HOW ABOUT THIS???

HappyNurse2005, RN · Nov 20, 2010

Well, we can't meet "every" need.....

llg, PhD, RN · Nov 20, 2010

Historically, people don't associate "better care" with more and happier professional nurses. They associate "better care" with the types of services that can be provided by lower-paid assistants. (e.g. fetching items from the gift shop, providing refreshments for visitors, valet parking, more menu choices, cleaner rooms, etc.)

In order for the idea to work and catch on as a marketing strategy, the public would need to develop a greater awareness and appreciation for how having more RN's would improve their care. And for that, we need to have more research demonstrating the improvements in outcomes that better ratios would give.

If research can be done that shows the outcome improvements that come with better ratios ... that research can be used to market the idea to both the public and to administrators. There is a little research on that topic, but there has not yet been enough research to tip the scales in our favor.

carluvscats · Nov 20, 2010

Too funny, OP! If only!

Meriwhen, ASN, BSN, MSN, RN · Nov 20, 2010

This post reminds me of that article on here from a while back about nurses baking cookies for the patients :)

Don't get me wrong: I'm all for a 4:1 ratio (mostly because tonight I'll probably be facing a 16:1). But like llg said, we need more research backing that up for us.

MoopleRN · Nov 20, 2010

This just encourages patients and their families to expect their nurse to also be their waitress/babysitter/personal slave. Hospitals already expect this of the nursing staff and and some patients/families do as well when the the ratios are more than 4:1.

Want better patient satisfaction? HIRE MORE STAFF and support the staff when they treat their patients as patients and not members of a spa/hotel. Oh. Wait. That means a smaller profit margin.

It's all about the money. Always has been, always will be.

noyesno, MSN, APRN, NP · Nov 20, 2010

New Jersey and Illinois are required to publicly disclose their nurse-to-patient ratios. Illinois is only required to offer up this information on request though, (White, 2006).

I think all hospitals should be required to disclose this information. I think people would be more inclined to go to the hospitals with lower ratios and hospitals would have an incentive to keep the ratios low.

I just wrote a paper on nurse-to-patient ratios... can you tell? :)

White, K. (2006). Policy spotlight: staffing plans and ratios. Nursing Management, 37(4), 18.

ebear, BSN, RN · Nov 20, 2010

Sounds pretty, OP. Unfortunately, it's not true...and patients would discover that fact after their admission. In my experience, these hospital slogans are a joke. :rolleyes:

Altra, BSN, RN · Nov 20, 2010

I think sufficient research is there.

(no, I don't have links right now)

However, this marketing strategy would require educated consumers (patients/families) and that is not cost-effective. Much easier, and cheaper, to play on emotional responses that don't require education/thoughtfulness about what really produces better patient outcomes.

Foster an image of a nurturing female nurse putting her arm around your shoulders or baking cookies for you -- SOLD.

An image of a clinically competent nurse with a patient assignment based on ratios that allow him/her to fully utilize his/her education, training and experience to pick up subtle changes, educate the patient and family, and follow up on issues with all the other disciplines for the good of the patient -- is difficult if not impossible to convey.

Kooky Korky, BSN, RN · Nov 20, 2010

This post reminds me of that article on here from a while back about nurses baking cookies for the patients :)
Don't get me wrong: I'm all for a 4:1 ratio (mostly because
Are they still baking cookies? Sounds good to me right now!

nurseraphael · Nov 20, 2010

Last time i looked at the budget - we were losing money. about 100,000/ monthly due to overtime, poor reimbursement rates, and capital investment in infrastructure to improve the quality of care . . .

we run 4/5:1 on days and 5/6:1 at night for RN's and 10:1 for LNA's . . . it does not get much better than that and were loosing money - sorry to burst the bubble but reimbursements are going down and costs of labor / materials / services go up every day!

Good luck on that one

maybe we sell the cookies and milk!

BluegrassRN · Nov 20, 2010

Well, our unit did just that. We redesigned how we did staffing, got rid of team nursing (where an RN was responsible for 6-8 patients with the help of an aide), initiated primary nursing, limited the RN to pt ratio to 4:1 during the day and 5:1 during the noc. Our nurse manager was on board with this, went to bat for us, increased our staffing budget, and fought for the budget increase with the VPs, CEO and the board. We argued that we would increase staff and patient satisfaction and increase pt safety. We've been doing this for 6 months now; our fall rate has been cut in half, our low turn over rate remains the same (despite the fact that our hospital pays RNs less than area hospitals--so in other words, we aren't looking for greener grass), and our medication error rate has dropped 25%. Our code rate, low to begin with, is nearly zero (though our rapid response rate has remained the same). We've also cut our overtime by 75%; nurses aren't staying over to chart, because they can get their work done during the shift. All of this is unofficial thus far; we're waiting until our next full quarter to start really compiling evidence that we can correlate these improvements directly to our staffing.

I just wanted to throw out there that there ARE hospitals that do these things. All of this was initiated from our unit based council. Our main push was that the hospital paid a lot of money to have speakers and educational programs regarding "relationship based care" and "shared governance". Basically, when the board and VP of nursing initially shot down our budget increase, our nurse manager responded "So this relationship based care and shared governance is all just meaningless lip service? You paid tens of thousands of dollars to have a speaker come and tell my nurses about shared governance, but then you don't actually want to implement it? You directed us to improve pt safety and satisfaction on our units. THIS is what my nurses have decided to do to improve care on the floor." It worked.

Edited to add: This is a med/surg floor in a 120 bed hospital.