Nurses feel pressure of daily workload

  1. By Christine Haines, Herald-Standard

    Even when hospital administrators say they are fully staffed, nurses on the floor often say they need more help.


    "It's been an age-old dilemma, the difference in thinking between the administration and the floor nurses," said Michele Campbell, executive director of the Pennsylvania Nurses Association (PNA). "The critical issue that brought it to the attention of everyone was hospitals not being able to fill shifts, but floor nurses have always felt they were understaffed."

    An international study conducted in 2001 by the University of Pennsylvania involving 43,329 registered nursed in 711 hospitals in five countries supports the anecdotal reports of the shortage. Two-thirds of the nurses surveyed said there are insufficient nurses in their hospitals to provide adequate quality care to the patients.

    Campbell said that medical care requires more nurses today than ever.

    "The technology is more advanced and the drugs are more complicated. ...It's no longer reasonable for one nurse to be taking care of eight, 10, or 12 patients on the off-shifts," Campbell said.

    No states have staffing ratio regulations, she said, and while some nursing unions have been calling for minimum staffing ratios, the PNA is not.

    "We are not supporting numbers in legislation because then you establish ceilings. We do believe that each institution should establish staffing ratios for individual departments. It needs to be flexible," Campbell said.

    Campbell said certifying agencies set some regulations on staffing, but no general staffing guidelines are mandated.

    Full Story: http://www.heraldstandard.com/site/n...d=480247&rfi=6
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  2. 15 Comments

  3. by   VivaLasViejas
    Where I work, we are fortunate in that we are generally staffed fairly well; our managers are working nurses who can, and do, jump in and help out on the floor when we need an extra pair of hands, and while I don't think we have enough CNAs, it's because they keep going to nursing school and becoming RNs!

    However, there are days---and they happen on a regular basis---when we could have a dozen RNs out there on our 38-bed unit and it wouldn't be enough. Many 'med-surg' patients these days are ones who would have been in the ICU only a couple of years ago, and we are beginning to attract specialists who do only certain types of surgeries, thus the volume of post-op patients has increased with no corresponding increase in staffing. And contrary to upper-management's beliefs, the extended-recovery pts. who come in for a procedure in the morning or early afternoon and then leave in the evening are NOT easier to take care of than regular post-ops; you still have to do frequent vitals and assessments, and since their pain/nausea is often not well-controlled in PACU, the first hour or two after their arrival on the floor can be VERY time-consuming. Then when they're ready to go home, of course, you have to do their post-op teaching and discharge paperwork.......well, it's just a zoo sometimes.

    Naturally, there's a lot of grumbling, and I myself have protested to the staffing coordinator when I'd receive my fourth admit or post-op of the day while still scrambling to finish the others. It's one thing to have four stable patients and take an admission or post-op, and a different matter entirely to have four brand-new ones and be asked to take still another. But, as I remind myself and my co-workers every so often, our ratios are so much better than they are in other parts of the country---we don't have teams of 7 patients on day shift with or without an aide, nor are we expected to take an admission that's not appropriate for our floor (Acute ETOH withdrawal in five-points and on Diprivan? Huh-uh. Fourteen-year-old DKA with a blood sugar of 900? No way, Jose!).
  4. by   rstewart
    Quote from brian
    michele campbell, executive director of the pennsylvania nurses association (pna).

    no states have staffing ratio regulations, she said, and while some nursing unions have been calling for minimum staffing ratios, the pna is not.

    "we are not supporting numbers in legislation because then you establish ceilingswe do believe that each institution should establish staffing ratios for individual departments. it needs to be flexible," campbell said.
    .


    we hear the above "reason" for opposition to minimum staffing ratios by so-called nurse leaders with such frequency, i am afraid that it might escape scrutiny. simply put, the argument is moronic on its face.

    as we all know, hospital organizations oppose minimum staffing ratio regulations because they believe (with good reason) that on the whole they will have to increase staffing levels and hiring beyond current levels. they complain that there are not enough available nurses to meet the mandated ratios, or that the associated costs will be excessive.

    but in nurse leaderspeak "minimum" is apparently synonymous with "maximum". so a mandated minimum ratio actually functions as a mandated maximum ratio. a floor becomes a ceiling. black becomes white.

    at least when most business sector leaders oppose proposed increases to the minimum wage, they don't couch that opposition in terms of fears that they won't be allowed to raise wages high enough.
    Last edit by NRSKarenRN on Apr 4, '05 : Reason: fixed quote link
  5. by   live4today
    They can write all the articles they want on the critical staffing issues that face hospitals today, but there won't be any changes made until nurses unite and stand on the White House lawn in record numbers until they have their day in court (so to speak). Until then.....unsafe staffing will continue.

    ALL nurses MUST take a stand and unite to make a difference. That means NO SCABS coming into the hospitals for the big bucks, but they must join their fellow comrades in fighting against unsafe staffing.

    I'm leaving hospital nursing because I find it very unsafe to practice anymore, and will NOT put my nursing license on the line anymore for money hungry corporations who own hospitals, rake in all the money they can at the expense of the patients we are short staffed to care for.........and get no respect in the process. :angryfire
  6. by   LPN1974
    Quote from cheerfuldoer
    That means NO SCABS coming into the hospitals for the big bucks, but they must join their fellow comrades in fighting against unsafe staffing.

    Excuse my ignorance, but what are "SCABS"?
    I've seen that term on this board before.
  7. by   SmilingBluEyes
    Quote from LPN1974
    Excuse my ignorance, but what are "SCABS"?
    I've seen that term on this board before.

    Oh boy, big can o'worms.
    the term "scab" refers to those who work in the place of workers on strike. It's NOT a favorable term, as you can see.

    That is all I will say on this. I hope we don't turn this into a union versus non union fight already.....

    we have lots of those.
  8. by   SmilingBluEyes
    Quote from cheerfuldoer
    They can write all the articles they want on the critical staffing issues that face hospitals today, but there won't be any changes made until nurses unite and stand on the White House lawn in record numbers until they have their day in court (so to speak). Until then.....unsafe staffing will continue.

    ALL nurses MUST take a stand and unite to make a difference. That means NO SCABS coming into the hospitals for the big bucks, but they must join their fellow comrades in fighting against unsafe staffing.

    I'm leaving hospital nursing because I find it very unsafe to practice anymore, and will NOT put my nursing license on the line anymore for money hungry corporations who own hospitals, rake in all the money they can at the expense of the patients we are short staffed to care for.........and get no respect in the process. :angryfire
    I consider my non-hospital options myself. I need to further my education and make plans. Where I work, we are very well taken care of but that can easily change, esp since the place is up for sale. I can't say I see things getting easier in the hospital environment in the next 10 years, no matter where one works.
  9. by   pickledpepperRN
    Laura Gasparis Vonfrolio, RN PhD was the organizer of the Nurses March on Washington DC, March 1995 and May 10, 1996.
    Thirty-five thousand nurses marched on Washington make the public aware of the concerns nurses have for their patients.
    We filled Pennsylvania Avenue from the Capitol to the White House.
    Unfortunately the media focused on the baseball strike.

    NOW in California we have Safe Staffing legislation. We have ratios as the floor. Additional staff based on the needs of each individual patient based on the assessment made by a registered nurse is required. There IS no ceiling. Staffing must meet the needs of each patient.
    Last edit by brian on Apr 4, '05
  10. by   LPN1974
    Quote from SmilingBluEyes
    Oh boy, big can o'worms.
    the term "scab" refers to those who work in the place of workers on strike. It's NOT a favorable term, as you can see.

    That is all I will say on this. I hope we don't turn this into a union versus non union fight already.....

    we have lots of those.

    Thanks, just wanted a definition of the term.
    I have no further comment on the discussion.
  11. by   Tweety
    Nurses calling other nurses scabs...well never mind we won't go there. LOL

    Our administration calls my unit fully staffed when I have 8 patients on day shift. I call it dangerous.
  12. by   Marie_LPN, RN
    On one city block is our hospital, which includes the ER, CCU, OR, L and D, and all med-surg floors.

    Across the street is a two-story building that contains the administrators, the VP an P, HR, etc.

    And this street is 5 lanes wide.

    Which pretty much sums up just how clued-in our corporate people are to the problems. Yes, we can go to them and complain, but i think it's crap that WE have to go to THEM and they never come to US unless some sentinel event happens.
  13. by   barefootlady
    We all sing the "gloom, despair, agony on me" song, but I know I love nursing down to the marrow in my bones. I just can't imagine a day when I won't do it although I know that day is fast approaching. I only wish we could hold our heads up and walk proudly down the corridors like our peers did in their days.
    We do need to be more positive, present a national united front in the interest of the patients we care for and for ourselves and our fellow nurses.
    We need to pressure our elected officials to put ratios into effect. Realistic, workable, safe ratios. Tweety, I know the pain of 8 patients on day shift, NO nurse, no matter how good or experienced, should have to accept that many patients and be expected to complete every task, know every vital piece of information for those patients, and be ready to answer to the doctor when he comes rambling in for the few minutes he is there.
    We need to stop being so critical of our fellow nurses, stop pointing fingers when a honest mistake happens, stop expecting our new grads to know what we know after years of working.
    We need to develop a nationwide accepted and expected level of professional treatment from facilities, doctors, and other health care professionals that every nurse supports. We need to treat other health care professionals in accordance with our expectations.
    You say I am dreaming, this cannot be done, but IT CAN BE DONE! We can start in our own facility, our own state, talk to one another on boards like this, we need to support the nurses here and the students.
    If we don't stop voting with our feet every time we have adverse issues, take a stand and fight for a better future for ourselves and our future nurses, then our profession is going to be gone soon.

    Sorry for my rant, but Florence would be very sad if she saw our profession today.
  14. by   live4today
    Quote from Tweety
    Nurses calling other nurses scabs...well never mind we won't go there. LOL

    Our administration calls my unit fully staffed when I have 8 patients on day shift. I call it dangerous.
    Tweety........I referred to nurses who break strikelines as SCABS because that is the term I've been told they are called, not because I'm name-calling them. So if the use of that term is offensive to use, why do other nurses always refer to them as such? I don't mind a bit being brought up to date on this.

    And I agree that 8 patients is dangerous. I just left a hospital where the nurse-patient ratio was 7 patients to every nurse. I found the working conditions very unsafe based on how sick the population of patients were at that particular facility.

    I'm now looking for clinic jobs, or go strictly agency to work two days a week where I can select my own hours and working conditions. If there aren't any places where I feel safe practicing, I won't go to just any hospital anymore. Needless to say, I'm also applying for non-nursing jobs. If I am not able to offer safe patient care to the patients assigned to me, then I no longer want the job. I'm tired of the abuse going on in nursing today.

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