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

barton · Mar 16, 1999

Hi Pearl and Hi to All!!

Pearl, your shift last night sounds like a NIGHTMARE--but Thank God that you, your charge nurse and your co-workers are DOING something about it! I just LOVE, LOVE, LOVE what your charge nurse is doing and I hope you tell her that!

MY "polite" intervals (LOL)are defined as approximately once or twice a week. I don't know what the others are doing.

I am relatively new to computers, so the e-mail I wrote to Ms. Whittaker just went out today! Yikes! I meant to send it much sooner, but in the process of writing 1/2 the letter, saving it, retrieving and completing it, I LOST the end of it! It gets even worse after that, but I won't bore everyone with the details. I'll just tell you that I called my husband at work and asked him to give me a step by step on how to send saved mail. I told him that if I couldn't send that e-mail TODAY that I was going to stab myself in my stupid brain (KIDDING!!!!). So I now await a reply from Ms.Whittaker. I also have a return receipt that the FNA received my e-mail, so I'm waiting for a reply there as well.

Thanks again Pearl for your much needed encouragement to me, and I will give my BEST to encourage you and ALL on this BB!!

I STARTED THIS MISSION AND I HAVE NO INTENTION OF GIVING UP ON IT OR ANYONE ON THIS BB!!!

Hugs to all!

barton at the BBC (Big Bladder Club! LOL!!)

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Joellen · Mar 16, 1999

Hi All,

Received an email from Senator Dick Durbin's office yesterday. Stated he received my email and would be sending a reply via "snail mail". Hope to get it soon. Haven't received any response from my email to ANA---will probably have to send it again. Thsi week at work has been terrible!!!!! I've been in charge and have spent the majority of the time trying to call nurses in to work due to short staffing plus I've had patients!! They are all tired and no one wants to come in extra anymore and I feel bad calling them. At 3pm I had 3 open hearts in the OR and no nurses to take them after OR. The charge nurse last night had 2 patients of her own and 4 patients crashing at the same time!! The DON walked in about that time, making her night management rounds, but do you think that will make any difference?----I didn't think you would!! The charge nurse is about to quit and getting much encouragement to do so from her husband. Most of our families are getting fed up with the problems. You hate to involve your famiy in this mess but if you're never home it will certainly affect them. No one but nurses understand how difficult it is just to leave when your shift is supposed to be over. I'd have a nervous breakdown if I had time!!!!!

Bye for now,

Joellen

barton · Mar 17, 1999

Hi Joellen!

Another NIGHTMARE report---You certainly have my sympathy.

You also have my admiration and gratitude----in spite of everything, you still took time to post about your correspondence with the ANA and the legislature!

Just think---Joellen and so many of the wonderful nurses on this BB FIND THE TIME to try to make things better---even after LONG and DISHEARTENING shifts!

Please, all of you, keep up the great work. I think it's going to be a longer road than we'd like, but, to paraphrase another member's post, IT'S A HECK OF A LOT BETTER THAN ANOTHER UNDERSTAFFED SHIFT!!!!

THANK YOU ALL!!

barton

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Joellen · Mar 17, 1999

Hi--It's me!

I just posted a note on hospitalhub.com regarding our BB here. There is the same discussion going on there. Hopefully we will get more people to become active. It's depressing to read what is going on all over the country and in Canada. WE have to MAKE A DIFFERENCE!!! We need to get the public involved. I plan to write to 20/20 soon. I know this will probably take a long time to see any results so I encourage everyone not to become discouraged and just keep writing and documenting:-)

Bye for now,

Joellen

barton · Mar 17, 1999

Joellen,

Thanks for your last post! After reading your post, I followed your lead and posted on the hospitalhub.com and I hope they will join us.

Thanks for posting this and giving us the opportunity to invite MORE nurses to join in our efforts!

barton

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CHUBBY · Mar 17, 1999

I've been reading all the posts with interest. The job where I am now is busy and gets hectic, but it's a breeze compared to where I was. The other ER was an 18 bed unit. They saw 36,000/yr/level II trauma center in a "nice" part of town. Staffing was 7/7/3. Because of ICU overflow we were constantly keeping pts in the ER (even d/c from ER). This is WONDERFUL if you're a cardiac pt-with screaming children, MVA's etc,etc.

The people I work with now are busy, but don't fully appreciate that NOW, I get to dinner every night, and I don't have to worry about taking Bactrim for my UTI's.

A group of us left for various reasons, most were tired of the BS, anyhow- to fill the empty slots- (apparently the places rep was well known-on one applied for the jobs) they hired GN's...

Anyhow,a month ago, I was talking to a friend who is still there (a bunch of the hardest working people I ever had the pleasure to work with), she said they had 23 admissions (mostly cardiac admits-without beds) in the ER...yep, thats safe....

LRichardson · Mar 17, 1999

Ok.. here's a rough draft of my letter to the editor.. i've changed it a kagillion times.. first it was too emotional.. then it made me too vulnerable to my institution and i got scared.. then it was too long.. so i narrowed the topic to just staffing.. and now i'm afraid it's a bit too brainy for an editorial.. so i'm asking for your input before i send it.. but please.. send your critique IN PRIVATE to my email address please... i'm not quite as brave as i thought.. soooo without further adieu here's my editorial...

