Lots of Questions ... Few Answers

[sfn2008, RN]

nursing school taught nurses to use the nursing process to assess and treat people with health issues under md orders. we were taught that patient safety is one of the highest priorities. protect patients from falls, medication adverse reactions, protect them from md's that give wrong orders and even protect them from themselves at times.

the bon (board of nursing) gave us a license to practice what we were taught in school. our license can be lost if we do not follow what we have been taught. if a patient under our care is harmed, we are at risk of loosing the credentials that allow us to earn a living.

employers give money to put nurses education and skills to use. employers are in the business of staying in business. our employers need nurses to stay in business. some employers abuse nurses and ask that they work under conditions that are not safe for the patients that they are responsible in protecting.

if there is a conflict between patient safety and staffing ratios, the nurse is placed in a dilemma.

should they continue to keep the patient at risk and do the best they can under the circumstances?

should they leave the patients in one facility and seek another job in the hopes that another facility will be better?

should they leave the education and experience that they have acquired and find employment in another field?

should they sit back, collect a paycheck, raise their kids, mind their business, wait for someone else to fix the problem and retire when the time comes?

lots of questions.

few answers

[RN4MERCY]

nursing school taught nurses to use the nursing process to assess and treat people with health issues under md orders. we were taught that patient safety is one of the highest priorities. protect patients from falls, medication adverse reactions, protect them from md's that give wrong orders and even protect them from themselves at times.

the bon (board of nursing) gave us a license to practice what we were taught in school. our license can be lost if we do not follow what we have been taught. if a patient under our care is harmed, we are at risk of loosing the credentials that allow us to earn a living.

employers give money to put nurses education and skills to use. employers are in the business of staying in business. our employers need nurses to stay in business. some employers abuse nurses and ask that they work under conditions that are not safe for the patients that they are responsible in protecting.

it looks like you're new to nursing and patient advocacy. i would like to recommend a book, "code green: money driven hospitals and the dismantling of nursing". you've asked good questions and the book is a real eye opener in terms of nursing care, the changes in health care delivery, and what has happened to nursing as a result of the commodification of health care. basically, nurses have lost control of the model of care and their ability to control the delivery of health care. i've posted a link to a review of the book, code green. the review is comprehensive and very well written by suzanne gordon. http://findarticles.com/p/articles/mi_qa4110/is_200402/ai_n9398458/print

another, book that i would recommend, is called, "safety in numbers" which is written by suzanne gordon. http://www.suzannegordon.com/safety.htm

these books will give you some insight into what other nurses have done when considering the questions you have asked, and they may help you to reach your own conclusions about what the "right answer" is for you.

in my experience, the nurses who have the most satisfying careers in nursing had the benefit of a good preceptor, and more important a professional mentor. nurses who are serious about patient advocacy, need to join nnoc! http://www.calnurses.org/nnoc/about-nnoc.html

fundamentally, you have the duty to act in the exclusive interests of your patients. when work environments and working conditions are such that they pose barriers to that advocacy, nurses have a duty to change those conditions, as circumstances require, to insure that the patient will progress toward optimum wellness and will suffer no harm.

nurses have a moral and an ethical duty to their patients, and a legal duty; this is the social contract inherent in the profession of nursing. i would like to attempt to correct your fact base. hospitals don't "give money" to nurses. registered nurses have substantial scientific knowledge and technical skills; they have a license to provide nursing care. hospitals need to have sufficient registered nurses to carry out the medical treatment plan and provide nursing care to meet the needs of the patients. nursing care includes protecting patients from the complications of their injury or disease; and provide ongoing assessment of therapy to prevent complications of treatment and insure that the treatment is effective and therapeutic.

when the employer's "bottom line" interferes with the "patient's needs" for medical treatment and nursing care--i.e., fast track, early discharge/transfer, replacing rns with unlicensed techs and aides, or failing to hire enough nurses to care for patients or provide meal and break relief...etc. the real question for you becomes, what are you going to do to change those circumstances. employers may say do the best you can, but you will be held accountable for the nursing care if harm befalls a patient. rns get the blame for what is inherently a system problem!

what you do, is up to you. all the best:up: