accreditation, (and if none, ask why,)
    and ASK who is delivering care to them or their loved ones, that CA is now the ONLY state in the nation to have a mandated RN to patient ratio--as well as, in most CNA hospitals at least, lift teams and plenty of other ancillary help. Patients shouldn't have to sit on a bedpan or wait hours to be logrolled after spinal surgery because they are heavy and nurses don't want to hurt their backs or have previously hurt their backs--or simply can't gather up enough co-workers to help them. With those big body builder guys that compose lift teams, they are there in a heartbeat to take over, and it's their pleasure to take over and to assist in achieving optimal patient care conditions.

    Don't sell patients short, and don't feel like you need to keep them in the dark to give good patient care. When there is a strike involving nursing, in my experience, patients often won't cross the strike line unless they have absolutely no other option. They "honk" their support; they drop by with food and beverages; they stop and talk and tell the striking nurses how much they appreciate them--and to keep up the good fight. They know it benefits them.

    Patients, and potential patients and their families can all help effect change. They are all consumers. They pay their taxes. They pay their insurance premiums; if they are Medicare recipients, they have worked for many years to become eligible. They are honored citizens.

    If I worked the floors, and we were dangerously understaffed due to management trying to save a buck and not call in registry, per diems, etc., and a patient wondered about why the floor seemed so hectic and why his needs weren't being tended to in the timely fashion they deserved, I would tell him that we were understaffed, why, and advise him to talk to the unit manager on the spot, demanding an answer as to why the patients on that floor, himself included, weren't deserving of quality care, including safe staffing. I'd also ask him to go up the chain of command, to membership services, to hospital administration, and write a letter to the local newspaper and, perhaps, his local congressman (or even call the media) once he's discharged (or earlier, if he is feeling up to it) to make his concerns public, and describe his hospital experience, so that others can be forewarned--and know what questions to ask; perhaps deciding to avoid that hospital for future care; perhaps even deciding to terminate membership in that health plan.

    Patients have the right to know what corners are being cut and to stay fully informed. It's not our place to withhold information from them or sugarcoat it, particularly when they ask. To do so would be patronizing and disrespectful.

    I have no problem with patients, legal pad in hand, writing everything down--names, times, dates, conditions, etc. If the care you deliver is care you can be proud of, then why worry about it? You should be intorducing yourself to the patient anyway--he shouldn't have to ask anyone's name. If a patient is taking notes, maybe nursing management, Risk Management, and hospital administration needs to sit up and take notice and wonder what they could do to put patients more at ease--in other words, get their heads out of the sand and out of denial. Perhaps that patient is an attorney perhaps just an informed consumer who has a right to quality care. I applaud him for questioning what goes on and planning to take action, as a consumer, to implement change.

    We are patient advocates, first and foremost, mandated by ANA and our nurse practice acts. Don't ever forget that. That means giving our patients full, honest information.

    Stevierae,

    You hit the nail on the head. Patients deserve to know how many other patients their nurse is responsible for. They deserve to know that MANAGEMENT AND ADMINISTRATION have allowed unsafe staffing to occur and that is why they are not getting the care that they deserve and they are paying for. Nurses have, for too long, been reluctant to make the public aware of the politics that affects their care. We have remained silent for too long and allowed others to take over and control our profession. Teachers go straight to the public and parents when they are unhappy with the classrom situation. Aren't teachers professionals? They have one of the strongest unions in the country.

    It is MANAGEMENT'S JOB to ensure safe staffing for hospital patients. Not ours. We have NO CONTROL over our working and staffing conditions. I grew tired of patient complaints about their care and the care of their family members. I got sick of acting as the hospital "whipping boy" for unhappy patients, when I have no control over the conditions. We should direct all unhappy patients and their family members to administration. Let them sit and listen to patients and family members screaming at them, and throwing temper tantrums. You would see how fast the concept of "customer service" would end, along with "open visiting hours in the ICU". They did not pay me enough to put up with it. I left four years ago, and exclusvely do legal nursing.

    When the staffing is the pits because the nurse manager floated off two RN's and an aide to "right size the budget for this month", let the patients and family know why the unit is a madhouse. Let the responsible individuals take the heat for their piss poor management and administative decisions. We have let them off the hook for too long and not held them accountabe for their decisions.

    As Stevierae said, they have a right to know about the decisions that affect the quality of their care, and the reasons for it. I worked at Sacred Heart for 12 years, and after the "care re- design" of 1994, the staffing and conditions became intolerable. The above scenario happened to me, in the ICU, after two nurses and an aide were floated off the unit, because our "numbers" did not fit Sharon's budget. We had no helper nurse, no aide, and to add to my workload, the supply shelves in the room weren't stocked, and the linen closets in the rooms were empty. I spent a good part of my day, running to the unit supply and linen closet retrieving suppplies that I needed to properly care for my patients.

    My assignment was atrocious, as you can probably figure, and I spent 12 hours listening to the unhappy family members screamng at me. To add insult to injury, as an incentive for nurse managers, they received year- end bonuses for successfully cutting their units' budget to the bone.

    Even though I am happy that the nurses as Sacred Heart stepped out of their comfort zone, and took a rather militant step, most of them are too scared and weak to take any definitive action against the hospital. They must have really pressured WSNA for them to do anything against the hospital. I was always frustrated with the nurses, and what they were willing to put up with. The crap that they took from the hospital was unbelievable. No one ever wanted to pressure the hospital and WSNA to do anything. They were under the illusion that they really has some protection with WSNA. The best thing that the nurses there can do is dump WSNA and go with the union that is on the coast in Tacoma. They have been worthless as a bargaining unit for the nurses, and as protection from abusive management and adminstrative practices. Grievances were a "kangaroo court" joke. The hospital bullies WSNA more than they bully the nurses. There is a post on the United States Forum for Washington, concering nursing unions in Washington. I posted a reply on that as well, and a nurse from Tacoma responded. You all should read it and act accordingly.

