Please Tell Us If You Are Contacting Legislators/ANA, etc. Re: Nursing Concerns

Gigi Dues · Mar 24, 1999

Hello everyone!

Wanted to let you know that I have not had a response from ANA nor the Ohio Bd. of Nsg. Guess it is time to use the "polite" interval & re-write my concerns.

The PACU that I work in is still having many ICU 'holds' due to lack of staffing in the SICU. Recently we have experienced difficulty getting routine surgical patients to the med/surg floors due to their decreased RN positions. It can take several hours to get the patient to a floor. On top of this, we still are functioning as phase 1 PACU nurses for post-op pts. coming out. Least to say-a bad situation for patients, families & staff. Any advice on how others are dealing with this on a day to day basis?

Thanks for the encouragement & support!

[This message has been edited by Gigi Dues (edited March 23, 1999).]

barton · Mar 24, 1999

GigiDues,

Thanks for posting. Posting MULTIPLE LACK of replies AND difficult working conditions, especially when received from many/all areas of the country just serves to make our message stronger, don't you think?

Keep up the good work---and keep posting!

Thanks!

barton

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Joellen · Mar 24, 1999

Hi all,

Just wanted to let you know I didn't fall off the face of the earth!! I just emailed the President and The Center for Patient Advocacy. Maybe I might get a response! Still haven't heard from Sen Durbin via snail mail. Might have to write him again. I've heard a few of my co-workers have been reading the BB (including my Supervisor!) PLEASE anyone who is reading this PLEASE, PLEASE get involved. I know everyone cares about the patients so get active and do something about it!! You never know when your family member will need the care of a nurse and there isn't one around!!

bye

Joellen

barton · Mar 24, 1999

Joellen,

Thanks for posting-----good work!

Happy to hear co-workers and SUPERVISOR are reading as well. So,..........if they're all reading it, imagine how many others are reading that we don't know about!

Let's keep ALL of them interested, and hopefully participating folks, with your continuous posts, OK?

barton

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NurseyK · Mar 25, 1999

Over this past week I have received what can be called "lukewarm" responses at best from my New York State Nurses' Association, and the American Nurses' Association (excerpts of my letter are posted previously on this BB). I am ashamed and appalled to call myself a member of these organizations, and have since cancelled my memberships with scathing letters and looking for a lawyer to see if I can get my dues back on the basis of false representations, or such. These two organizations that are meant to be "for the nurse" are more concerned with management and supervisory ends of the nursing spectrum. The responses I have received included statements to the fact that "mandation is needed to cover staffing shortages", "if you deem yourself incompetent after 20 hrs on you must go home or face diciplinary action from the State Board, but you will run the risk of getting fired if you leave" "that is the employers' right" "it's called patient abandonment", and "you can document your protest to your assignment", "these documentations are collected" and "if something does happen on duty during a mandated 20hr shift the State Board MIGHT not take your license away" "but you still can get fired and/or sued", they are "sorry" I'm working 20hr shifts in a Trauma ER but "management is doing what they need to do to keep safe patient/nurse ratios"....and on and on with the Marvin Milktoast responses. These two organizations are NOT bringing ANY staffing issues to our State and Federal Legislatures (I specifically asked). I am so incensed right now I cannot see, even my husband's jaw fell on the floor when he read the responses (he's a cop). On the up side, my local and state government representative, senator, congressman, and majority leader have responded to me with (apparently) personal letters. They all say they are willing to hear what I have to say, to make an appointment to see them, and my local representative is drafting a law to be brought before the State re: nursing mandates.

My husband raises the point (don't worry, he's on our side): hospitals are private businesses, does government want to enact legislation that involves regulation of private businesses? will this open up a can of worms for other private, large or small, businesses? I think we nurses need to approach our needs from the standpoint of our LICENSES - enacting legislation to cover how long a shift we can work, possibly how may pt's a nurse can cover on various units of various acuity..etc. What do you all think?......I know I just want a law saying that I legally, according to my nursing license, can't work these 20 hr shifts, and that I can't get fired if I leave after 16 hrs on.....

