Jacho wants input!

[hoolahan, ASN, RN]

Actually, I think they want management level input, but I gave mine nonetheless!

Go here JACHO Survey and click on "complete the evaluation" right under the page heading.

It asked a lot of interesting things, but the best part was the comment areas. Here is some of what I wrote...

I think it is a good thing when agencies refuse new clients based on factors such as not enough IV certified staff, or case managers being overwhelmed.

Having to cancel visits, or being late should be no reflection on an agency in these times of staffing shortages, no one ever wants to postpone or cancel a visit, it is only done when necessary, to triage pt's whose needs are more critical.

Falls, some med errors, and some wound infections should not be a reflection on staff, particularly if clients are non-compliant. One can teach until they are blue in the face, in some environments, a good outcome will never be possible. We must respect individual choices, even if they may be unsafe, when an individual has been deemed competent to make their own decisions.

May I take a moment to comment on behalf of my poor colleagues who still work in hospitals. My issue is with this restraint free environment. When was the last time any of you had 10 pt's on an evening shift and had a pt who was climbing out of bed and a pt having chest pain at the same time? Would you rather the pt fall out of bed and get a concussion, or be restrained. A restraint-free environment is a utopian idea which cannot be realized in the present state of understaffing. Please be more realistic. I mean side rails are being considered as a restraint?? This is just ludicrous!!!!

These are from a staff nurses perspective...

HHA Sup's....can be done if not constantly rescheduled by managers and/or HHA schedulers. This is one of the most impossible things to accomplish, especially in-person!

I feel very strongly that nurses should be scheduled according to their experiences. For example, as a cardiac nurse, I am opposed to seeing a C-section wound pt. I feel that to provide wholistic care, the nurse should be one experienced in OB/GYN. Fortunately, I have been able to cite references to my agency, and they support my choice.

I have never been asked about my inservice education hours, and to my knowledge, the only staff education that is tracked, is the mandatory topics required by JACHO.

One thing that baffles me, is why most states require a minimum of 20 hours of inservice in order to renew your nursing license each year, but not NJ. Every agency should have a mandatory number of inservice hours required, not just infection control, which we all have heard a million times Zzzzzzz. Or, each each agency should offer topics of interest on CLINICAL issues, not just how they want us to fill out paperwork. Documentation is important, but a spoonful of sugar helps the medicine go down!

Staff satisfaction? I've never had a survey passed my way. We have been asked to submit ideas in writing. From what I have observed, we are asked, but our input has not been implemented. Example, I am asking to have us contract with more hospitals so we can drop off labs more locally. The one local lab in my district, sends labs out to philadelphia. This is a very slow turnaround. Nurses in Princeton have to drive all the way back to the city of Trenton to drop labs at St Francis. WHY can't this nurse drop labs at princeton medical center. This would not only be more convenient for the nurse, but also more cost effective in terms of mileage, and productivity. It would also increase physician satisfaction as labs result turnover would be faster, which would then also result in higher pt satisfaction. One late PT/INR on Monday, delays coumadin changes by another day, which pushes back the next day labs can be drawn, and ends up with Saturday visits, when it is hard to reach the primary physician, and may result in delay in therapy changes until the following Monday. Can you see the snowball effect?

That's it. Please go and give them your ideas. The survey is a little confusing, but worth it if we can make a difference. Whay should our agency be penalized for things that are unrealistic?? You know what happens when the agency gets penalized, the $hit rolls downhill onto us! Speak now or forever hold your peace!!

[nur20]

Bravo,Bravo!!!!!!!

[RoAbreu]

"May I take a moment to comment on behalf of my poor colleagues who still work in hospitals. My issue is with this restraint free environment. When was the last time any of you had 10 pt's on an evening shift and had a pt who was climbing out of bed and a pt having chest pain at the same time? Would you rather the pt fall out of bed and get a concussion, or be restrained. A restraint-free environment is a utopian idea which cannot be realized in the present state of understaffing. Please be more realistic. I mean side rails are being considered as a restraint?? This is just ludicrous!!!! "

Try the new nursing home rules, where this also applies, you can't possibly see all the rooms, and there are usually upwards of thirty patients (with one nurse) on a station.

It's no wonder to me that LTC has such a high rate of falls.

[l.rae]

Couldn't resist putting in my .02...here's my response to the question..."what do you like best about our speak up campaigne?"

The oppoetunity to tell you what a waste of time and money your organization is Bed side nurses form all over the nation share the notion that JCAHO makes policies based on the land of OZ...for one thing regarding your restraint policies...you make it difficult for nurses to deliver safe care to patients due to overloads of paperwork that is not possible to complete in a typical ''not expecting JCAHO'' climate which we refer to as reality....If you want the respect of nurses who actually do patient care, you will make your inspections unannounced and see the circumstances our employers make us work in on a day to day basis...but that will never happen! And when you come to our hospital, everything will be hunkydory cause we are sprucing up, cleaning up...one hospital I used to work for rented a Semi trailor truck for the day and drove around with all the out dated, mal-functioning crap that was brought right back the day you left...So when you come to our facility you will find us catering to the propaganda de jour...pain control....money for fancy posters that actually could have been spent on nursing and improving patient care...just to impress you....what a crock!