Doris Carroll
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Management feels they are acceptable risks. It would never pass in any state to make short staffing a criminal offense, although research does correlate less nurses with increased adverse outcomes. This is why we need a federal staffing bill or states to pass their own staffing legislation, putting hospitals on notice with severe penalties and staffing committees with more leverage. Oregon just announced proposed ratio legislation for 2023, very detailed. https://www.oregonrn.org/page/SafeStaffing-legislation
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You're very kind! And congrats on your retirement--but you look very busy still! I'm still working with my former union as a retired member, to re-introduce staffing ratio/acuity legislation in 2023. And busy here in Florida with Labor unions and politics ? (here's my view of the backyard pond...)
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Oh my-this brings back so many terrible memories as I have retired in early 2021. I have to say my last 10 yrs were less toxic. I'd have to dig deep for those reasons though. Perhaps I changed what I could actually do to change the toxicity- I became active in my union. ? But I do recall working in an high risk OB tertiary care clinic and loved the physicians and patients. But my supervisor was a nurse who started each day with a morning meeting- "Our day is going to be very bad" Each day. I couldn't tolerate her ineptness, her negativity and left to go back to inpatient L&D! In 9 months, that was 1987...
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Nurses can join in the fight to pass federal legislation- S. 1567/H.R.3165 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021. Go here to learn the steps you can do to educate, organize and agitate. Learn how you can educate yourselves, other nurses and congressional legislators for these bills. https://www.nursestakedc.com/legislative-information These bills will die in committee within the week. Next year we hope to see the bills re-introduced. But- the value of learning this information is that it can be applied to fighting for legislation in your own states. Ask unions what are they doing to support and pass ratio legislation? Don't be fooled by the ANA, AONL and the AHA-they want to see staffing committees as opposed to ratios. Staffing committees allow the hospital to remain in control, attempting to pacify nurses. Yes, some increases in FTEs can be had, but it is a slow and arduous process. Even Dr. Linda Aiken has raised her voice in mandating legislation now in the past few years as her own and others research is ignored by the AHA. Dr. Linda Aiken in 2019–“…There has never been one shred of evidence to show more nurse staffing made things worse, but there have been a lot of studies to show they made things better,” says Aiken. She also notes that all of the fears the hospital industry in California expressed were unfounded. “No hospitals closed, and the public didn’t pay more even though it was an unfunded mandate. The hospitals just shifted their resources…Critics of nurse-to-patient ratios say they take away from nurses’ discretion, but I don’t buy it,” says nurse researcher Aiken. “We can show people are dying unnecessarily. I’ve been doing research for over 40 years, and there has been no other example that improves patient outcomes more than staffing.”https://www.aft.org/news/fed-unsafe-staffing-nurses-are-organizing-change?fbclid=IwAR0ojOPQuRy-E1GKPyTH-KjyUXMQ6ZP63arnOCmGEMCx3x-Pwlqy9q5m1kg
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Thanks for posting the Patch article. They have now fired the CNO. And they've given the nurses a "final warning" which does not follow the usual steps in the disciplinary process. It's the step before termination at their facility. As you said the union continues to meet with administration, community leaders and legislators...
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I understand. My union did that in 2017. I was told we hadn't properly educated our nurses on the staffing issues. It wasn't an urgent issue that my own nurses were ready to strike on. I was devastated. Then in 2020 I made sure ratios were front and center. We won 200 more positions in a hospital of 1400 RNs. Hospital refused to call it ratios, called it FTE staffing commitment. However, now many nurses have retired or went to travel nursing. Yet our turnover rate is quite low compared to other IL hospitals. So the way you get your voices heard in your union- you run for office on the local union board-it's run by nurses with organizers to assist. And the the state board. That's how it's done. It's a democracy so majority will rule.
