#NursesUnited: Can we continue the momentum for necessary change?

Nursing has been plagued over the years by division within its ranks. However, recent events have resulted in nurses uniting together despite those divisions. What can we achieve to improve the workplace and patient care if we keep that unity's momentum going? Nurses General Nursing Article

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#NursesUnited: Can we continue the momentum for necessary change?

Nurses all over the country have united in protest against the comments made about nurses on The View. One single act has managed to unite many despite the inter-nursing battles of different specialties, RN versus LPN, and varying entry-level degrees. It's great to see nurses unite, but can we keep that momentum going to effect change in patient care?

Yes, ignorance of the role of the nurse is common within the population. It just so happened that some of those expressed their lack of knowledge on public television to quite a large crowd. Perhaps this will give nursing the visibility and opportunity to educate the public as to our role in health care.

But there are many other issues plaguing nursing that, in my opinion, are much more crucial in providing safe, effective patient care.

Staffing ratios

To date, only California has managed to pass legislation mandating nurse: patient ratios. We need to look to our legislators and put the pressure on them to start introducing bills reflecting safe, doable ratios.

Lack of uninterrupted breaks

We all need the opportunity to recharge during a shift, get nourishment, and empty that overfilled bladder. But how often does it happen that while on an unpaid break the phone rings or the pager goes off, and that break gets interrupted?

Mandatory overtime

How safe is it to force someone to work more than their scheduled shift because of a lack of adequate staff? The longer one nurse works, the more likely it is that he or she will be tired and prone to mistakes. We deal with people's lives where mistakes can mean serious harm or even death.

Lack of adequate functional equipment

How often do we have to run around the unit looking for that one piece of some type of equipment that actually works? How often are we borrowing from other units? How closely do we guard that computer on wheels we managed to claim at the beginning of the shift? Why are the powers that be not providing what we need?

Potential for injury

How many facilities offer enough lifting equipment and manpower to move patients without risk of injury to the staff or the patient? What about violence from patients, visitors, and even other staff members? There are not enough states with laws on the books specifically to protect nurses and other healthcare staff.

Focus on customer service

Nurses are not customer service representatives. We are knowledgeable healthcare professionals responsible for the care of patients to return them to their optimum level of health. Scripting, patient satisfaction scores, and a focus on "the customer is right" idea lead to actual healthcare coming in a distant second to keeping patients happy.

So where do we go from here?

How many of us are members of organizations that are pushing for such changes?

Many state nursing associations as well as specialty organizations have sections on their web pages addressing such issues, with ideas of how to fix them. National Nurses United (again, personal opinion) appears to be much more in touch with the issues of the bedside nurse than another national organization.

What can we do to continue being #nursesunited and push for the necessary changes? I will admit that one thing that turns me off of some nursing organizations is the political spin and endorsements, but is that really as important as working to improve nursing? Can this sudden unity over something that may be insulting yet not very significant in the day-to-day life of a working nurse continue?

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Rose_Queen

About Rose_Queen, BSN, MSN, RN

(Editorial Team / Admin)

Rose_Queen started her nursing career over a decade ago in the OR as a new grad. She has experience in multiple surgical specialties and currently works in cardiothoracic surgery.

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Stopped working in a large orthopedic practice..because patients became a number with 2-5 minutes with any provider. It all can down to money and quantity NOT quality !!!

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Specializes in MICU, SICU, CICU.

It would be powerful if nurses told their stories of unsafe staffing in real time.

Here is mine.

I was working a nightshift contract in an eight bed ICU and two nurses called out on a Friday night.

I had seven critically ill patients, a cna until 11pm and a terrified nurse from Labor and Delivery. I never saw the house supervisor once during that shift. She did call once and ask if I would take an admission. I can not post what I said to her but suffice it to say I did not take the admission.

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Specializes in Med-Surg, OB, ICU, Public Health Nursing.
icuRNmaggie said:
It would be powerful if nurses told their stories of unsafe staffing.

Here is mine.

I was working a nightshift contract in an eight bed ICU and two nurses called out on a Friday night.