I'm sorry this took to long but I don't know whether to cry, smile, or punch a speed-bag after these horrible responses. I'm going to have to sit on this over the weekend and then plan my approach for Monday. Any suggestions are welcome....

[This message has been edited by NurseyK (edited March 25, 1999).]

barton · Mar 26, 1999

NurseyK,

It sounds like the old "damned if you do and damned if you don't" to me. I think it's a wise decision on your part, to use the weekend to think things over. I received a reply from the FNA in the last couple of days and it explained some of what the ANA and FNA are doing. I'll have to research her info to understand it better before I can explain it to anyone else. I'll try to come up with some suggestions for you as well.

I think that this is a GOOD TIME to ask all writers and readers here to read the posts that caused the creation of this Forum.

Please read, under "General Discussion", the posts under these Topics:

"Management Wake Up",

"Reply to barton", and

"Hospitals in Trouble".

There are many great posts there like:

Brian Short's decision to create this forum to FOCUS the discussion from the topics listed above, and his decision to highlight our discussions in "Nurse-zine."

Canrckid's post re: Sylvia Johnson's (ABC's 20/20) interest.

The names and posts are too numerous for me to recall, but please read them while you're here on wwnurse.com.

I ask all of you to also read my proposed "Mission Statement" there and invite comments, criticisms, and suggestions for improving it. If any of you would like to use it in your letters to the ANA, etc., as a suggestion for reform, please feel free to do so.

I wrote it because I felt that there was no one definitive power to whom we could appeal, and I think NurseyK's post is a perfect example of this.

I'm also going to ask Brian to reprint, on THIS FORUM, the "Mission Statement" as well as 20/20's info..

Regards,

barton

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[This message has been edited by barton (edited March 26, 1999).]

barton · Mar 26, 1999

HELLO ALL and A SPECIAL HELLO to NurseyK!

The following is the actual, (in quotes), reply I received from the FNA:

"I am not sure from you letter whether you are a member of FNA or not. It doesn't sound like you are from the questions you have asked.

Staffing and quality of care have been priorities for both FNA and ANA for the past several years, if not longer.

At the ANA level, there has been legislation introduced over the past several years that deal with Patient Safety-The Patient Safety Act. That Bill has provisions in it that deal with staffing, access to hospital information on staffing and skill mix and outcome information.

At the FNA level, we monitor all legislation that has anything to do with health care, nursing, nursing practice etc. In addition, we sponsored legislation several years ago that called for a nurse staffing study to be conducted-the study was done and the report was issued last year.

FNA is also working on a collaborative project with the FONE looking a staffing, skill mix and outcomes. Part of that research group are representatives from AHCA.

Hope this information is helpful."

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This is the body of the letter only---I omitted the signature, to respect the writer's anonymity, in case that is what she desires.

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Helpful?!?! Do any of you think this is helpful?

Nursey K, does this "kind" of information sound familiar?

Does anyone else have a headache?

I know that change usually requires time, research, studies, reports, and so on, BUT, HOW long has understaffing been an issue and HOW long before we get some relief?

I WILL CONTINE to appeal to legislators for help and PLEASE-----ALL OF YOU------do the same!

barton

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barton · Mar 26, 1999

I'm bringing Canrckid's post forward to this BB, as a reminder, and so it doesn't get "lost" in the old forum:

Canrckid

Member posted March 09, 1999 07:53 PM

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Barton...........

Yea! Here it is! Sending you her response. Make the best of it!

Go ahead and post my name, email, and phone. I am interested in staffing

issues involving nurses and techs, and am willing to hear from anyone who

has a specific concern. I am most interested in hearing about situations

that are ongoing, where patient care is being affected. Anyone may leave

their number and a description of their concern and I will call them back as

soon as I can.

Sylvia Johnson

ABC News 20/20

212-456-1421

[email protected]

I will email her my thanks, and let her know about this bulletin board where she can read some of the issues for herself......in case there are those of us who are too "shy" to respond. And by all means, all of you pass this info out at your places of employment (discreetly of course!), so we can give input from places other than this BB.