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We need to continue to volunteer our expertise in pushing the federal legislation forward. No one will do it for us. That message should be very clear now. There are many ways that one nurse can make a difference. First see if your congressional senators and representatives are co-sponsors: https://www.congress.gov/bill/117th-congress/house-bill/3165/cosponsors?r=84&s=1. If not email them, then call, then see them in person. https://www.usa.gov/elected-officials Use this to familiarize yourself and review with legislators, nurse colleagues, family and friends. Demand your legislator become a co-sponsor and pass it! From www.NursesTakeDC.com Schedule appointment with nurses and congressional legislators. The legislative session ends with the Nov 8th election. Hopefully, Jan Schakowsky-IL and Sherrod Brown-OH will re-introduce the federal bill in 2023. It has been re-ntroduced for decades. Nurses must do this!! Support organizations that fight for patient safety. Show up in Skokie Illinois for a Patient Safety Advocate Org on Nov 10th. Get tickets now! https://ci.ovationtix.com/34423/production/1141887.. Preparing for NTDC federal Legislator visit document HR 3165 S 1567.docx Vote Yes on HR 3165 and S 1567 Nurse Staffing Ratio bill NTDC June 2022.docx
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Agreed. Apparently the CNO was just fired. There are ways to fight back. Create an ADO form-Assignment Despite Objection to document the unsafe staffing. Remember-if we don't document it didn't happen. It means you've taken your assignment despite your objection that it's unsafe. Unions have created this document. If you're not in a union what to do? Create your own ADO using Google Forms. Here's an example from a union -https://ado.wsna.org/ado . Start creating a file folder of emails you sent to the charge nurse, copying the supervisor or director of your assignments. Obviously this can not happen if only one nurse does this. Get your entire unit to buy in, get multiple units to do it. Call your legislator in that hospital district. Make an appointment. Present the folder to them. Call your public health department. File a report anonymously. Organize and educate yourselves. Depending on which state you live in you may have laws to protect you. Whistleblower legislation, staffing legislation. Although social media, marches have helped engage and network with others, it's just not the endgame. You must speak out. Silence=acceptance. Join a union.
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We have seen the exodus of hundreds of thousands of registered nurses these last 2 years, after bravely caring for the public during the Covid pandemic, with significant risk to themselves. Many nurses became infected, and some died, due to the failures of a healthcare system that values-whom? Certainly not nurses. And I daresay, not the public either. We have seen hospital administration resume normal practices of staffing dangerously claiming there are no nurses applying. They are partly correct. And our own nursing organizations have convinced legislators to provide funding to increase nursing graduates, believing adding more nurses to this broken system will ease the staffing issues every hospital faces.1 Don't believe it. I know many of you don't. As a recently retired nurse of 37 years. I have fought for Illinois nurses as a statewide nurse union president and co-chief steward at my state hospital of 1400 nurses. I remain actively licensed as a retired member of the Illinois Nurses Association, the Nurses' Union, working collaboratively with other unions and organizations to bring forth safe nurse staffing Illinois legislation in 2023. To pass legislation to protect nurses- and more importantly, the public. Our last attempt was in 2019, before the Covid pandemic started. It is a fight nurses across the country have fought for over 3 decades, alerting the public and legislators of inherent dangers to them when there are not enough nurses at the bedside of our loved ones. Dangers repeatedly corroborated by two decades of evidence-based research.2 Case in point: Ascension St. Joseph's Hospital in Joliet, IL. Here is what we know –4 nurses were suspended on Saturday, Oct 22, after notifying nursing and hospital management for weeks of how unsafely staffed the emergency room and ICU were. Their fate will be determined in the next few weeks, with possible termination most likely. From Becker's Hospital Review, dated Oct 24th: "According to the Illinois Nurses Association, which represents the workers, four nurses were available to treat 46 patients at the time, despite hospital guidelines that recommend the unit be staffed with 10 nurses. The union contends the nurses notified hospital management of the issue and urged that the hospital go on bypass. Hospital management did not address the nurses' pleas, and security personnel escorted the nurses out of the hospital, the Illinois Nurses Association news release read. On Oct. 21, nurses also reported threats of retaliation and termination, according to the union. The union said nurses in the hospital's intensive care unit experienced a similar staffing situation on Oct. 17. "Instead of working with the nurses to help make sure the patient population was adequately cared for, on-site management seems to have decided on an approach to exacerbate, rather than resolve, the problem," Julia Bartmes, Illinois Nurses Association executive director, said in correspondence to the hospital, according to the union news release. The Oct. 21 incident came after nurses and the hospital reached a three-year contract in 2020. The agreement followed a strike that took place amid nurses' staffing concerns. In a statement shared with Becker's, the hospital said, "Ascension Saint Joseph-Joliet is committed to working in partnership with our nurses, while also respecting the terms of our labor contract. In doing so, we are conducting a thorough investigation of recent events. We remain dedicated to our mission of providing compassionate and quality care to the communities we are privileged to serve." 