How to make the public aware of the importance of nurses?

pickledpepperRN · Sep 23, 2003

Perhaps a compare and contrast chart of the educational requirements for the different licensure? Also the same for the scope of practice in your Province.

This is a short summary by the California Department of Health Services of an article. I believe Nurse Karen, moderator of the Nursing Activism and Politics topic posted it here once. Note the study showed that the less patients assigned a REGISTERED NURSE the less chance of death.

There was NO correlation for other categories of caregiver including LVNs. I personally suspect that physical and psychological comfort IS MUCH improved with more LVNs.

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In October of 2002 Linda Aiken, PhD, RN et. al. published a study in the Journal of the American Medical Association entitled "Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction".

The study was designed to determine the association, if any, between nurse-to-patient ratios and risk-adjusted patient mortality and failure-to-rescue within 30 days of admission, as well as nurse-reported job dissatisfaction and job-related burnout (Exhibit V-2). ("Failure-to-rescue" refers to the licensed nurse's failure to respond quickly and intervene effectively when patients (in this study, post-surgical patients) begin to develop signs and symptoms of serious complications. Failure to rescue, then, results in increased patient mortality.) The likelihood of failure-to-rescue was expressed as odds ratios (ORs), after patient and hospital characteristics were controlled for.

The study concluded that the OR of failure-to-rescue was sizeable and significant, indicating that the odds of patient mortality increased by 7% for every additional patient in an average nurse's workload and that the difference from 4 to 6 and from 4 to 8 patients per nurse would be accompanied by 14%and 31% increases in patient mortality, respectively.

The study concluded, "If the staffing ratio in all hospitals was 8 patients per nurse rather than 6 patients per nurse, we would expect 2.6 additional deaths per 1000 patients and 9.5 additional deaths per 1000 patients with complications....Our results do not directly indicate how many nurses are needed to care for patients or whether there is some maximum ratio of patients per nurse above which hospitals should not venture.

Our major point is that there are detectable differences in risk-adjusted mortality and failure-to-rescue rates across hospitals with different registered nurse staffing ratios."

The study also showed that nurses who worked in hospitals with the highest nurse-to-patient ratios were more than twice as likely as nurses who worked at lower ratios to report burnout and job dissatisfaction, and four times as likely to report that they intended to leave their current jobs within one year. If that increase in stated intentions truly resulted in resignations, given the high (and steadily increasing) cost of replacing nursing staff, then improving staffing may not only prevent patient deaths but may also improve staff retention and decrease hospital costs.

nursegoodlove · Sep 23, 2003

:) Thank you for your wonderful reply. I must tell you that the surgical nurses have presented a 112 page "position paper" with all of the surveys, articles, etc. probably out there. Our newspapers even publish the studies that have been done, citing the less deaths/infections and so on with re: to increasing nurses. It just doesn't seem to pack a punch somehow, as you think it would:confused: Our union has published letters outlining the difference in education, standards, expectations.

There doesn't seem to be any human outcry. I don't know if people don't understand what's happening, if the stats/polls/studies are not clear........they just aren't getting it.

I thought if there were "some way" I could articulate the seriousness of it all - in some form of "real story" type of telling...so that I could grab peoples attention.

And I seriously do not want to bash any LPN or NA. This is not their doing and some of them are fearful of the positions they are being put into.

This is very overwhelming.

pickledpepperRN · Sep 23, 2003

Oh Boy!

Trying to think!

Any near misses or tragic outcomes where the family or patient is willing to speak out?

Don't give up! People need to know what danger they may be in.

I was an LVN for years. Left with no supervision some of my patients would have died because I did not have the scientific background to base critical thinking on. With the worldwide nursing shortage we need all who have the temperment and desire to care for the sick.

All levels of caregiver must be valued. A team is good. Making a person responsible without the training is not safe. It is unfair to an LVN or NA to force them to risk a patient

nursegoodlove · Sep 23, 2003

There actually was one article that hit the second page of our largest paper, The Vancouver Sun & it was entitled: "Death blamed on care cuts" (August 7, 2003).

