Political hope for bedside nurses

dialysisnurseLC · Mar 29, 2013

I'm interested!!! Sounds like a great read and inspiration! I would love some staffing laws in the lovely world of dialysis nursing!!!

forrester · Mar 30, 2013

1 down, 2.9 million to go!

I wonder where all those disgruntled nurses are?

Personally, I think ratios are THE most important issue for nurses. We are getting beat up and making gazillions of dollars for others. We need to be able to bring the value of nursing to our patients, and we can't do that with the current state of affairs.

Once empowered, we can start leading the discussion on health policy.

LadyFree28, BSN, LPN, RN · Mar 31, 2013

A new book is coming out which details the history of the California Nurses Association. Just a union...of nurses
This book is now available on Amazon. It details how and why the California bedside nurses managed to get staffing ratio laws, and how we can do it all around the country.
It is readily apparent the industry will not do it (provide truly safe staffing levels) unless there are fines for not doing it. Don't worry, they'll still make tons of money, and no, hospitals won't close because of this.
Dr. Laura Gasparis Vonfrolio (well known nurse activist and clinical expert ER nurse) has called this book the one book every RN in the U.S. needs to read.
We are not powerless

^THIS!!!

I have been a nurse for seven years and in healthcare for about 13 years. I have NEVER felt powerless...this is a GREAT read for those who feel this way...

If you advocate for your pts, you MUST have the POWER to advocate for yourself and the profession as a WHOLE.

I am in a state that has a VERY powerful voice in shaping healthcare, scope of practice, and are introducing staff ratios. I am proud to be a part of a hospital that has a heavy presence of our state nurses association in terms of continuing to shape and collaborate the advancement of our profession. We do not have a union, yet, the nurses have a seat at the table, ALLL the way UP into the executive board.

Nurses have a seat at the legislative table as well, especially with the recent changes in scope for LPNs, increasing scope and opportunities for RNs, and increased scopes for APNs.

This process can work if people stay in contact with local chapters if several nursing associations, find out when there are collaborative processes within the groups and BE INVOLVED in ANY way.

Nursing is a very POWERFUL profession...BE empowered!

forrester · Mar 31, 2013

Go tell your nurse manager that the staff has decided to only take 5 patients on their med-surg floor due to the risk associated with each additional patient.

Staffing ratios are the number one complaint from nurses around the country, and the statistics on retention in the first 2 years of practice are atrocious.

We rank 37th in healthcare

!00,000 Americans die each year from avoidable errors, with another 100,000 dying further downstream.

Almost 1/3 of nurses are trying to find other employment than bedside care.

The current non-system rewards medical task completion, not nursing.

NP prescriptive authority is up for the 20th straight year in Florida.

Np's have independent practice in only 8 states.

The ANA cancelled its "health care summit" in New Orleans in 2009 (you know, when the country was in the midst of a national discussion about healthcare) due to lack of attendance. So much for the White Paper!

Our leadership is more affiliated with the AHA than with actual bedside nursing practice.

I'm glad you feel empowered...most don't.

LadyFree28, BSN, LPN, RN · Apr 1, 2013

Go tell your nurse manager that the staff has decided to only take 5 patients on their med-surg floor due to the risk associated with each additional patient.
Staffing ratios are the number one complaint from nurses around the country, and the statistics on retention in the first 2 years of practice are atrocious.
We rank 37th in healthcare
!00,000 Americans die each year from avoidable errors, with another 100,000 dying further downstream.
Almost 1/3 of nurses are trying to find other employment than bedside care.
The current non-system rewards medical task completion, not nursing.
NP prescriptive authority is up for the 20th straight year in Florida.
Np's have independent practice in only 8 states.
The ANA cancelled its "health care summit" in New Orleans in 2009 (you know, when the country was in the midst of a national discussion about healthcare) due to lack of attendance. So much for the White Paper!
Our leadership is more affiliated with the AHA than with actual bedside nursing practice.
I'm glad you feel empowered...most don't.

^And In turn, it's not too late for those who don't feel empowered. Sites like AN can give a connection and catalyst to what we CAN do. Again, grateful for a state who are involved in the legislative process, and BTW, they are floor nurse, educators and administrators, but it is a healthy mix. I believe my state will be able to pass mandatory staffing ratios in the VERY near future...we still have work to do, as well as make sure nurses aren't apathetic in getting involved...IMHO, feeling powerless IS a choice, especially if so many want changes. I've been through enough professional and personal challenges that can make heads spin...and I'm sure many people have...those strengths have the ability to allow us to make the changes that we seek in the world. Again, it is a choice.

It is unfortunate that each state has its own challenges, but it does take some great grass roots organization and coming together to collaborate for the safety of our patients.

John Silver · Apr 1, 2013

It is unfortunate that each state has its own challenges, but it does take some great grass roots organization and coming together to collaborate for the safety of our patients.

Yes, it does take grass roots organization. That is what this book really talks about. How to do this.

We are nurses and are not necessarily educated in how to achieve political victories. The model examined in this book presents a way to organize and become politically effective.

Not sure what state you are in, but good luck with the ratios.

I would also argue that our political "foes" are very strong and politically well connected. That requires a special effort in achieving political results. Opposing the AHA and/or the AMA is daunting. SO, it is not really a level playing field and it requires special tactics to get success.

So in that sense, powerlessness is not necessairly an internal thing so much as it's a structural thing. I do not feel powerless as a person, but we are politially powerless in many cases as nurses.

LadyFree28, BSN, LPN, RN · Apr 1, 2013

I was educated on becoming a part of the political process in my PN and my BSN program. I was involved in NAPNES as a LPN. There is a heavily influential Nurse-Dr union that works with the state nurses association that has full support of the ratios.

In my years in healthcare as a nurse, If I was not working in LTC, unsafe staffing was NOT the norm, nor is it now. I work in CC now; usually 2:1 ratio or 1:1 ratio.

When I worked in Rehab, 5:1, 4:1 with one T/V patient; on nights 6:1. Only one time I recall having to split the floor because there was a turnover problem, two people quit, under suspicion of abandonment and neglect, and one was fired. The nursing supervisor rounded two hours with us, and passed meds...it had to be done.

My previous job had a set ratio, 3:1 for LPNs, 6:1 for RNs at a pediatric extended day center. If there were not enough RNs due to turnover (over salary) supervisors took a full assignment, even the head administrator would split an assignment with an LPN.

When speaking about activism, feelings of powerlessness, we also have to have an honest conversation about that time...about the year 2000, where in my area, corporations were taking over hospitals, closing them down or consolidating and building health systems seeing the dollar signs in healthcare on one side, and the many students who changed their major to nursing because "Nursing is where the money is at". There are people who do not think that nursing is a "profession" or value the investment that we do for our clients health, or have another ulterior motive when coming into this profession, to say "I didn't sign up for this, but I'm trapped." A lot of these people are on the side of powerlessness. There are a finite number who do not fall in that category. I know 2:200 nurses that I do know that feel powerless-only two, who ADAMANTLY do not want to get involved in nursing associations, attending meeting at our state Capitol, and believe "it's a waste of time"; yet they feel powerless. I truly believe in a systems theory; if intrinsically powerlessness is ruling you, and you have enough power in your powerlessness, it can create a systems problem.

If you are surrounded by nurses who are empowered who support you and TEACH you the power of your profession and create and environment of empowerment, the system can work.

We have to find a way to meet with these two tracts...do we encourage those "who didn't sign up for this...I have my worth in dollar signs" with the ones who love their pts, have theorists like Benner, Orem and Watson and countless others as their basis of practice, who are invested and have better ways and ENJOY nursing, and want to ensure it is about the pt?

I don't have those answers, but I can honestly say I have been powerful to my patients. I want EVERY nurse to feel that way. BUT we have to have this discussion and come together powerfully.

forrester · Apr 1, 2013

Critical care IS somewhat protected...and isolated, but I am hearing more and more of 3 patient assignments in Florida for ICU nurses. California has a law about staffing ICU's that actually dates back to 1975. When I worked there, I never had more than 2 patients, 1 if need be.

When I cam back to Florida, I started seeing 3 pt. assignments regularly in the ICU's starting around 1997.

Administrations will push the envelope as far as they can, as they have on the "floors". It seems the only thing they do respect is state laws that punish violations.

The hospital associations and their nursing puppets (the AONE) will not do this on their own.

The ANA, for whatever reason, will not get off the fence on staffing ratios.

When I brought this up at an FNA meeting on staffing issues, I was told they will not talk about ratios.

We can change this dynamic...but it will take some work from all of us. "just a union...of nurses" provides a blueprint for nursing action. We've had nothing but rhetoric for 40 years now. Read the nursing surveys for the last 40 years- nurses have been speaking up on this issue but nobody seems to be listening.

forrester · Apr 1, 2013

"I was educated on becoming a part of the political process in my PN and my BSN program." QUOTE

Not really- re-read your books.

They either show the ANA as the solution or provide information about addressing foot ulcer problems by appealing to legislators.

The REAL political world is not to be found in nursing textbooks...until now.

In FLorida, for example, the FHA has 20 full-time lobbyists.

The FMA has 18 lobbyists.

The FNA has 2 (it used to have 1)

APN's have 1.

LadyFree28, BSN, LPN, RN · Apr 2, 2013

"I was educated on becoming a part of the political process in my PN and my BSN program." QUOTE
Not really- re-read your books.
They either show the ANA as the solution or provide information about addressing foot ulcer problems by appealing to legislators.
The REAL political world is not to be found in nursing textbooks...until now.
In FLorida, for example, the FHA has 20 full-time lobbyists.
The FMA has 18 lobbyists.
The FNA has 2 (it used to have 1)
APN's have 1.

I DON't need to re-read my books lol; were YOU in my class???

Please...It was NOT through books, thank you.

My instructors are actively a part of my state nurses association and other professional nurse associations, NOT ANA.

Please refrain from making assumptions about what is going on in my state...instead of nit-picking through my quotes, UNDERSTAND I have been around long enough in this profession, and also HOW my state is doing significant strides in my state in regards not only in pt safety, but many other nursing issues, including standards in fighting other battles. It's NOT just in CA and FL that have lobbyists...In my state we have two nurses in our state senate. They encourage nurses to be a part of the political process. The program I graduated from had 5 lobbyists, INCLUDING the dean.

Instead of analyzing my experiences, let's focusing on collaborating on what can move forward in equality of practice and power in our profession. What will be our barriers based on state, since it seems that is your analysis on your comparison to your state yet dismissing my experiences...will that be the barrier??? Can we respect our experiences and work past that. I am MORE interested in moving forward with that.

Home Health Columnist / Guide · Apr 2, 2013

I started the Activism forum in 2001 to educate nurses on understanding political process and flexing their political muscle.

My training wheels for activism started with discussions from RN Educators at ANA/PSNA district nursing association meetings, later state nursing conventions, split of nursing union from our state association along with education sessions at State Nursing Association, ANA conference/conventions and state hospital association meetings. More you understand the process, greater impact you can have on influencing legislation passage, rewritten/amended or blocked from passage at state level--easier than federal level.