3, 4 After speaking to my colleagues who work at Ascension St. Joseph's, the story becomes clearer. The regular staffing grid for the emergency room called for 10-12 nurses, quite challenging at best. And certainly, Ascension was fully aware of the staffing shortage for that night since it had been posted for 6 weeks with only 4 nurses scheduled. How dangerous is this? Imagine a patient arriving at the ER with symptoms of a MI. How many nurses does a code blue require? How many nurses are left to care for the remaining 45 patients? Quite shockingly dangerous to patients that Ascension is responsible for. The nurses utilized the chain of command in their repeated requests for additional staffing. Attempts to transfer to other facilities were futile. One nurse, upon arrival to her shift, finding she had no additional nursing staff, experienced a PTSD episode, and had to leave. Another nurse with 17 years of service, who worked 7 days a week, 10-hour shifts to help cover the constant shortages was emotionally overcome as he spoke out... only to be retaliated with a suspension. Again, I ask the question, who does Ascension value? Ascension's failure to provide patient safety in a hospital whose purpose is to deliver nursing care services for the public- safely. That is a public safety crisis created by Ascension. A choice to not staff enough nurses to care for the needs of the patients. Let me be clear- Ascension's administrative decision was to choose NOT to staff safely after repeated alerts by those who provide nursing services, that is, Ascension staff nurses. Rather they chose to retaliate, punish and lock out the nurses who were notifying corporate of the breach of public safety and potential harm to patients. The nurses' staffing needs are not a surprise to Ascension. The nurse staffing plan for nursing units arises from the direct care staff nurses who work at Ascension. The nurses who serve on the Nursing Care Committee, who base staffing needs on national nursing standards and create staffing recommendations according to IL regulatory Nurse Staffing by Patient Acuity law of 2008. 5 The Problem Every IL hospital was not under any obligation in the law to meet those nurse staffing recommendations! "Data suggests that current law has not been effective at promoting adequate staffing levels to address the shortage of registered nurses. Illinois lawmakers are considering whether to follow California's lead and adopt safe patient limits, which would establish patient-to-nurse ratios in Illinois' hospitals" 6 Therefore, new legislation was passed in 2021, the IL Nurse Staffing Improvement Act, with the intent to strengthen the legislation from 2008, shows clearly that Ascension has violated it with retaliation and should be strongly penalized. However, this bill remains weak since hospital fines are small if there are violations of the Act. "Retaliation is prohibited against an employee who expresses a concern or complaint regarding a violation of the Nurse Staffing by Patient Acuity Act or concerns related to nurse staffing"7 Conclusion What exists in nurse staffing law is NOT adequate to protect the most vulnerable in need of nursing care, as recommended by those nurses who use national nursing standards to address patient care nursing services. Instead, Ascension retaliates and disciplines those nurses to silence them. The Remedy Listen and follow safe nurse staffing as proposed by your own staff according to IL law. But obviously much more is needed. Secondly, we the nurses in Illinois will push to mandate minimum nurse staffing levels - with regulated accountability to address the need for more nurse staff based on a patient needs component. And Finally All Illinois nurses can assist in passing minimum nurse staffing levels in several ways. One way is by completing a new survey, the Illinois Nurse Staffing Survey 2022. The data collected will support the legislation we intend to introduce in 2023. Here is supporting research, including studies conducted in IL: Resources for Safe Patient Limits in Acute Care Settings September 2022 Stay tuned for further actions to pass minimum staffing levels. 8, 9 Ascension must cease these current dangerous staffing practices, deliberately putting Illinois citizens, and our patients seeking nursing care services, at risk. Listen to your nurse experts who care for patients according to national nursing standards of care-- your cost-cutting business model is not working. Patients' lives depend upon adequate numbers of nurses to care for them. Their bottom line is money and casting a blind eye to the human condition of pain and suffering. It must be the care for the patients and those nurses attempting to provide safe quality care. You can see what happens when the empathic, Catholic, and Christian teachings take a backseat to monetary gains versus patient outcomes. I thank the nurses who shared their heartfelt stories and words with me. They will remain anonymous since they risk termination for speaking out about dangerous, unsafe staffing at Ascension St. Joseph's in Joliet, IL. Let your voice be heard Complete the Survey References 1AACN Fact Sheet Nursing Shortage 2 Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: an observational study 3 Nurses escorted out of Ascension hospital 4 700+ nurses strike over new labor contract at Illinois hospital 5 https://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=095-0401 6Do Nurse Staffing Standards Work? Evidence from a 2018 Survey of Registered Nurses 7 102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 SB2153 8Illinois Nurse Staffing Survey 2022 9Illinois Nurse Staffing Survey 2022 Research
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Nurses— this survey is for LPNs RNs and APRNs! We have 2 weeks left and the response rate is quite low compared to last time. We had close to 9500 RNs respond. It’s no where near that amount. I know everyone is tired. But please do it. Your voices will be heard. It will be published. Please share with your colleagues. Here’s an article I wrote for Medscape. We’re trying to get the word out about the survey. https://www.medscape.com/viewarticle/960519?src=
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Wow. My 87yo mother says-Unbelievable- as I read aloud your story to her. I would say-get out to maintain your mental health. You’ve been traumatized and the employer will never replace what you’ve lost. And will continue the abuse. I remember once working for high risk OB home health back in the 80’a for only 4 mo. Because as a new hire I watched everyone leave until there was just 2 of us. I was working 72hr/wk. I got out. I hope you do too.