An LPN went into a panic when an elderly resident she was feeding choked & the lady died just shortly after. A "death Cruz (the daughter) feels may not have happened if registered nurses, more highly trained than licensed practical nurses, were more available at the Minoru Residence in Richmond." (This is one of the many facilities where they have replaced RNs with LPNs). :eek:

I know that one could say that nurses assess, prevent, act on, monitor, evaluate, educate, do treatments, medication, advocate...but those lines are becoming so "blurry" with our LPNs and their "full scope" practice.

pickledpepperRN · Sep 23, 2003

Well that family was distraut and may have been mistaken. In my experience most LVNs have a better sense of when a patient should be fed and how to do it than many physicians.

Other complicating factors that may have been assessed be the RN could have been influential.

Then again, perhaps not.

Once a short of breath and agitated patient was trying to get out of bed. The NA suggested restraints. The LVN wanted sedation. The RN insisted on holding the O2 to the patients face while the LVN called the MD.

It was 'flash' pulmonary edema. The diabetic patient on an orthopedic floor was having an MI.

If not for the RN the patient would probably have died.

He went to the cath lab, then open heart surgery within a couple hours of this.

I am glad your union is working with you on this. Greed over need is becoming a BIG problem because people, including administrators and polititians do not understand.

mdfog10 · Sep 23, 2003

Hi Nursegoodlove,

check out http://www.nursingadvocacy.org for ideas and information on how nurses need to communicate to the public. Also see the book FROM SILENCE TO VOICE (what nurses know and must communicate to the public), by Suzanne Gordon.

nursegoodlove · Sep 23, 2003

Thank you mdfog10 & spacenurse for the helpful tips. I will be researching all suggestions! I agree with your comments spacenurse - I was just putting out there - what is out there, unfortunately. Your story of the MI is very telling. Thank you again for all the help! :rolleyes:

AmyLiz · Sep 23, 2003

Kind of a sidenote here...I thought of this last night after watching that show on TLC about "resident life"... wouldn't it be cool if they came out with a show like that about nurses? I mean, they cover docs, trama teams, paramedics, etc on shows like that, but nurses are few & far between on those shows. If they'd do a day in the life kind of show like that, that would show what nursing was all about, I would think that would change some of the public's notions of nursing & let them see what an important job that nurses do.

Just a thought.

I know I'd watch it.

nursegoodlove · Sep 23, 2003

:idea:

Hi AmyLiz,

Funny you should write that... (great minds...)

I was just cruising the website that mdfog10 had suggested: http://www.nursingadvocacy.org and clicked on "taking action" (on the left side of the screen)...and they had a spot where you could actually email some of the large tv stations and make those very same requests! :cool:

This website has a wealth of information on it. I see I could virtually lose myself on this site............ thank you, thank you, thank you.... my faith has been restored & motivation to do something about the situation is now in high gear!

p.s. I would watch it too!

OriginalWmn · Sep 23, 2003

AmyLiz,

I used to work at the hospital featured in "resident life", Vanderbilt University. One of my friends still works there and she told me that she asked one of the camera people following around a resident about doing a similar show with nurses. The camera woman told my friend that she would be "honored if Vanderbilt would allow us to follow around their nurses." I told her she should have tried to get in contact with a producer and make her suggestion. I think it would be a great idea.

And back to our friend from BC's problem.... I don't know if this will be helpful, but in a marketing class I took they said the most effective and cost effective way of getting info out to the population of an area was direct mail. Maybe you could put together a pamphlet with your major points on it and perhaps even a postcard survey where consumers could give you their input. Something with 5-10 yes or no questions. Then you would have something to show the government about how the people view the replacement of RNs with other staff.

nursegoodlove · Sep 23, 2003

OriginalWmn

I think I am in nursing advocacy "heaven"

Your suggestions for a mass mail-out pamphlet & survey are priceless. I am going to take these suggestions to our "Big U" (the British Columbia Nurses' Union). Many thanks!:kiss

*ask and ye shall receive