I had seven critically ill patients, a cna until 11pm and a terrified nurse from Labor and Delivery. I never saw the house supervisor once during that shift. She did call once and ask if I would take an admission. I can not post what I said to her but suffice it to say I did not take the admission.

SCARY! Telling your story is critically important. The question becomes who do you tell the story to? It is very easy to click on the web page of either your US congressional representative or US senator and say, I support bill______because I know dangerous staffing conditions exist and this is how I know. If you feel your state person isn't the most supportive, you can click on the web page of one of the authors of the bills and say I support your legislation because of (my night from hell example).

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Specializes in Med-Surg, OB, ICU, Public Health Nursing.

This is a question and I am confused. Are you suggesting they sign the petitions and then post in social media that they signed the petition? I don't think signing a government petition is social media. Or are you suggesting that once a week you post the links on social media which is what I believe you mean. I guess I am not clear where you are posting the petitions and if your social media is All Nurse, FB or both? At some point, I think nurses need to sign the petition or contact their representative. I don't think just FB posting will work for ratios.

Forgive me, I am not young...Anyway, I applaud all nurses trying to do something and following through. Thumbs up!

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Specializes in Med-Surg, OB, ICU, Public Health Nursing.

I believe, that the main reason, The View responded was because of the advertisers pulling their dollars. So, if nurses just "whine" on FB about staffing, the government does not respond with ratios. We have to reach out to the bill authors and tell our very compelling stories/"whine" or show our numbers via the government petition, FB numbers or both which was successfully done with The View.

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Maybe instead of petitioning the government, which I'm sure is already well aware of unsafe staffing issues and clearly doesn't care, we should be writing to Johnson & Johnson with requests to provide funds to popularize our "movement."

Elected officials don't talk about all the big social issues (gay marriage, abortion, immigration) because they really care, they use those things to get people to vote for them. Personally, I don't think nurses uniting is going to cause any significant change. People in charge aren't ever going to be concerned, because they can afford top notch care for themselves and their loved ones.

The general population needs to become aware of these issues, they need to be afraid for their safety. Then people running for office can use safe staffing ratios as a platform to run on.

Johnson & Johnson can stop with the feel good commercials about being a nurse, and make some commercials that could actually help us. Maybe if people were as upset about the possibility of their grandmother getting a mucous plug and suffocating to death because her nurse had two other ICU patients and was also trying to help the three new grads in the unit as they were about the idea of two men getting married, we could make some progress on the issue before we all retire.

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Specializes in Med-Surg, OB, ICU, Public Health Nursing.
SubSippi said:
Maybe instead of petitioning the government, which I'm sure is already well aware of unsafe staffing issues and clearly doesn't care, we should be writing to Johnson & Johnson with requests to provide funds to popularize our "movement."

Elected officials don't talk about all the big social issues (gay marriage, abortion, immigration) because they really care, they use those things to get people to vote for them. Personally, I don't think nurses uniting is going to cause any significant change. People in charge aren't ever going to be concerned, because they can afford top notch care for themselves and their loved ones.

The general population needs to become aware of these issues, they need to be afraid for their safety. Then people running for office can use safe staffing ratios as a platform to run on.

Johnson & Johnson can stop with the feel good commercials about being a nurse, and make some commercials that could actually help us. Maybe if people were as upset about the possibility of their grandmother getting a mucous plug and suffocating to death because her nurse had two other ICU patients and was also trying to help the three new grads in the unit as they were about the idea of two men getting married, we could make some progress on the issue before we all retire.

The only action that I know that absolutley fails is doing nothing. I think new ideas are interesting and worthy of consideration.

Nurse elected officials are very interesting and come from all political persuasions.

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Specializes in ICU.

As always, well said RoseQueen!!

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National Nurses United is an organization of nurse, and for nurses. The reason that nurses are burning out is basically the for profit hospitals owned by huge corporation. Nurses are just a commodity to them. All they care about is their bottom line. Inadequate staffing is prevalent because again staff is one of their higher costs, so they cut staffing, they give us older or inferior equipment.There aren't sufficient amounts of equipment or supplies that we need to do our job ,again because it costs too much.Whoever heard of an OR running out of sterile gloves, or gowns? Broken equipment takes quite a long time to repair, and we are not provided with loaner equipment.

