Driving a great hospital into mediocrity...

[shavsha]

I use to be so proud of the great care we were able to give our patients at our hospital. The maximum nurse patient ratio on our floor was 6 with a CNA to help. Now a consulting firm has come into to help us work "smarter, not harder." First they took away our charge nurses. Then they said they didn't want the nurses to be doing CNA work because they wanted us to be doing more analyzing of the charts (along with everything else) so that our patients can be discharged sooner. Of course, since we would be freed up from the CNA-type tasks we could be assigned a few more patients! Now there's half the CNA's (who are exhausted) who are assigned to the whole floor (not a specific group of patients) and of course, they can't be everywhere at once...so we are still answering call bells and cleaning patients (which believe me, I am not above!)

The last time I worked I had 14 patients with an LPN (but I am still "in charge" of my team) and that was before a complicated admit and two CNA's for 25 patients. That night I had post-op bleeding, stat critical lab values, two very miserable end stage patients (one of which died!), another in chronic pain, one afraid and anxious of being discharged due to an unsafe home situation, one patient with a very demanding family, complicated orders that needed numerous clarifications.

Everyone is crabby and stressed. A fellow nurse broke into tears in the report room when she saw her assignment. We have plenty of staff but they are all "on call" due to the new staffing grid. If we go one minute over the end of our shift we have to have the supervisor sign a waiver (to find out who the "inefficient" nurses are!) If we miss our lunches and breaks it is our own fault for not working them out with our co-workers...

I am an organized nurse and I do not mind hard work but I absolutely hate feeling like I am giving crappy care due to too many demands. I feel set up! One of my patients was distraught because she apparently had her call light on for 15 minutes needing pain medication! (I was with another patient and I guess the CNAs were busy too). Despite the frantic pace when I found out I went in and sat down and profusely apologized for her long wait. (Of course I didn't mention the staffing to her...I just "ate" it!) Oh yeah, I was 25 minutes into overtime at the end of my shift...shame on me!

I take pride in my profession. I have high standards. How can I remain if this is the way it is going to be? :angryfire

I am sorry! I just have to vent.

[suzanne4, RN]

What has your nurse manager said about this or the director of nursing?

Many of those consulting companies are quite scary. One, that some of the hospitals in Detroit were using, specialized in the automotive companies. so how does that fit with nursing? I think that they need to have themselves on the unit as a patient for a few days..............

[Critical care rn]

We went through this about 4 years ago...It was horrible. Same quote about working smarter not harder. Must be same company. All I can say is that we lived through it, many left. Now 4 years later they have saved some money and we are right back where we started as far as staffing, and ratios. They found poor pt surveys and that made them go back to the "old way".

Good luck!

I use to be so proud of the great care we were able to give our patients at our hospital. The maximum nurse patient ratio on our floor was 6 with a CNA to help. Now a consulting firm has come into to help us work "smarter, not harder." First they took away our charge nurses. Then they said they didn't want the nurses to be doing CNA work because they wanted us to be doing more analyzing of the charts (along with everything else) so that our patients can be discharged sooner. Of course, since we would be freed up from the CNA-type tasks we could be assigned a few more patients! Now there's half the CNA's (who are exhausted) who are assigned to the whole floor (not a specific group of patients) and of course, they can't be everywhere at once...so we are still answering call bells and cleaning patients (which believe me, I am not above!)

The last time I worked I had 14 patients with an LPN (but I am still "in charge" of my team) and that was before a complicated admit and two CNA's for 25 patients. That night I had post-op bleeding, stat critical lab values, two very miserable end stage patients (one of which died!), another in chronic pain, one afraid and anxious of being discharged due to an unsafe home situation, one patient with a very demanding family, complicated orders that needed numerous clarifications.

Everyone is crabby and stressed. A fellow nurse broke into tears in the report room when she saw her assignment. We have plenty of staff but they are all "on call" due to the new staffing grid. If we go one minute over the end of our shift we have to have the supervisor sign a waiver (to find out who the "inefficient" nurses are!) If we miss our lunches and breaks it is our own fault for not working them out with our co-workers...

I am an organized nurse and I do not mind hard work but I absolutely hate feeling like I am giving crappy care due to too many demands. I feel set up! One of my patients was distraught because she apparently had her call light on for 15 minutes needing pain medication! (I was with another patient and I guess the CNAs were busy too). Despite the frantic pace when I found out I went in and sat down and profusely apologized for her long wait. (Of course I didn't mention the staffing to her...I just "ate" it!) Oh yeah, I was 25 minutes into overtime at the end of my shift...shame on me!

I take pride in my profession. I have high standards. How can I remain if this is the way it is going to be? :angryfire

I am sorry! I just have to vent.

[Havin' A Party!, ASN, RN]

... Same quote about working smarter not harder. Must be same company...

Probably not. A lot of them just re-cycle the same old crappola.

[Rapheal]

It's always about the money isn't it? May those greedy, souless, poor excuses for human beings rot in Hades. :angryfire Sorry- I better get a grip before I say what I really mean.