Freedom of speech in health care.

cjmjmom · Jun 22, 2008

advocateforsafety I could not agree with you more!! Those who run our healthcare system have alot to lose when the current system changes however it is OUR responsiblity to inform the public and the legislators what the REALITY of healthcare is. We must not be silent! Silence is what has gotten us to where we are today. NOW IS THE TIME TO SPEAK OUT!

Mijourney · Jul 19, 2008

Very thoughtful comments. I feel that alot of the suppression of communication regarding health care has to do with the fact that it is considered a priviledge as opposed to a right. Make certain areas of health care, like prevention services, a right or entitlement, if you will, and you then have the opportunity for more open dialogue.

Chico David, BSN, RN · Jul 19, 2008

Very good and interesting thread. I would add the one point that we are best and most effective in speaking out - not to mention safest - when we do it as a group with the support of a union behind us.

RN4MERCY · Jul 21, 2008

Very good and interesting thread. I would add the one point that we are best and most effective in speaking out - not to mention safest - when we do it as a group with the support of a union behind us.

Fight on, brother! Just got called in to the manager's office yesterday; she'd received a call from the DON regarding our advocacy activities. Thank God for my union, CALIFORNIA NURSES ASSOCIATION. Without the just cause discipline procedure, advocacy language, and the law that's incorporated right into our contract, my advocacy could be tagged, "not a team player, not a good fit, doesn't get along well with others, or insubordination." It would have been, in the old days, BC--BEFORE CONTRACT; and I'd have been out the door with a black mark on my employment record.

We have a new computerized/electronic medical records/cpoe system that went on line last week. It cost management a lot of money, and I must admit, I didn't drink the Koolaid they were serving to toast the emporer's new clothes. Safer, more time with patients, accurate....NOT!

It seems they're getting tired of the collective sound of our union voice. And the patients and their families are noticing. "Who's taking care of the patients, all I see are doctors and nurses glued to a bunch of computer screens." OUCH!

Physician orders are incorrectly entered; treatment delays...hours and days have been the norm; pharmacy's not getting the meds out, computers are automatically populating data from the monitors onto the flow sheet even though it hasn't been independently validated by the RN. Was the mean BP really 30 on that craniotomy patient, or was the art line dampened, or was the patient being turned, or was the transducer on the floor? Who the heck's gonna remember when they're being sued because of a bad outcome, when the record is submitted as exhibit A, five years later in a courtroom somewhere?

The law holds us accountable for charting relevant and accurate data about our interventions and the patient's response to them. This system is an almost absolute barrier to our ability to do that. The administrations' bobble-head "champion super users" are available to help, they tell me. Sure, they're bringing in pizza, chocolate, fruit, and cooing, "how's it going, don't forget to breathe, we hear you" mantras.

They've diverted millions of dollars out of the patient care budget to pay for these "new clothes" the emporer is wearing, and they don't like it much when you tell them, "I don't see any benefit, only an increase in the potential for harm that can befall our patients."

We've collectively proposed solutions; we're not saying technology is bad. It's our duty and our right to protest the fact that they've pulled nurses out of staffing/away from the bedside, to try to make this system work. They imposed it on us in, "damn the torpedos, full speed ahead," fashion, and it's not safe for patients.

Management's interest is to put the best face on this in the interests of the business. Direct care RNs are advocating in the exclusive interests of the patient. We are advocating as professionals, to protect our practice.

Freedom of speech in nursing, backed up by documenting unsafe practices such as these, eliminates administrative deniability. The administrators will be held accountable for harm that befalls a patient when we document the fact that we've notified them of our concerns. Otherwise they say, "no one told us," or, "just do the best you can, and sign it anyway, we're working on it." Ha! Any one who believes they can protect their patients and their license in this commercialized, industrialized, proprietary system without a union like CNA/NNOC is delusional.

The bobble-heads' names aren't on the record, they're not licensed, and their frequent interruptions make us even more prone to making errors. They're not any help at all--keep your pizza, and don't come between me and my patient. I've got my whistle, and I'm blowing it.

