Losing momentum?

Joe,RN · Jun 9, 1999

Jen,

Short staffed nursing homes fit in the same as every other facility. If your facility is short staffed, then patient safety is an issue, it does not matter what type facility it is! This is just a start, we have a long way to go. It will take some time to address each and every problem in healthcare today!

eliza · Jun 10, 1999

Working in the VA, I note that the pt acuity / staffing ratio may EVEN be near adequate on paper....the problem I have is that the acuity numbers do not NO WAY come close to adequately describing the acuity of the patients. The system doesn't take hardly anything into account, or give credit for the majority of care needed (ie. #meds adm times per shift, # of iv meds, or resp tx's, or wound care, or complexity of either, nor ambulation, teaching, admitting, or turning, or even FEEDING needs...the list goes on).

It is so insufficient, and administrators, leaders shrug it off, as if "that is just the way it is", after 8 years in this system I still hope that it will change. I would love to see this system be more accurate, then we could prove our needs for more nursing staff. Until we do this, I do not see us getting more staff. I do not know how to implement this change...yet, I just had to voice my opinion and say that I haven't given up hope. Our veteran population deserves the best of care. I would be interested in advice, other's concerns, and ideas.

LRichardson · Jun 10, 1999

OOOOOOOOOOOklahoma here

Joe,RN · Jun 11, 1999

You know? Eliza, I have often wondered how nurse/patient ratios and acuity were established in VA facilities. I was in the Army as a corpman, did two tours and came out as a LPN. I had the opportunity to pull some duty in several VA facilities. This was (wow) 25 years ago and I am sure things have change dramatically. I have, more recently, visited friends who were patients at VA facilities and talked to some of the staff. I saw critically ill patients sharing rooms with patients recovering from minor surgery. One of the nurses stated to me that there was little distinction as to floor assignments. Patients were divided at shift start by the nurses themselves. Seems you could have two bad ones and three good ones or seven good ones or three bad ones and so on and so on. There seemed to be an air of complacency and lack of patient care. This may be biased because of my limited exposure to this environment. Oh, and I saw one RN on duty! Does this help you at all?

Joe,RN · Jun 11, 1999

Something I forgot to tell you! Would you believe that some of the patient care was done by the other patients assigned to the unit? I saw a man shaving another and assumed he was a friend or relative. He was a patient assigned to the next bed! Such kindness, brings tears of compassion to my eyes, such neglect of care, brings tears of anger. Just goes to show you, vets are indeed special people.

eliza · Jun 12, 1999

joe, you're right about your observations. When I first worked at a VA and saw 5 beds / 5 pts in room , I thought how inthe world can they get their rest. But, fortunately it usually works out for the best. Pt's, (men) (vets) more often than not 'take care of one another'- willingly. They watch out for each other in a way I've never experienced in 14 years of public nursing, nor do we see this with women...???interesting, huh?

back to staffing methodology; the va system is so poor but makes the 'numbers look good', wheras when i worked in public, the staffing methodology reflected pt care better, however the 'staffing'numbers were more deficient.