Nurse-Patient ratios

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  1. Do wou want to fight for nurses rights?

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Hello my dear fellow nurses. I have been given a lot of thought about the number of patients we have to take care for at the same time. I really would like this to change. I want to start a petition in change.org to our members of congress. And make everybody aware of the unsafe, unfair conditions we nurses have to work under. I want to keep loving this profession but with the working conditions we have to endure is becoming harder and harder.

I know someone will tell me to move into another area of nursing, but are we going to just keep running away and ignoring the problem?

I want to be part of the solution and not part of the problem. What I am asking from you is to help me create a petition started in change.org in order to bring awareness to what we nurses have to face in a daily basis.

Thank you and please send suggestions, thoughts and let's stand together, it's time we do something

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Specializes in Critical care, tele, Medical-Surgical.
Safe RN-to-Patient Staffing Ratios | National Nurses United
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It isn't just the RN to patient ratio that is a problem in our country. It is ALL nurse to patient ratios that are causing so many problems. LPN's are taking a royal beating too. Is this request for petitioning to include LPN's thus making it a different fight than the one already in progress for RN's in hospitals?

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Specializes in Critical care, tele, Medical-Surgical.

the national bills we are working for include a provision to staff by acuity with the rn to patient ratio as the minimum staffing. it includes on page seven:

"... in developing the staffing plan, a hospital shall provide for direct care registered nurse-to-patient ratios above the minimum direct care registered nurse-to-patient ratios required based upon consideration of the following factors:

"... staffing levels and services provided by licensed vocational or practical nurses, licensed psychiatric technicians, certified nurseassistants, or other ancillary staff in meeting direct patient care needs not required by a direct care registered nurse. ..."

read the full text of s. 992, introduced by senator barbara boxer, may 12, 2011

read accompanying house bill h.r. 2187 introduced by rep. jan schakowsky - il, june 2011

i worked as an lvn for many years. i wish hospitals would hire more lvn/lpns.
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At the risk of looking stupid here can I ask to have you explain a bit further what I am reading in these links? I am a pretty new nurse (LPN) so there is a lot that I do not know or understand yet.

What EXACTLY constitutes "skilled nursing" in this bill? We have recently went to computerized charting where I work. We have options we have to put certain charted information under different headings. One of which ironically is "skilled nursing". I don't fully understand our new system or what is suppose to go were but I saw a memo that told us that all medicare charting is to go under this "skilled nursing" tab.

One of the issues with this is that most of us are not even sure what all needs to be in the "medicare charting" anymore because we got a lot of memos about that before we went computerized! LOL One nurse told me "We have to put everything we do for them in this charting right down to how we transfer them, toilet them and feed them. Now these things are what the CNA's do most of, not the nurse's. So it is ALL care CNA.LPN or RN in my facility is to be put under this tab for the medicare patients.

What all do RN's do at hospitals? Are they also doing all the direct personal care too? Do they toilet, shower, feed, brush teeth, change briefs and bed linens etc? I did not see anything in this like the one in California that prohibits the hospitals from getting rid of "auxiliary" staff to increase the number of RN's on staff. Did I just miss that or are ALL auxiliary staff already eliminated and the RN's are the only one's left to do ALL the care for all their patients alone therefor making it already to late to have that as part of this federal law or something?

What exactly constitutes a rehab unit in this bill?

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Specializes in Critical care, tele, Medical-Surgical.
at the risk of looking stupid here can i ask to have you explain a bit further what i am reading in these links? i am a pretty new nurse (lpn) so there is a lot that i do not know or understand yet.

what exactly constitutes "skilled nursing" in this bill? we have recently went to computerized charting where i work. we have options we have to put certain charted information under different headings. one of which ironically is "skilled nursing". i don't fully understand our new system or what is suppose to go were but i saw a memo that told us that all medicare charting is to go under this "skilled nursing" tab.

one of the issues with this is that most of us are not even sure what all needs to be in the "medicare charting" anymore because we got a lot of memos about that before we went computerized! lol one nurse told me "we have to put everything we do for them in this charting right down to how we transfer them, toilet them and feed them. now these things are what the cna's do most of, not the nurse's. so it is all care cna.lpn or rn in my facility is to be put under this tab for the medicare patients.

what all do rn's do at hospitals? are they also doing all the direct personal care too? do they toilet, shower, feed, brush teeth, change briefs and bed linens etc? i did not see anything in this like the one in california that prohibits the hospitals from getting rid of "auxiliary" staff to increase the number of rn's on staff. did i just miss that or are all auxiliary staff already eliminated and the rn's are the only one's left to do all the care for all their patients alone therefor making it already to late to have that as part of this federal law or something?

what exactly constitutes a rehab unit in this bill?

by your posts i think you are smart.

i'm not an expert either.

it seems your charting system was created more for billing than for communication and documentation of nursing care.

i'm not familiar with medicare regulations. my opinion is that certified nursing assistants and licensed nurses (rn, lpn/lvn are education and trained to provide skilled nursing.

in a health facility i don't think anyone should try to provide nursing care unless they are skilled. a certificate or license is evidence of completing an educational program that includes clinical experience sufficient to care for patients at an advanced beginner level. with experience most of use learn much more.

have you seen the section that starts on page 12 titled

''sec. 3403. minimum direct care licensed practical nurse staffing requirements"?

read the full text of s. 992, introduced by senator barbara boxer, may 12, 2011

in critical care some facilities try to use only rns. in my experience we have had at least one nursing assistant to help with nursing care that requires more than one person.

i know of very few hospitals that still have lvns. but it can be unsafe for one rn to be assigned to five medical-surgical patients who need complete assistance with activities of daily living in addition to treatment of the acute condition they are hospitalized for. but when an lvn is part of the team it can be ok. this is practice on one unit when patients need frequent tracheal suctioning, tube feedings, dressing changes, and/or routine medication administration. and an lvn or rn can do all that nursiong assistants do.

i've seen both orthopedic and respiratory rehab units. i think the patients need at least the same staffing as other hospital units. the only reason they may be a bit less stressful is that because the patients stay for a longer time there are fewer new patients to get to know. less admissions, discharges, and transfers.

i hope this is helpful.

i've been working for safe staffing in acute care for decades, but am far from expert.

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Yes I did read both of them. I am just questioning specifics in the bill itself I suppose. I understand that LPN's and RN's CAN also do direct care. (or at least I THOUGHT we could until recently and I am still working on figuring out that fiasco. "Apparently" their is some "law" (or rule at my facility?)that does not allow for the nurse to do ANY patient care during med pass maybe? Again fiasco) The REALITY is we cannot do it AND all the other work safely.

In clinicals (as ridiculous as it was to make us go there) the hospital in town here had already eliminated all the LPN's but the CNA's were still there and actually had fairly decent ratios for them at least on the med surg floor. Each CNA had 4 rooms which maxed them out at 8 patients if all their beds were full. Those patients required far LESS CNA care than what people in nursing homes require but still far to much to think the nurse could take on all that work on top of their own. I was wondering if that is what is happening now as if taking all the LPN's out didn't dump enough extra work on the RN's already.

I did see the link you have shown me, it just seems as if it still leaves everything number wise up to debate for certain areas of nursing and for LPN's all the way around. I see that as another way for them to put the screws to us anyway. Sad but true.

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I am a MA and I have heard that they are going to start hiring MA's to help the nursing staff to lighten to load of responsibility, save the facility money, as well as better patient care. has anyone lese heard of this?

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