I've been a hospital nurse for the last 17 years- I'm very strong in my nursing skills, and I'm having difficulties keeping up with the nurse to patient ratio and the acuity of my patients. The floor where I work hires brand new graduates every year-they stay for one or two years, then go elsewhere because they can't handle the stress and the pace.I can't remember the last time they hired someone who has experience.There are a few nurses who have been there for years, but the pace is getting to us as well.I have gotten to the point where I hate my job, and every night we are asked to take too many patients, or patients that are not safe with the nurse to patient ratio. The management tell us to "Do the best you can....", and we fill out assignments despite objection forms at least once a week. The sad part is, this isn't exclusive to our hospital. It's getting like this everywhere.And I see it as only getting worse.It's very upsetting, but I also see how it affects patient care. I know patients have had bad outcomes because of these issues, and I do bring them up to management...but nothing seems to be changing.I can't remember the last time I had a chance to do range of motion on a patient, or some of the other basic care we are supposed to be doing. I'd love to challenge the management to come and work a shift in our shoes, and see them try to flounder through the 12 hours of endless paperwork and crap that they tell us we have to do.It sure would be an eye opener, but of course THAT would never happen..And despite the whistleblower legislation, anyone who has worked in a hospital knows how easy it is to manufacture a case against a nurse.This is the problem with the nursing shortage that isn't talked about. If the positions are filled, then they don't see a problem, in spite of the fact we are having huge issues and it is really starting to impact the patients.Am I the only one who is seeing this problem? Is anyone else seeing this same trend?
This problem of nurse/patient ratios isn't exclusive to one or a few hospitals....it is rampant in the United States. When there has to be a choice between patient safety and making an extra dollar for the hospital, the patient loses out every time. It's all about the bottom line. The only way to attempt to ensure patient safety is federally mandated nurse/patient ratios. No hospital is going to do this of their own accord because it will cost them m-o-n-e-y.....state and federal government will have to force compliance before hospital's will comply. The general public has no idea of how their safety is jeopardized by the "bean counters" in medical facilities. I've noticed that the farther up nurses and doctors go within hospital administration how their view becomes more concerned with making the most money and less about patient safety and care......If the publlic had any idea of how dangerous it is to be a patient in a hospital these days....there would be another 'revolution' in the U.S.
And if a nurse or nurses complain about how patient safety is jeopardized with such high nurse/patient ratios, it isn't too long before they're labeled as 'mal-contents' and are soon fired with the proper documentation to back-up the decision for their termination. Is it any wonder that there's a nursing shortage?
Does anyone have any solutions to the understaffing of nurses on the hospital floor? Is mandatory nurse/pt ratios the answer? Would a union fix it? I don't see an end in sight as long as the hospital is making money. And the hospital always makes money when you pay fewer nurses.
Specializes in Infusion Nursing, Home Health Infusion.
All the states need to follow California and mandate safe staffing ratio laws... That is the only way hospitals and other health care organizations will make the change. Yes CNA did this for us here!!!!
What would happen if all of us flooded Joint Commission with letters from the viewpoint of patient safety and how it is affected by the corporate greed policies of the hospitals. Do you think if they received enough letters from nurses across the nation that this is something they would look into?
Safety in hospitals ???? Since when ?? I've "been there" both as a patient and as a nurse.....after I discharged from my patient status I quit and went into Home Health and loved it.
Recently a hospital ,where my husband had been a been a patient, was given the Nursing Excellence Award. They've got to be kidding me. My husband had an ASD closure. For the newbies who are not familiar with this procedure...a catheter is placed in the femoral vein to work its way up into the heart.....a device was placed in the opening between the atriums because it was too large for regular surgery. This procedure requires specific nursing observation and specific teaching to be given to the patient on what to report after discharge.
Well....the bed on the recovery floor was broken and bent in semi-prone position. The RN on the floor turned him on his side to put a pillow under his back less than half an hour post-op!!! I had to go "potty" and wasn't there. A while later the nurse came in, didn't wash her hands, took his BP and left. For some reason I peeked under the sheet and saw a blood-soaked dressing. I ran to the door, couldn't see the nurse, used the call button ro report it, go no response then went to the door and called out to the nursing station that we had a femoral bleed. When the other nurse came in the first thing she told me was I was not supposed to be touching the dressing....I had been applying pressure, of course. Her next comment was "Why didn't you use the call button? " Naturally I called the surgeon.
Before he had been brought to the room I was curious about his orders that were on a clipboard the nurse had left in the room. Naturally, the different diagnoses I saw were not his, looked further and noted they were for all the patients on the floor !!! His "patient teaching" order was "cessation of smoking"...!!!!! He's a non-smoker !!!! And was never given any teaching...........
Techs came in, without washing their hands, couldn't work the machines to do vitals....no one who entered the room washed their hands......so I had to be vigilant and awake for 72 hours before he discharged to ensure his safety. When we passed the nursing station on our way out I informed the charge nurse that she had done a pathetic job of patient care and of oversight....that turning this type of patient on his side less than half an hour after being in his bed is forbidden, that cessation of smoking for a non-smoker does not help when the patient needs to be taught to watch for swelling, pain and redness at the site and to call the MD immediately then go to an ER....and to not bend over or lift anything heavier than a dinner plate.....Oh, and there were several cardiac surgeons writing in their charts at the station. I also wrote all of this down on the form sent us for an evaluation....and did receive a phone call from the DON to whom I gave names of everyone involved, dates, and times. But still, they received the Excellence in Nursing Award !!!
I'm not the only nurse who has had a family member in a hospital and we well know to stay there till they leave to go home. Cost cutting is the prime reason for cutting down on RNs and using more free "learning" Techs from schools to replace valuable and experienced LPNs. This hospital didn't have enough pillows for all the beds on the unit....or enough sheets or blankets.
I loved hospital work but when cutting the budget became prime I left.....to protect my nursing license. If RNs would notify their State Board with specifics (dates, times, names and occurences and the fact that they went to the Charge Nurse with these instances) they will get the backing of the Board if anything happens....and with enough pressure from the Board changes might be made. I do know one male nurse who quit after he was told he had to stay 3 straight shifts in the ICU because there was no one else to replace him. He was turned into the Board for patient abandonment a couple of weeks later but he had already gone to the Board first ....and had also given them a copy of his paycheck and timesheet !!!
Specializes in ER, Urgent care, industrial, phone triag.
I'd love to challenge the management to come and work a shift in our shoes, and see them try to flounder through the 12 hours of endless paperwork and crap that they tell us we have to do.It sure would be an eye opener, but of course THAT would never happen..
Actually I did manage to get this to happen a time or two. I worked in a very busy Walk in care at my local hospital years ago. We worked 12 hours shifts and with minimal staff. There was the RN (me), one tech, and a registrar. It was announced that although we were open from 9am to 9pm that after 6pm, I would no longer have a tech. Those last few hours were often times the busiest times we had.
So, I told my department head that if there was not going to be a tech to help after 6pm, I was only available from 9am to 6pm. I was a per diem nurse, so I could name my hours. Of course I was the only one to do it, so it didn't change anything, but on a few occasions, the DH couldn't get anyone to cover from 6pm to 9pm. SHE had to cover. I clearly recall one day she came at 6pm all cocky and bossy, and I had all 4 rooms full and several patients in the waiting room. I proceded to give her report. As soon as I finished, she trotted down the hall and demanded help from the ER staff!! The lowly WIC staff nurse couldn't do that, but she could. We were expected to trudge through, no matter how many patients we had.
I got my point accross and I never had any more satisfaction about it than when I walked out leaving that bi#@! with a big bunch of patients to care for....even if she used her power to get help! Big time double standard.
The problem is that WE nurses do it to ourselves...We as nurses don't have a BACK BONE...most of us will not stand up to management b/c "i need my job". I have had managers tell me that their is power in numbers, if all of us say we won't do something then the policy or whatever bullsh!t management want to change will not happen.
People, the public, don't realize that nursing is all about an illusion of "great care" also administration just wants you (the nurse) the give the illusion that patients are recieving "great care". to be honest i'm sick of this profession, so why am i doing it? b/c i actually like helping people... also where else can i make what i make...
So with this nurse to patient ratio issues, where do we report this, who do we go to? I don't have that much exp as an RN but I can see that it is unsafe to have a ratio of 1:8 or 1:9 patients. I experience this and I don't agree with it.
Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.
I would never leave anyone I love alone in a hospital. The care I've witnessed by my co-workers past/present is atrocious and dangerous. A perfect ratio is 4:1 and should be pushed for by all nurses. Do we really need 2 managers for each unit? How about all of the meetings, food supplied for these meetings, food supplied for doctor's. I think some extra nurses could be paid for with this money. Sadly I worked some where that would stick to the ratio and got bad press because people had to wait too long for a bed. I don't like waiting either but think I would understand if they said to me "We cannot admit your loved one yet because it would be unsafe" How about holding off on elective procedures until staff is available. Many hospitals continue operating without an available bed open for this patient. One day after being called multiple times for beds that we didn't have, I said to the person "Do you want me to squat and $h*t you a room?" I know highly inappropriate but got my point across.
tanjaccurn
11 Posts
This problem of nurse/patient ratios isn't exclusive to one or a few hospitals....it is rampant in the United States. When there has to be a choice between patient safety and making an extra dollar for the hospital, the patient loses out every time. It's all about the bottom line. The only way to attempt to ensure patient safety is federally mandated nurse/patient ratios. No hospital is going to do this of their own accord because it will cost them m-o-n-e-y.....state and federal government will have to force compliance before hospital's will comply. The general public has no idea of how their safety is jeopardized by the "bean counters" in medical facilities. I've noticed that the farther up nurses and doctors go within hospital administration how their view becomes more concerned with making the most money and less about patient safety and care......If the publlic had any idea of how dangerous it is to be a patient in a hospital these days....there would be another 'revolution' in the U.S.
And if a nurse or nurses complain about how patient safety is jeopardized with such high nurse/patient ratios, it isn't too long before they're labeled as 'mal-contents' and are soon fired with the proper documentation to back-up the decision for their termination. Is it any wonder that there's a nursing shortage?