I've been reading this BB and others, and some of the things I hear about the nursing profession today are truly appalling. I can see why some of you would discourage others from entering the field. Yet, it can't go on like this forever...Here's why I think this is so: through the Internet and other forums, nurses are talking to one another, gaining information and education, and discussing solutions. Medicine and technology are moving rapidly and opening up new options for preventing and treating disease. And a large chunk of the population is getting older and many will be in need of health care. I think that these factors and others are going to cause great change in the healthcare system. I'm excited about being a part of it and hope that things will improve for nurses--sounds like they can't get much worse. I see it like the stock market, in a way--right now the nursing profession is like the stock that's bottomed out and no one thinks it's any good. But if you buy it now and hold onto it for a while, the price might skyrocket. The nursing profession could do the same. It could become desirable and united and respected once again. I could be totally wrong in my prediction. But that's how I see it today.
Jun 25, '02
I like your optimistic way of thinking. I hope your thoughts are right. God knows, good people are leaving the career by droves....I just hope we can replace some of them before it's too late...or lure those good ones back. Either way, I do love what I do. Stay POSITIVE! You will do great.
Jun 25, '02
I guess if I didn't love what I do then I'd have found a different career by now. Honestly, there isn't anything else I'd rather do than be a nurse. Well, maybe there is like be Britney Spears--with her body and money, so then I couold open the allnurses.com hospital and we could all work there!
Jun 25, '02
When the suits wise up and put the money in the correct budgets then things will improve. 3 hospitals in NJ are moving in the right direction as they have added staffing language in their contracts. I haven't seen the contracts but was told by a relatively reliable source that it is 1:2 icu, 1:4 step down/tele, 1:6 med surg. Not sure about OB or psych or ER ratios.
Had execs, ya know, the ones making well into the six figure range, done this 10 years ago, more people would have stuck around at the bedside. If they correct the working conditions and compensation and retirement benefits, more people will enter and stay in this profession.
A suit from my health system was just quoted as saying we have an 8% vacancy rate for RN's across the system (3 hospitals, home care and some nurisng homes) and that we have very high employee satisfaction and low turnover. LIES, LIES, LIES!!! After reading this I took the liberty of counting the overtime shifts available on my 24 bed ICU. 110 shifts are available on days and 110 shifts are available on nights for the current and the next schedules!! 60 full time positions are posted on the board for just my hospital. Keep in mind, we do not staff by ratios. Our staffing is based on average daily census which for my unit is usually between 18 and 20. We are never allowed to count more than 24 patients in a 24 hour period of time even if we have 30!! So if you count how many positions SHOULD be available based on ratios it would be safe to assume that the number of posted positions could easily ( and I am being ridiculously conservative here) rise by at least another 1/4 to 1/2. Guess this suit failed his math class or took that fuzzy math class many politicians take!
I wish us all luck. We have a rough few years ahead of us!!
Last edit by fedupnurse on Jun 25, '02
Jun 25, '02
"I see it like the stock market, in a way--right now the nursing
profession is like the stock that's bottomed out and no one thinks it's any
good. But if you buy it now and hold onto it for a while, the price might
skyrocket. The nursing profession could do the same. It could become
desirable and united and respected once again."
I hope and pray you are right about nursing AND the stock market!
Jun 25, '02
Dianacs, I hope to welcome you into the field of nursing; but I can't quite fathom the comparison of nursing with the stock market! Maybe my hangup is that I KNOW what nursing is and what it involves; whereas I view the stock market as something I have to study and not quite trust yet, even though I cautiously invest in it.
Nancy, if I were you, I'd inform the media of the job listings on the health systems' website (or its' job posting boards); and then tell them to ask for info on available shifts. You have 220 available shifts within a 60 day time period for one 24 bed ICU? I'd be shaking in my boots, working there!
One of the concerns I have (in this day and age) is why the heck do we nurses say we want ratios instead of insisting on staffing by acuity? A sick patient (let's say a pt. with MRSA, and dehist'ed draining wounds and poor nutrition) takes so much more time, energy, and resources than a stable post-op; yet WE NURSES want to rate them the same?????
WHAT IS WRONG WITH THIS PICTURE?
My hospital was able to do time studies way back in the '80's to figure out acuity; and through the years we have found that acuity has increased instead of decreasing (I know, it IS an amazing concept, isn't it?); so we need more nurses to keep our patients alive and healthy.
Jun 26, '02
I am contacting the media about the misinformation from the suits editorial. I have contacted them before and they chose to not look into it. At that time the owner of the major paper around here had a seat on the hospital Board. Amazing coincidence huh???
I am for ratios only because of the "acuity" interpretation the execs where I work use. I think we need both actually. Start an ICU with a maximum of 1:2 and then staff based on acuity. Patients circling the drain are 1:1. Currently, the only patients in my unit that are permitted to be 1:1 are those on balloon pumps or continuous dialysis. Frankly, I have had nonvented patients who required 1:1 care due to no BP and titration of drugs. These patients can be 1:3 if we don't have all thos OT slots (average 4 per shift per day) filled for the day. Our hospital uses Medicus which is a classification system rather than an acuity system. Myself and several other nurses in my hospital are currently meeting outside of work to attempt to put a ratio to the numbers we can get from how patients are classified. Biggest problem we have is that we can never count more than 24 patients. I have worked night shifts where we started with 24 transferred 7 or 8 out and got 8 in. Usually the ones we get in are gone by morning, either off to the OR for emergency surgery and then going to SICU or dead. They are never counted. So then the suits say we only averaged 18 patients last year and that is what we are staffed for. I was in charge one night where acuity demanded 12 to 14 nurses and we had 9. Me, 3 nurses with 6 months or less ICU experience and 5 agency nurses only one of whom I knew. That short staffing form was 4 pages long detailing the unsafe conditions.
There is light at the end of the tunnel, I hope anyway. A former colleague who now works in another department has a daughter working for a local newspaper. She may just go for a story like this which would totally embarass the bigger paper. I hope to have something to her by next week.
I'm glad to hear that it sounds like your hospital DOES focus on quality care based on acuity rather than the budget. If I could find a hospital like that around me, I'd go in a heartbeat!! I think the ratio issue would have never even come up if most hospitals guilty of understaffing had staffed by acuity all along.
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