As patient advocates, we're going to see to it that this new technology benefits patients and nurses, instead of just the companies/consultants who are selling it! We're going to ensure that it doesn't override the independent, professional clinical judgement of the nurses and doctors who are accountable for providing safe, therapeutic, and effective care.

WHISTLE-BLOWER PROTECTION. FREEDOM OF SPEECH. YA GOTTA LOVE MY UNION, CNA/NNOC. Join us!

http://www.calnurses.org/get-involved/ :up: :redbeathe

advocateforsafety · Jul 21, 2008

I couldn't agree more RN4Mercy and I wish we could have what you have. I live in a more union hostile state and will probably not see unions for nurses here unless the NLRB is changed and they change the rules tosupport union cards as the method to allow unions to achive a vote. The powers that be are to powerful here and don't tolerate union talk. I was recently fired for my advocating for patients safety, ratios and universal health care. I am a member of the NNOC and was a leader in a movement to bring unions to my facility. It is in my opinion a dead horse now but I have hope we can one day revive it.

I support the NNOC and any other organization or union for that matter that can bring about reform to this broken system. I have been a nurse for ten years and believe my first responsibility is to be a patient advocate. I am tired of practicing good enough or the best under these conditions nursing. Most of the obsticles are ones that are created by the administrations in their quest to ensure profits. I have seen people die as an indirect result of their practices and they should in my opinion be held responsible for it.

Any way keep up the fight. I sure the hell will!!!

RN4MERCY · Jul 21, 2008

I couldn't agree more RN4Mercy and I wish we could have what you have. I live in a more union hostile state and will probably not see unions for nurses here unless the NLRB is changed and they change the rules tosupport union cards as the method to allow unions to achive a vote. The powers that be are to powerful here and don't tolerate union talk. I was recently fired for my advocating for patients safety, ratios and universal health care. I am a member of the NNOC and was a leader in a movement to bring unions to my facility. It is in my opinion a dead horse now but I have hope we can one day revive it.
I support the NNOC and any other organization or union for that matter that can bring about reform to this broken system. I have been a nurse for ten years and believe my first responsibility is to be a patient advocate. I am tired of practicing good enough or the best under these conditions nursing. Most of the obsticles are ones that are created by the administrations in their quest to ensure profits. I have seen people die as an indirect result of their practices and they should in my opinion be held responsible for it.
Any way keep up the fight. I sure the hell will!!!

I love the "I won't surrender in advance" spirit. There are a lot of people who believe they can't make a difference so they give up. You don't have to go into their den alone. Your fight is our fight...speaking of anti-union/right to abuse workers' states-Texas now has their first UNION hospital-the RNs at CyFair organized with and won their election to belong to CNA/NNOC. As the saying goes, "The Difficult is that which can be done immediately; the Impossible that which takes a little longer."

Nurses are the vanguard of the revolution, and we intend to take back our ability to control the delivery of healthcare. We intend to end those working conditions that are driving nurses from the profession. It doesn't have to be that way. JF Kennedy, once said, "...ask what you can do for your country." We nurses know healthcare, and we have a vision and a duty to act now that we've made the assessment that it's a broken system. Our country needs healthcare, not more insurance. Our country needs nurses, not more computers.

Thank you!

UofMRNBSN · May 11, 2009

All nurses NEED to read "From Silence to Voice".

Chico David, BSN, RN · May 11, 2009

All nurses NEED to read "From Silence to Voice".

It's a very interesting book. One of the things I become more conscious of after reading it was the importance of claiming our full name and title. Introduce yourself to patients by full name and title and insist on reciprocal relationships with doctors. If they call you by your first name, respond in kind. It's very interesting to try that one for a while!

Honnête et Sérieux · May 12, 2009

We have a new computerized/electronic medical records/cpoe system that went on line last week. It cost management a lot of money, and I must admit, I didn't drink the Koolaid they were serving to toast the emporer's new clothes. Safer, more time with patients, accurate....NOT!

Of course, maybe the hospital was just trying to get on board with Obama's plan to have all health records digitized in five years.

Obama said this would save $80 Billion annually in health care costs, and improve patient care and save lives by reducing errors.

Or maybe the hospital was simply being idiotic.