Do you think acute care nursing is becoming less safe?

Nurses Safety

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My facility, like many, has increased staffing ratios in all departments in response to the economic pressures. Meanwhile, the Joint Commission continues to mandate supposed safety concerns, with mostly extra documentation demands and other inconveniences. They fail to address the elephant in the room, nurse/patient ratios.

I think bedside nursing has become less safe. From the ER point of view, we are less able to safely monitor patients, there is more friction with the inpatient nurses as they are too bogged down to receive patients. There is a cold war going on between some of our ER nurses and floor nurses, causing a big distraction and detracting from teamwork for the greater good.

Meanwhile, we're getting ready for the Joint Commission inspection and are going to be temporarily inconvenienced by their nonsensical edicts. No IV buckets to be left out on the counters of the nurses station, and other rules that are so minor compared with the real problems that we are dealing with. Of course, like other facilities, we have to spend money to hires nurses to make sure that our charting pleases them, that we fill in the many mandatory charting prompts to their satisfaction.

Nursing has become a bureaucratic mess, bogged down in more and more red tape than ever before. All this to be accomplished with fewer nurses at the bedside, and more nurses behind the scene. Insurance companies and the government are running things, and hospital administrators focused on the bottom line. If we keep going down this road, I think we are going to implode.

Healthcare in general is more dangerous. Sure we have advances that save lives, but if there aren't the people to implement them they are for nothing. You are to "streamline and simplify", but seriously where does it end? We as individuals can only do so much, and even on our best days that isn't always going to be enough.

Specializes in Pediatrics.

I agree. The healthcare system today could barely be called one anymore - it's a business, just like Wal-Mart or Rotorooter. We as nurses provide services, and the public is our consumer. They can even shop between hospitals, we get our HCAPS just like customer service surveys. Instead of focusing on providing safe, quality care that would actually INCREASE patient satisfaction, hospitals just focus on the budget, and all of the sources are going to be stretched so thin that there will be multiple patient incidents that will be made public, and that just MIGHT change things.

But I wouldn't hold my breath. Healthcare today is a sad thing indeed.

Specializes in Med-Surg, NICU.
Mandated ratios don't apply anywhere outside California, unless you have a contract that says otherwise. Contracts don't happen without unions.

I work at a union hospital and all the nurses have stated that the union "doesn't do anything and just takes our money."

Unions can be great...when they are functioning properly and as intended.

No doubt about it. :coffee:

My facility, like many, has increased staffing ratios in all departments in response to the economic pressures. Meanwhile, the Joint Commission continues to mandate supposed safety concerns, with mostly extra documentation demands and other inconveniences. They fail to address the elephant in the room, nurse/patient ratios.

I think bedside nursing has become less safe. From the ER point of view, we are less able to safely monitor patients, there is more friction with the inpatient nurses as they are too bogged down to receive patients. There is a cold war going on between some of our ER nurses and floor nurses, causing a big distraction and detracting from teamwork for the greater good.

Meanwhile, we're getting ready for the Joint Commission inspection and are going to be temporarily inconvenienced by their nonsensical edicts. No IV buckets to be left out on the counters of the nurses station, and other rules that are so minor compared with the real problems that we are dealing with. Of course, like other facilities, we have to spend money to hires nurses to make sure that our charting pleases them, that we fill in the many mandatory charting prompts to their satisfaction.

Nursing has become a bureaucratic mess, bogged down in more and more red tape than ever before. All this to be accomplished with fewer nurses at the bedside, and more nurses behind the scene. Insurance companies and the government are running things, and hospital administrators focused on the bottom line. If we keep going down this road, I think we are going to implode.

Hi there,

I quit my last job after someone called out and I was issued 50 patients to take care of by myself. at least 5 were morbidly obese ( few were exceeding 400 pounds). I refuse to be in unsafe situations for myself, the patient, my license, or my peace of mind.

Kadeem

Specializes in NICU.

I just experienced this today....they close our beds, cut staff, cancel shifts....then open beds and we get slammed while being short staffed. I had 5 patients today and they were all very sick and needed a lot of attention! I stayed 2 hours past my shift to get charting done...and feel like I didn't even talk to my patients at all, all i did was complete tasks. It's getting worse, and our managers don't seem to understand or care. I find it weird because my clinical manager and leader are both recent bedside nurses turned to management....I'm thinking this is coming from higher up.

Specializes in LTC, med/surg, hospice.

My first shift off orientation as a new grad on a medical floor I had 8 patients. I took that as a sign of what things would be like.

They add on more tasks and take away staff. If you complain, they blame it on your time management skills.

Of course it is.There is absolutely no other way it can ever be safe, now that corporations and profits are the ruling factors.

I agree. Nurse to patient ratios are getting higher, resources are being taken away, and responsibilities are getting more and more. At a hospital I work at, you can start out with 7 tele patients on a neuro floor. Oh, but you can't have a sitter for fall prevention with these sick, confused patients - costs too much money. Now, you can also titrate some cardiac drips because you definitely have the time to monitor your 7 patients that close. They pull the monitor tech to the floor so the charge nurse has to watch the tele monitors - meaning that now the charge nurse isn't available to help. It's really ridiculous, which is why I am transferring to a different hospital that sounds better... I hope in reality it is.

While there's stuggling nurses on the floor, there's the top level managment who is in their offices, figuring out how nurses can do a whole lot more for a whole lot less--and be "grateful to have a job" in this economy.

Uhm, ya, ok.

For every one nurse, there's at least one top tier manager who is finagling ways to make more money--for themselves--while still seemingly "caring".

Uhm, ya, ok.

It is sad what nursing has become. All about the economics....

The reason I left acute care. Being a charge nurse in these conditions was scary. I honestly don't know how I kept things safe. It just got worse over time.

I worked under a union. Staffing ratios were never addressed. We have a union coming in where I work now. Again staffing ratios not even being discussed. Whether that is due to the nurses representing the staff not finding that important. Not sure.

Specializes in Clinical Research, Outpt Women's Health.

Is it this bad everywhere for the acute care nurses? Those ratios seem unsustainable.

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