Canrckid

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barton

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barton · Mar 26, 1999

NurseyK,

The reason I wrote this "Mission Statement", contained in the old post below, is because I could find no ONE DEFINITIVE power to give nurses relief. I'm assuming, from your last post, that this is a frustration we share.

To NurseyK and ALL:

I'm bringing this post forward, from the earlier forum. PLEASE READ my proposed

"MISSION STATEMENT"------and I invite comments, criticisms and suggestions.

barton

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barton

Member posted March 10, 1999 04:07 PM

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Hi BethanyJ!!

Great to hear from you! I'm SO glad that you continue to post. I think that updating each other frequently like this is a GREAT way to keep us ALL actively involved. We don't want ANYONE to give up, do we?

I LOVE your idea re: a new topic list re: nursing issues/concerns and how they affect patient care-------and I REALLY like your idea to forward this topic list to legislators, ANA , etc..

I'd like people to continue to write it on THIS topic list though, and here is my reason: I'm concerned that if we move any of our communications to another topic list, the people that have been invited to join/read this BB (legislators, other BB users on this site, media, etc.) might "get lost", so to speak, trying to find us.

WHAT DO YOU AND EVERYONE ELSE THINK?

I also suggest that we ALL brainstorm and form a "Mission Statement".

Perhaps something like this:

We nurses, acting in our roles as patient advocates, and finding no ONE definitive power to represent us, are prepared to perform the following acts to ensure the safe care of our patients and ourselves:

1) We will communicate with any and all parties who are charged with the responsibility of legislating and/or mandating the practices of nurses.

2) Since we believe that nursing administrators and other nurses not currently involved in direct patient care do not have first-hand knowledge of the rapid and dramatic changes in bedside nursing, we will ask our legislators to form a body of nurses, comprised ONLY of currently practicing BEDSIDE nurses.

3) We will charge this body of nurses with the solemn responsibility of formulating a patient acuity system that reflects the true nature of today's more seriously ill hospital patient. Based on this and the additional time that nurses require in using Universal Precautions, they will formulate a safer and more realistic nurse/patient ratio.

4) We will ask our legislators to support these findings as law and to impose a fine on hospitals that do not comply. We will ask them also to withdraw federal dollars, if applicable, from hospitals that repeatedly ignore this law.

Just a start..........and a thought.....my brain is tired! (Ha!)

AS I SAID EARLIER, LET'S ALL BRAINSTORM!!

PLEASE ADD TO, DELETE FROM, REWRITE---(WHATEVER) TO WHAT I'VE JUST WRITTEN, OK?

Hugs to ALL!!!

barton

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NurseyK · Mar 27, 1999

Barton -

I am not sure if the FNA is referring to something being batted around Congress in 1998 (and to be brought to the table again in 1999) call the Patients' Bill of Rights?

If this is not, bear with me, I would ask us ALL to become involved in writing to our legislator's on this bill - whether Emergency Nurses or not - what comes thru my door eventually affects the floors.

Currently there are 2 bills (Republican and Democrat) being proposed - two VERY different versions of the same old yarn: health plans paying for ER services, who and when can a person go to the ER, etc. The issue I, and I believe all of us, are most concerned with is a provision for "whistle-blowing" protection for nurses and other health care workers who express concerns about unsafe care or patient neglect against retaliation such as being fired or harassed. The DEMOCRATIC VERSION PROVIDES FOR THIS, called the "Patient's Bill of Rights" (HR 3605 and S. 1890 in 1998's 105th Congress). The Republican version DOES NOT provide for this, called the "Patient Protection Act" (HR 4250 in the 105th Congress). In a letter to other legislators, 1998 Republican House Majority Leader Dick Armey of Texas is reported to have stridently argued against any such protection, warning that nurses would use the whistleblower provision to make false accusations about quality of care..and then demand higher pay...(you don't even want to read the quote, it'll make your jaw drop).

I refer those interested to www.ena.org site to read more about it and other issues of interest to us ALL (not just ER nurses).

