Hospitals Creating Programs for Nurses to Combat 'Compassion Fatigue' - page 3

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Programs for Nurses to Combat "Compassion Fatigue "Bruises and pulled muscles, hope and heartbreak emotional and physical fatigue have contributed to a profound nurse shortage in hospitals across the country." "Nurses... Read More


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    Our administration does. We recently implemented a EMR which has caused havoc on our care delivery. It was probably broke before but after implementation it truly highlighted how broken it was. Our CNO has convened a group of staff nurses to look at our care delivery and redesign it. I read many posts that speak very negatively about nursing administration etc., however not all nursing admin. are as described. I am a director of nursing and I get frustrated because I want the nurses I represent to be involved and part of the solution instead of simply complaining all the time. It seems many are more comfortable complaining than helping to take the responsibility of improving our profession. It is going to take a professional team to do this.....
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    Quote from sandyrae
    Our administration does. We recently implemented a EMR which has caused havoc on our care delivery. It was probably broke before but after implementation it truly highlighted how broken it was. Our CNO has convened a group of staff nurses to look at our care delivery and redesign it. I read many posts that speak very negatively about nursing administration etc., however not all nursing admin. are as described. I am a director of nursing and I get frustrated because I want the nurses I represent to be involved and part of the solution instead of simply complaining all the time. It seems many are more comfortable complaining than helping to take the responsibility of improving our profession. It is going to take a professional team to do this.....
    Do you direct in an acute care hospital?

    Are you able to implement safe staffing levels? Break relief nurses?Nurses cannot be expected to go do a puzzle while patients are not being cared for.
    janhetherington and RN1982 like this.
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    Quote from herring_RN
    Do you direct in an acute care hospital?

    Are you able to implement safe staffing levels? Break relief nurses?Nurses cannot be expected to go do a puzzle while patients are not being cared for.
    Yes I do. I am director for critical care and emergency serives. We do have staffing grids as most places do, however my departments understand that safety trumps numbers. I trust their judgement to utilize the staff they need to provide safe care. Are we able to have perfect staffing all the time, of course not but it is not because of some higher administrative body saying we can't staff a certain way. We all know about late call outs, etc. It is a high priority for me that nurses have their time to get away from the care enviroment to take time for themselves. That is the only way they will be able to take good care of their patients. I do take offense to the many posts that make it sound like once someone enters a nursing adminstration position they are deemed the enemy. I entered because I felt we needed strong advocates for nurses, but it is like anything else, how long to you expect someone to keep fighting for us when they feel half the time they are fighting each other. I expect us all to act as professionals, especially if we expect other disciplines to treat us that as professionals.
    janhetherington and aknottedyarn like this.
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    The, " us against mentallity" mode is alive and well. I spoke out against this while in nursing school. Things were such a mess that a meeting of all student body and staff was convened. I could see clearly it happening and knew it would worsen unless adressed. I am pleased that a member of management is expressing frustration with current circumstance. Perhaps the administration where you work has seen the light and is willing to attempt to staff adequately but this is not the norm. The vast majority of administration and management prefer to remain members of the, "mushroom club ", And they sit and wonder why they are so resented and why staff nurses will not respond to them.
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    I'll give you an example of what frustrates me to no end.

    Scenario: Night shift, tele/ICU stepdown unit, 36 beds
    A safe n/p ratio: 4 patients per nurse (we get a LOT of pts because "ICU doesn't have another nurse," not because they actually NEED to be on our floor, so we usually have really high acuity)
    Average n/p ratio: 7 patients per nurse
    a safe CNA/P ratio: 1 per 10 pt
    average: 1 for all 36

    How does this actually play out? I've been a nurse about a year. Last time I worked, there were 4 nurses for 36 beds, and no CNA at all. My charge had been a nurse about 6 months, the other RN only had 18 months as a nurse, and the 4th nurse was 2 months off of orientation. My charge and the newbie have never worked a code. I've worked a bunch (mainly because I don't run in the other direction when the code goes off, but I digress).

    I went thru the whole shift with a knot in my stomach, and going over the ACLS protocols in my head, because if we'd had a code, I was the only ACLS certified person on shift.

    During our shift, we had one person have an MI, and a second had a CVA -- but we had to hold them on our floor until another ICU nurse could drive in... We had one DNR pass. A third of the pts on shift were total cares, q2h turns, we had 10 (10!) PEGs. We had 5 colostomies, including one dementia pt who's family flatly refused to allow her to be in restraints, and she was pulling her colostomy off and fingerpainting herself with the contents 3 times on the shift. We had one person with a BMI of 56 who took everyone on the floor to turn. We had 4 people going thru the DT's. Everyone's meds were late, everyone's turns were late, and we were supposed to give all the totals baths (they got a bath if they were dirty, that's all we had time for).

    Dayshift came in, and we were exhausted, trying to fly around and do the 7 am med pass before dayshift takes over at 0730. Did we get an "atta girl" -- of course not. Our NM B'd us out because the station "didn't look tidy" ...

    Bite me.
    ArwenEvenstar likes this.
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    Quote from nerdtonurse?
    I'll give you an example of what frustrates me to no end.