We are forced to work with marginal Physicians or hostile Physicians. Administration is aware of this but these doctors bring in a lot of business, so nothing is done. We are patient advocates, but we are forced to evade a patient's questions when they ask their nurse "is my doctor good." Now the nurse who has worked with that physician for quite a while knows that his or her skills are marginal at best. We are not allowed to tell the patient this, so we say well he/she is on staff here.That puts the nurse in a very compromising position.

What about mandatory overtime? This is prevalent in many states where again they use the call team to work overtime on non-emergent cases. IN an OR they know what a caseload for the next day looks like, and how much staffing they will need. But they don't take into account staff calling in sick, staff not knowledgeable about the case they're assigned to, and not enough staff. The nurses are told that you're a nurse you can figure it out. After being on call and working overtime sometimes in the amount of 24 ours in a 24 hour period, we are expected to continue our shift when it starts again in the morning, without breaks to eat or use the restroom.f we complain that we are too tired, we are told we will be written up. In the ORs the charge RN doesn't tell the RN working in a room that there's no one to replace them, so they are forced to stay, otherwise they are charged with patient abandonment. Then they are expected to continue and do the additional non emergent cases that were added on, and they are only paid overtime rates if they work more than 40 hours/week. On other units this a commonly done plus the nurses on that unit have a enormous workload. Then they wonder why nurses burn out

In some facilities if a nurse reports an unsafe condition for her patients (calling Safe Harbor). She/he has to fill our additional paperwork in addition to her regular computerized charting. Afterwards that nurse is called before Peer Review Committee. These nurses are not that nurses peers and they really find in behalf of the nurse who made the complaint. In addition that nurse is reported to his/her Board of Nursing, and they look into the nurse's license. In the meantime they never address the unsafe condition and nothing is done.

With National Nurses United, nurses are protected. When they negotiate their contracts, they get paid rest and meal breaks, they get mandated rest between overtime shifts and when they are expected to return to work. Unsafe working conditions, patient safety concerns, and "Standards of Practice," are brought before a Patient Care Committee. This committee is made up of working RN's, not management. hey address a problem, come up with a workable solution, & present it to the DON (Director of Nursing). If there is no agreement then it goes to a neutral third party who is not part of the hospital or hospital management, to make a binding decision.

Nurses need a voice, a say in how their facility is run. They need to know that upper management will listen to their concerns and act on them instead of doing nothing and telling the nurse "I'll get back to you,but they never do and working conditions never change. This doesn't happen in magnet hospitals, nor in hospitals represented by National Nurses United. Isn't it about time for all nurses to unite to speak up, be heard and make necessary changes in their facilities?

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SallyRNCNOR said:
Then they are expected to continue and do the additional non emergent cases that were added on, and they are only paid overtime rates if they work more than 40 hours/week.

Maybe I'm not understanding you. Why would you feel entitled to overtime if you have not worked more than 40 hours a week? Isn't that pretty standard no matter the industry?

I never wanted to take a job which included call for the exact reason you stated. I would not want to come in at 2 am and then have to be back at 0630. No thanks.

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Specializes in OR, Nursing Professional Development.
Horseshoe said:
Maybe I'm not understanding you. Why would you feel entitled to overtime if you have not worked more than 40 hours a week? Isn't that pretty standard no matter the industry?

It really depends on the policy of the facility. On call and call back time is different from standard overtime, and should be compensated as such. When I'm on call, I must remain within 30 minutes of the facility. It's a restriction on what I can do and where I can go, and as my on call time is end of shift to beginning of next, that's a big time commitment.

Because I take a fair amount of call (2-3 days/week plus every 4th weekend) and stay late a fair number of days, I do expect to be paid at the policy's stated 1 1/2 times base pay, with a minimum of 2 hours when staying on call. If I were to volunteer to stay late when not on call, then I would be okay with only receiving overtime if over 40 hours for the week.

Now, if the policy stated that I would only get 1 1/2 times base rate if I worked a minimum of 40 hours, then I would accept that. And then I'd find a job whose policies respected the additional responsibility on call hours require.

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