As an aside...do you honestly believe there is enough public support and sympathy for nurses? or will the public look upon us as a whiny lot if we go to the media?......

barton · Mar 28, 1999

NurseyK and All:

NurseyK, Are you referring to a bill of rights that concerns managed care? If so, I have to agree with the Republicans on this one. Now before all you Democrats out there decide to go on to the next post, please hear me out. I feel nothing but PURE DISGUST for HMO's, and I think that a lot of the "rights" people wish to have under an HMO are justified. However, if all of these rights were to be granted, I believe that our insurance premiums would SKYROCKET, and what good will these rights do if no one can afford the insurance? I am not suggesting that we accept mediocre or substandard care, but I think that we created our own problems when we accepted HMO's in the first place. I believe that a lot of people, when HMO's were first introduced, "sold their souls" for a $5.00 prescription, when they should have said, "No!- I want to keep the insurance I have." Let's face it, if we had refused to purchase HMO's, don't you think that healthcare costs would have been FORCED down? If no one had insurance, or only the "traditional" insurance we were accustomed to, then do you think that pharmaceutical companies, surgical supply companies, etc. could EVER get the money they are getting today? I don't think so. I think that all involved in healthcare would have had to settle for less money, but still provide great care. You know WHY I believe this?---Because I believe that the ONLY people left in healthcare would be the ones who REALLY care about PATIENTS. Sure we need to make a living and sure, a PART of healthcare has to be run as a business, but otherwise, to me, healthcare is a business UNLIKE any other----if we can't afford a tune up on a car, then that's unfortunate but not likely to be deadly---if WE need a "tune up" and can't get it, it might be. I could continue but, right now, I'll get back to the business at hand. :-)

I just finished reading several articles and/or "Position Statements" on the ANA web site.

I have to say that I was very impressed and pleased by two of the "Position Statements":

1) Supply, Demand, Need-- Nursing's Numbers Revisited"----Oct. 9, 1996, and

2) one written about "Maintaining Professional and Legal Standards"--Aug. 1992.

I believe that these two statements reflect A LOT of what we have been discussing here---TRULY---and I ask all of you to please read them and other info on that site.

HOWEVER, what concerns me, are the DATES of each of these: 1992 and 1996! I ADMIT that I have not read EVERY article or proposed legislation---BUT, if these were the ANA's positions as far back as '92 and '96, WHAT has been the result? If someone knows where we can get that info, I'd sure like to know. It appears to me that the ANA agrees with us on a lot of things, but I haven't witnessed any relief for nurses---have you?

I don't know.........maybe I think I know what I'm talking about and I don't?......

At this point, I am very, very, tired, and very, very discouraged, and have to think about this some more......

I STILL can't find any ONE entity that has the power to ENFORCE what we believe to be right. It seems to me that we need to CREATE one----by writing our legislators---(I imagine this sounds OLD by now----but THEY make the laws, right?)

Let's tell them how much patients and nurses NEED this, OK?

barton

P.S. I DO believe that patients should have the right to SUE HMO's under the appropriate circumstances and, HOW THE HELL DID THEY BECOME SUIT-PROOF TO BEGIN WITH??!!??

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Another P.S.--NurseyK, I don't know why Mr. Armey has concerns about false accusations. IF someone DID lie, I believe we have laws to deal with that, right? (or maybe he was thinking of Clinton when he said this, huh?) :-)

[This message has been edited by barton (edited March 28, 1999).]

Canrckid · Mar 28, 1999

Barton..........

I have to disagree with you on some of your statements.......First of all, many of us (the public) didn't "choose" HMO's. If we were lucky enough to have an employer that offered health insurance at all, (remember, they are not required to offer it), HMO's were often the only choice available. If families paid for insurance out of pocket, they were the only plans they could afford, good/bad or otherwise. You can also bet that pharmaceutical companies make their money, whether we pay full price, or a small co-pay......imagine the profit if they contract with the HMO to supply a particular classification of drug to the exclusion of all similar drugs from their formulary. Though not a big fan of HMO's, there are some that do an excellent job of providing care, especially here in California where we have a long not-for-profit HMO tradition. It was when Wall Street got involved that Health Plans began to sacrifice patient care for shareholder profit. Anyway, I agree with one thing, if you take the profit motive out of healthcare, then and only then will we begin to see enough money available to begin to provide services for those who have NO insurance at all!

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