    Scenario: Night shift, tele/ICU stepdown unit, 36 beds
    A safe n/p ratio: 4 patients per nurse (we get a LOT of pts because "ICU doesn't have another nurse," not because they actually NEED to be on our floor, so we usually have really high acuity)
    Average n/p ratio: 7 patients per nurse
    a safe CNA/P ratio: 1 per 10 pt
    average: 1 for all 36

    How does this actually play out? I've been a nurse about a year. Last time I worked, there were 4 nurses for 36 beds, and no CNA at all. My charge had been a nurse about 6 months, the other RN only had 18 months as a nurse, and the 4th nurse was 2 months off of orientation. My charge and the newbie have never worked a code. I've worked a bunch (mainly because I don't run in the other direction when the code goes off, but I digress).

    I went thru the whole shift with a knot in my stomach, and going over the ACLS protocols in my head, because if we'd had a code, I was the only ACLS certified person on shift.

    During our shift, we had one person have an MI, and a second had a CVA -- but we had to hold them on our floor until another ICU nurse could drive in... We had one DNR pass. A third of the pts on shift were total cares, q2h turns, we had 10 (10!) PEGs. We had 5 colostomies, including one dementia pt who's family flatly refused to allow her to be in restraints, and she was pulling her colostomy off and fingerpainting herself with the contents 3 times on the shift. We had one person with a BMI of 56 who took everyone on the floor to turn. We had 4 people going thru the DT's. Everyone's meds were late, everyone's turns were late, and we were supposed to give all the totals baths (they got a bath if they were dirty, that's all we had time for).

    Dayshift came in, and we were exhausted, trying to fly around and do the 7 am med pass before dayshift takes over at 0730. Did we get an "atta girl" -- of course not. Our NM B'd us out because the station "didn't look tidy" ...

    Bite me.

    I would have told her to bite me. At my former job, which was my contingent job, which is now permanantly my former job, I worked on a critical care stepdown, n/p 4:1 when the acuity of the patients were ICU-like. One night we had 5 nurses for 24 patients, no clerk, one CNA. Our sister unit had the same staffing. So we were suppose to rely on the one ICU clerk that night. Where was the assistant nurse manager? In the office and she said and I quote "I have my own work to do". Kiss my fat a$$ is what I wanted to say to her
    nerdtonurse? likes this.
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    Quote from nerdtonurse?
    I'll give you an example of what frustrates me to no end.

    Scenario: Night shift, tele/ICU stepdown unit, 36 beds
    A safe n/p ratio: 4 patients per nurse (we get a LOT of pts because "ICU doesn't have another nurse," not because they actually NEED to be on our floor, so we usually have really high acuity)
    Average n/p ratio: 7 patients per nurse
    a safe CNA/P ratio: 1 per 10 pt
    average: 1 for all 36

    How does this actually play out? I've been a nurse about a year. Last time I worked, there were 4 nurses for 36 beds, and no CNA at all. My charge had been a nurse about 6 months, the other RN only had 18 months as a nurse, and the 4th nurse was 2 months off of orientation. My charge and the newbie have never worked a code. I've worked a bunch (mainly because I don't run in the other direction when the code goes off, but I digress).

    I went thru the whole shift with a knot in my stomach, and going over the ACLS protocols in my head, because if we'd had a code, I was the only ACLS certified person on shift.

    During our shift, we had one person have an MI, and a second had a CVA -- but we had to hold them on our floor until another ICU nurse could drive in... We had one DNR pass. A third of the pts on shift were total cares, q2h turns, we had 10 (10!) PEGs. We had 5 colostomies, including one dementia pt who's family flatly refused to allow her to be in restraints, and she was pulling her colostomy off and fingerpainting herself with the contents 3 times on the shift. We had one person with a BMI of 56 who took everyone on the floor to turn. We had 4 people going thru the DT's. Everyone's meds were late, everyone's turns were late, and we were supposed to give all the totals baths (they got a bath if they were dirty, that's all we had time for).

    Dayshift came in, and we were exhausted, trying to fly around and do the 7 am med pass before dayshift takes over at 0730. Did we get an "atta girl" -- of course not. Our NM B'd us out because the station "didn't look tidy" ...

    Bite me.
    And the hospitals wonder why we have compassion fatigue??!!?!?! IMPROVE WORKING CONDITIONS and maybe we wouldn't have compassion fatigue!!!!!! TREAT the cause of our compassion fatigue, not just the symptom!

    Duh! And they wonder why nurses are leaving the profession or at least leaving the hospital??? I left the hospital almost 4 years ago now - NEVER going back. No amount of money is worth it. I now do private duty. With a BSN and and 17 years experience, I am essentailly "underemployed" doing private duty. But to have my sanity is worth it.

    Besides the short staffing, it is wrong to have such an out-of-proportion ratio of experienced nurses vs. new grads. I had similar expereinces where I would be the ONLY experienced nurse with all the other nurses having one year or less under their belts. I also felt horrible stress and pressure knowing I was the only experienced one on if there was a code or other crisis!
    nerdtonurse? likes this.
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    :yeahthat:What kills me is rather than saying, "hey, we need to hire some more nurses, get the PRN pool larger, etc.," they are actually talking about increasing the staffing ratios -- so that it's "normal" to have 8 pts....

    God, I've got to find another job before I lose my license....
    Last edit by nerdtonurse? on Oct 10, '08 : Reason: spelling
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    I agree that takiong care of yourself is really the antidote to compassion fatigue. You take care of yourself and you have a lot more to give to others! Thanks for writing this.
    Wendy Leebov


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