Staffing doesn't sound like an issue that effects the public welfare but when it's the

staffing of Registered Nurses in our hospitals that are caring for the Oklahoma public, for our neighbors, for our mothers, fathers, the people we love, then it IS an issue that directly effects the health and safety of the public. As a critical care RN in a well respected hospital, I see the effects of understaffing on our patients health and safety on a daily basis and it frightens me. Increasingly, I walk out of the hospital at the end of the day and rather than reflecting on the quality care I was able to give to my patients, I breathe a prayer of thanks that my patients survived my shift. So far, my patients have been lucky, but how long can the luck hold out?

According to a 1999 study by the Economic Policy Institute, a nonprofit, non-partisan economic think tank in Washington DC, nursing represents 30% of a hospitals annual budget which makes it "the most attractive cost-cutting target. As a result, administrators have sought to redistribute tasks within the nursing units in ways that may seriously impact the quality of patient care." The RN is the only consistent person at the patients

bedside 24 hours a day. We are the eyes and ears of the physician. Their decisions about your health are made based on objective and subjective data received from the nursing staff. Yet, the number of patients Registered Nurses are required to care for per shift has increased dramatically. The result is that your nurse has less time to care for you and has

less information to give to your physician upon which your plan of care is based. It's not too far a leap to say that if your physician is getting lower quality information then perhaps you're receiving a lower quality of healthcare!

In a recent study by the U. S. Agency of Health Care Policy and Research (AHCOR), it was found that hospitals who have fewer Registered Nurses per patient than other hospitals run a higher risk of developing AVOIDABLE complications following surgery. These complications lead to an increase in the cost of hospitalizations, an increase in the

length of stay and an increase in human suffering. As administrators strive to balance cost cutting and quality of care, they should pay attention to the one of the authors of the AHCOR study who said "the finding of a strong inverse relationship between registered nurse staffing and adverse patient events should be considered when developing

strategies to reduce costs."

In the meantime, next time you or your loved one is admitted to the hospital, ask your nurse how many other patients are depending on her for care. Empower yourselves, afterall you are the customer. Until there is a public outcry at the decreasing quality of care received in the presence of cost cutting practices our patients, your loved ones, will

continue to pay the price. Unfortunately the price they pay will be in their health!

NurseyK · Mar 17, 1999

Here is an excerpt of the letter that I have sent to my State labor board, State licensing board, State nursing board, ANA, ENA, and my Local and State government officials (with the letter I sent copies of the "weak" responses I received by my State licensing and labor boards):

...The following correspondences relate to an issue of great importance, since each of us, at some point, will either come in contact with, or have a family member or loved one come in contact with, the Emergency Medical Care System. The Hospital referred to in this case handles a 2 County area in XXXXXX State. I have not been more specific due to the fact that nurses are unprotected in cases where allegations of unsafe patient care have been expressed. The issue at hand is whether a nurse providing emergency or critical care in the 20th hour of a work day due to mandation is the person you want taking care of you or your family member in a critical emergency situation.

The hospital where I currently am employed mandates RN's housewide for 20 hour shifts when staffing is short. What is the State's

position on this practice, and does the State believe a nurse is competent to make life-or-death appropriate decisions in her/his 19th hour as (s)he would in their first hours of work? This practice, in my

opinion, directly impacts the quality of patient care delivery, and can lead to medication errors, needlestick injuries, and other fatigue-related incidents.

I, as an Emergency Department RN, literally hold a patient's life in my hands every day I go to work. Placing the added stress of fatigue from a 20 hour shift can have potentially disastrous results. Medical school students, and even truck drivers, have limits to their length of shifts

based on public safety issues. Yet a nurse, after being on shift for 19 hours, is required to perform their duties in a competent manner, making decisions and performing procedures that directly impact on the health and well-being of critically ill or injured patients.

The State Nurse Practice Act has spelled out the obligations of an RN's practice. It should also encompass this issue, as shift length and the associated fatigue can specifically harm patient care delivery....

Hope you all enjoyed it. Let me know what you think, and feel free to use any parts of it in your own letters. Keep the faith...

barton · Mar 17, 1999

NurseyK,

LOVE IT, LOVE IT, and..........LOVE IT!!

I'm also happy to hear that you included the "weak" responses.

And.....since I read about some of the goals and functions of the ANA and FNA BEFORE I wrote to the ANA, I wrote in my letter to them that I could find NOT ONE entity with the DEFINITIVE power to address our concerns---that all I could find were weak and blurry terms like: listen, assist, guidance and influence.

I said that prenatal care and clean indoor air (some of the "goals" I found in my research named above) may be important in "wellness care" but don't you think that patients who are already in hospital beds should come FIRST?"

Just a small part of my letter, and you are all free to use it if you wish.

KEEP UP THE GREAT WORK GUYS!!!

barton

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[This message has been edited by barton (edited March 17, 1999).]

barton · Mar 18, 1999

TO JOELLEN!!

Matt Craine, the Editor-in-Chief of hospitalhub.com, left a post for YOU and ME to call him if we wish---I guess he has some ideas to help!!!

Between this BB and that one, maybe we can get even MORE nurses involved!

Great, huh?

barton

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Sophie · Mar 23, 1999

I just put some info on the 20/20 thread. I'll put them here now. In Calif. there's a senate bill (SB394)- Safe-staffing bill. In Sacramentao on Apri; 6 at 1:30PM there will be a hearing. If you live close to there GO and give your support. The CNA website has all the Calif. legislative item listed under 'Government'. It is really helpful to see what's in the work.This stuff is hard to find out about so if you look you can be weel-informed. Perhaps the other states' nursing associations have a similar set-up.

Sophie

barton · Mar 23, 1999

Sophie,

Please, please, e-mail me! Thanks!

barton

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