    I wish the nurses luck, but it will take guts to stand up to the hospital. There is power in numbers, and a stronger union than you have. Been there done that, will not go back.

    Lindarn, RN, BSN, CCRN
    Spokane, Washington
  8. by   leslie :-D
    you guys should read brian's new thread "nurses advocate disclosure on staffing"...so much more productive and conducive to change than wearing buttons.

    leslie
  9. by   SmilingBluEyes
    Quote from earle58
    you guys should read brian's new thread "nurses advocate disclosure on staffing"...so much more productive and conducive to change than wearing buttons.

    leslie
    I would agree.
  10. by   stevierae
    Quote from SmilingBluEyes
    I would agree.
    I had not had a chance to check it out--just assumed it contained the same material as this one. Whatever works to effect change is a good thing (as long as it doesn't involve Mafioso tactics, etc.!) I'll check Brian's thread out, for sure.
  11. by   Sue7573
    I don't want to get to far off the subject, this is about staffing kind of on a smaller scale. The nursing home I work for is owned by our local hospital. Prior to the hospital buying it, the nursing home was for profit privately owned. Once the hospital took over it was "not for profit" extension of the hospital services. While it was privately owned we were staffed adequatly all of the time. The CNA/Patient ratio was never more than 8 (rarely more than 6) residents. The employees wanted to come to work every one would be there not just on time but 30min-1 hour early. Never was there a call in and NEVER EVER insobordanation(sp) i.e. talking ugly to nurses or walk outs. We got raises at least twice a year. Usually it was cost of living raise and annual raise and it was never 2-3% I mean you could tell you got a raise. The adminstrator was there every one knew him, he knew everyone by name residents and staff members alike. He shook our hands he patted our shoulders, he hugged and loved our residents. Then when the hospital bought us out he was the first one out him and our DON. It was never the same since. We stopped getting the cost of living raise and we would have to fight tooth and nail to get our annual raise (which was on 2-3%) The cost of the beds went up the quality of care, food, staff went down. Now on a good day our CNA/patient ratio is 1:16-20 and to help cut the work load they came down with we didn't have to give baths everyday because the soap irritated the skin of the elderly and caused more skin tears. I could say that, that is true.. But giving fewer baths means not handeling the resident as much which could result in fewer skin tears.. Well my point is this... when it was "for profit" people cared more wanted to do more.. when it went to "not for profit" why bother right.. thing is all of the upper management still got bonus' and what is the word.... incentives for cutting corners and bringing costs down.... I don't get it I don't understand why would you cut patient care in order to bring costs down. I found out how much each bed cost and figured a few of the bills from being nosey and figured out that our "not for profit" hospital could very well be grossing a smidge over 400 million a year on just the nursing home alone. I am a nursing student (been accepted actually start in aug) and I would love to bring back 'the good ole days' when patient care was top priority and that is what every one in the building strived to achieve. thanks for toiling thru my spouting

    Sue
  12. by   stevierae
    Quote from Sue7573
    . But giving fewer baths means not handeling the resident as much which could result in fewer skin tears..
    Well, I have never worked long term care, and can certainly understand that the skin of elderly people can be more friable. But, to me, this sounds like a lame excuse offered by your administration for NOT doing basic patient care--and when I went to nursing school, (I graduated in '81) we were taught that the bath was the ULTIMATE opportunity to do a head to toe assesment. No bath? No head to toe assessment was done, in my opinion----I tend to believe that a lot of LTC nurses just fake their charting, with the attitude that "this patient is going to die soon anyway." Sad, but I firmly believe it's very, very true. There are a few caring nurses in LTC--but they are definitely in the minority.

    I have seen patients transferred from various LTC facilties to various operating rooms where I have worked--always with the same condition---deep, to the bone, in fact, decubiti in the exact outline of a bedpan. My question to the nurse was always the same--"Don't you ever make ROUNDS on your patients---you know, walk up and down th ehalls; talk to them, see how they are feelig, say hello, see if they NEED anything?" (Maybe I am dating myself, but when I was a corpsman in the Navy before nursing school, we had no intercom system--we walked up and down the halls, all night long, flashlight in hand.) Answer from these nurses? Always the same: "It's the nursing assistnat's job to answer call lights." Great. Just great. I wonder what a plaintiff attorney would do with this answer in depo or in court---because that nurse does not seem to understand that she is responisble for that patient, AND she is reposnisble for care given/not given by ancillary personnel--including nursing assistants---under her supervision. Laziness; pure laziness, on the part of those nurses.

    There was a San Diego RN on one of the threads a while back who thought it was perfectly acceptable for her nursing assistants to be caring for up to, I believe, 38 people at a time!!!!! Unreal. I cannot recall if they gave meds or not--I thought they did. Her rationale for her supposedly having a happy crew, with no complaints, is that she brought in coffee and bagels (or donuts) at leas once a week and also let them plan their own Christmas party, at the place of their choice. Gee, that makes it all worthwhile, huh? :uhoh21:

    I'm sure she has a waiting list of nursing assistnats, dying to work at such a desirable facility---hey, free coffee and bagels once a week; what more could one WANT? (Maybe less patronizing behavior--and more well-earned professional RESPECT-- from their supervisor would be a START.)
    Last edit by stevierae on Apr 23, '05
  13. by   Pangaea Unolandmass
    I agree with ocankhe and 2ndcareerRN. People are not only being put in danger, but they're being ripped off. Even if they don't die, it's fraud to make people pay ICU charges when their nurse has 3 vented patients, or 4 patients. That is not Intensive care.

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