Nurses are self governed

RNperdiem, RN · Jul 3, 2019

I am not sure what self-governed means, but I do see that nurses are facing the same economic climate that many other people are facing. In many ways we are really governed by the laws of economics.

BkirbyRN · Jul 4, 2019

This is what I thought I was taught, in essence:

As with many other professions, such as physicians
or pharmacists, registered nursing is a self-regulating
profession. The purpose of regulation is to
ensure that regulated health-care providers practise in a
safe, competent and ethical manner. Regulation is all of the
activities directed toward this end.
Self-regulation means that the government has granted a
professional group, such as registered nurses, the privilege
and responsibility to regulate themselves. In essence,
society contracts with the registered nursing profession
to regulate its own members in order to protect the public
from harm that could be caused by RNs in the course of
their practice.
Self-regulation acknowledges that a profession itself is
in the best position to regulate its registrants because
their specialized body of knowledge makes external
regulation difficult and impractical. RNs understand
registered nursing better than anyone else so it simply
makes good sense for the public to have professionals
regulate themselves as long as they do so in the public
interest.

Basically, if the ANA, for instance, stands up and says, "No. It is not ok, ethical, or safe to put 47 patients at one time in the care of one RN" -- All recieving dialysis, in a fragile patient population (meaning having to try to get 8 kilos of fluid off of one or more of them because the physician said to..), and also while all 47 are discharged at almost the same time WHILE there are 47 more coming in and starting their treatments. Dialysis is brutal.

The people running the fortune 500 company that are making those decisions are not "clinical" people and have no idea what our job truly entails. I thought WE decide as patient advocates to say NO. Wallets or no wallets.

BkirbyRN · Jul 4, 2019

Who defines nursing standards of care and scope of practice? Not the economy.

MunoRN, RN · Jul 4, 2019

Self governing only refers to how we practice, standards of practice, etc, just like physicians we don't get to dictate the way that the economics of healthcare dictate our workloads, that's separate from self-governance.

BkirbyRN · Jul 4, 2019

The RN's job and responsibility is to protect and guard our patients from letting anyone else harm them. That includes physicians and corporations. That's the point. If I say that it's reasonable to be put in that position under unreasonable circumstances, I deserve to lose my license.

BkirbyRN · Jul 4, 2019

5 minutes ago, MunoRN said:
Self governing only refers to how we practice, standards of practice, etc, just like physicians we don't get to dictate the way that the economics of healthcare dictate our workloads, that's separate from self-governance.

Okay, I hear you. I'm just trying to understand. Because in some states there are laws defining what nurse to patient ratios are safe and are legally enforced. But not all of them. How does that happen? Because being forced into unsafe situations just to stretch a company's bottom line just seems like something we, as a whole, should be professional and mature enough to have a say so.

MunoRN, RN · Jul 4, 2019

6 minutes ago, BkirbyRN said:
The RN's job and responsibility is to protect and guard our patients from letting anyone else harm them. That includes physicians and corporations. That's the point. If I say that it's reasonable to be put in that position under unreasonable circumstances, I deserve to lose my license.

And we do so by advocating for better funding for patient care from those who decide how our money is spent, but we don't directly control that funding, which isn't necessarily a bad thing. We then provide the best care we can given the circumstances that we don't control.

BkirbyRN · Jul 4, 2019

14 minutes ago, MunoRN said:
And we do so by advocating for better funding for patient care from those who decide how our money is spent, but we don't directly control that funding, which isn't necessarily a bad thing. We then provide the best care we can given the circumstances that we don't control.

It's just sad and like I said I don't understand all of the technicalities. I just don't want to drive home at the end of the day knowing that someone crashed while I was trying to stop someone else from bleeding out and there was no one standing where I should have been because a very rich private company was trying to get more for their money. And heaven forbid I get to use the bathroom or get to eat anything while I'm running around like crazy for 10 hours and having to choose which rules to bend just to get the legal standards achieved. Ya know? It's disheartening. Any nurse I've worked with at this facility will tell you that it is impossible to get every patient assessed before they are hooked up and before and after they are taken off plus do everything else we are needed for and trained for and liable for. And to get that all computer charted at the time it was done? That is more than unreasonable.

BkirbyRN · Jul 4, 2019

I was at the biggest dialysis clinic in Milwaukee. I quit because it was unsafe. The terrible thing is that I really loved it and I miss my patients and co-workers. I think dialysis is a really good fit for me and I think I'm a good fit for it. I wanted to cross over from surgery to a new and challenging specialty. But not like that. I've been a nurse for over 19 years. I know the difference between a challenge and a safety hazard.

BkirbyRN · Jul 4, 2019

47 minutes ago, MunoRN said:
And we do so by advocating for better funding for patient care from those who decide how our money is spent, but we don't directly control that funding, which isn't necessarily a bad thing. We then provide the best care we can given the circumstances that we don't control.

Ok, dumb question.... How do we go about advocating for better funding? Like as a verb. I want to be proactive, not an ignorant complainer.

K+MgSO4, BSN · Jul 5, 2019

On 7/4/2019 at 7:04 AM, BkirbyRN said:
Ok, dumb question.... How do we go about advocating for better funding? Like as a verb. I want to be proactive, not an ignorant complainer.

You need to be in a leadership position. Such as a unit manager or above who can advocate for further funding via a business case when the budget build is happening.