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Doing more with more?


Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

Hospitals face renewed calls for staffing mandates while dealing with recession-related workforce cuts

By Gregg Blesch

Posted: May 25, 2009 - 5:59 am EDT

An alliance of nurses unions rallied in Washington this month for new workplace regulations in hospitals--an agenda the unions and other nurse advocacy groups have had mixed results in pushing piecemeal state by state.

The agenda, aimed at improving professional satisfaction as well as patient safety and outcomes, arrives at a complicated confluence of circumstances. There is new unity among the unions and a more labor-friendly administration in the White House, along with Democratic majorities in both houses of Congress. There is also a broad commitment to undertake massive healthcare reform. The nurses see their priorities as part of reform, but they just as well could become casualties of that effort with scarce dollars to pay for reform amid the deep economic downturn...

...The centerpiece of Boxer's bill, the National Nursing Shortage Reform and Patient Advocacy Act, calls for minimum nurse-to-patient ratios similar to those in effect in California since 2004 and also pursued in a bill introduced in the House by Rep. Jan Schakowsky (D-Ill.). The bills prescribe nurse-to-patient ratios according to the type of unit, such as 1-to-5 in medical-surgical units and 1-to-3 in emergency rooms. Boxer's bill also would prohibit mandatory overtime for nurses, require lift equipment and lift teams to relieve nurses of demands for manual lifting, and whistle-blower protections to shield nurses who complain their employers aren't meeting the standards....



Specializes in Staff Nurse-OB primary.

I think this is a very informative article as to what we all have to think about in this profession. The unions represent the nurses only in a few states, what happens to the rest of us. I am not necessarily for unions but it seems the only way that this profession is represented clearly and fairly. There is a reason for what they are asking for. We all know this if we have worked in hospitals that don't have unions.

I have watched all of this unfolding. I have worked in large corporate facilities, county facilities and in the rural setting. The work load has increased as well as the documentation required to provide care for patients. The level of acuity has gone up in any give patient mix plus all of the new regulations instituted, many punitive, by the insurance companies, Medicare and Medicaid to ensure that all will be done with an expectation of perfection or they won't pay! It has become a place where a nurse not only has to watch their backs, their sides, below them and above them at all moments while working a shift. The above is a prayer from the greater Source to get through another shift without being threatened, degraded, shamed, made to feel less than or penalized for not being perfect!

It is no wonder health care providers are the highest users of the insurance system! It is apparent why there is a shortage of nurses with the level of stress an individual has to expose themselves to, all under the guise of the compassionate dollar. I don't think there is such a thing, does anyone else?

Over the years I have worked in institutions where management is very reluctant to assist staff in the work load. I have come to believe that they are nurses in initials only. If they were capable of doing the work they have so thoughtfully put on paper using statistics, grafts, trends to assuage all of us the importance of saving a dollar, they would be doing bedside care instead of pencil pushing. I have worked with managers who were so angry and disgruntled that they would have to help take care of a patient, it created more tension to the already tense situation. It almost wasn't worth the asking. I have worked for 17 years in OB where someone needed to be there as it just isn't cool to let the baby be born in the bed with no one around. If we asked for help it was always pointed out the AACOG standards of patient nurse ratio. Never mind what the reality was....there was a baby going to be born in the bed!

I have watched as nurses, shift after shift go without a meal break or any kind of break. Watch out if you have to go to the bathroom! I have witnessed nurses clocking out of a shift and staying up to 2 hours to finish their documentation of what had happened the last 12 hours of their shift. They do this because they have been threatened to be fired if they had any more overtime on their paycheck. They may have had a patient crump, go into an acute MI, have an adverse reaction to a new medication, fall, sundown or sun up, all in a patient load of seven to one nurse. Never mind that they truly cared about the PEOPLE they were responsible for by choosing to work in this profession.

What I am trying to put forth is a true picture of what nurses do. We are the bottom line, the direct caregivers, the ones who have to implement the grand ideas of the minds of the intellectual paper world. You know, the place where all things are written with Word Perfect and Power Point........ By PC and Mac if it can be written it can be done!

Where is it all going? How can we believe we can fix something that just doesn't work. In my mind there is no way ethically the anyone can put a dollar value on the human condition.......the caregivers and the cared for alike. The integrity of the health care delivery system is ill and in need of healing. How can that be achieved if there is a wall of denial between the problem and the solution? How can any change be initiated when there is tunnel vision like horse blinders to prevent any "outside" disturbance of the status quo? Why is there such a resistance to change even when what is only causes pain and distress in all those involved? Ahhhh, the human condition!

There are so many alternatives if only we could open up and just take a peak at what else is out there in our world. There is so much more to all of us if we would take what science is understanding about the human life and apply it to the humans that live on this earth. If we as individuals would take the responsibility to examine all that is available in healing ourselves we would be amazed at the peace it would bring to all of us, enabling us to be the healers we truly are....were.

I pray for all of us because, in the words of Fred Sanford, "This is the big one"!

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