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Exactly. The ones in power, healthcare administrators AND legislators get VIP service when they or loved ones are hospitalized. They don’t suffer from unsafe staffing. I’ve seen it. The disconnect is astonishing. Therefore to make change we need to make our personal stories heard, and demand change based on two decades of staffing research. However, it appears, like Covid, half of this country ignores science, are not compassionate or cognizant of over 600k deaths, therefore why should healthcare administrators and legislators consider staffing safely since they aren’t impacted by it directly.
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Previous poster stated “poor work ethic” might account for nurses leaving. Wow. As a nurse of 38yr, no not a poor work ethic. As Beth stated, Covid has shown the spotlight on our healthcare staffing failures. I fear it will collapse. But my cynical voice says— administration knows staffing crisis wax and wane. They’ll do ANYTHING to wait it out, instead of passing legislation. What I fear is UAPs will manage the bedside then. They’ll watch RNs leave in a mass exodus- to get unskilled cheap labor. It’s already happened in ambulatory settings for decades. #NursesUnite #StandUp #NationalStrike
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Nurse here 37+yrs. I have seen the degradation of our profession. We must stop the discussion and instead take action. We know it’s not burnout but instead moral injury. We know it’s not the shortage but a refusal to hire and a refusal to work in these dangerous conditions. It’s not short staffing but dangerous staffing. Like driving drunk , you may not kill someone today but the risk is there each time you work in unsafe conditions. Please educate, organize then agitate your colleagues. I cannot say it any louder. I grow weary as each year the discussion continues. You have a choice—get out of nursing or continue. If you stay then COMMIT TO MAKE CHANGE. After coordinating annual NursesTakeDC Conference/Lobby Day/Rallies since 2016, the lack of interest is quite staggering. This is your moment. We are still living in a pandemic. It will wax and wane. Get your a$$ up and going NOW. Educate yourself by knowing the peer reviewed evidence based research for staffing with ratios. Go to www.NursesTakeDC.com to find it. Or search/review Dr Linda Aiken’s staffing research. Educate yourself on understanding that your professional organization, the ANA, the AONE/AONL are NOT your friend. They are against ratios and have abandoned you at the bedside, clinics, LTC. Educate yourself that the AHA will ACTIVELY fight back (with the ANA) to destroy any attempt to pass ratio legislation at the state and federal level. They believe staffing committees are the GOLD STANDARD. There is NO research supporting staffing committees, except for one study based in Illinois, which reviewed CNO responses. IL —where I’m from— has had staffing committees and acuity law since 2007. It doesn’t work. No surprise. Yet the ANA and state chapters continue to push it. Anything to avoid ratio legislation. In fact, my assistant CNO said exactly that during 2017 negotiations. Yes—my hospital has a union, the Illinois Nurses Association for over 4 decades. I was the Chief Steward for 5 years. I also was the President at the state level. I firmly believe nurses need to organize in order to have safer work place protections. Please consider it. But you can still organize yourselves to collectively take action by contacting your Congressional legislators. You might say you’re not political, you dislike unions and politics. Get over it. This is how change will happen. You tell your legislators a personal story of a very difficult shift. By email and by phone. You MUST call them. How can our voices be heard if you do nothing but respond on social media? Here is the link to send email to have your legislators co-sponsor HR 3165, https://actionnetwork.org/letters/support-hr-3165-s-1567-nurse-staffing-standards-for-hospital-patient-safety-and-quality-care-act-of-2021?source=direct_link& Remember it’s not one email, one phone call but many to get your voice heard. Here is the bill, similar to California legislation, includes ratios for RNs and LPNs. https://www.congress.gov/bill/117th-congress/senate-bill/1567/text?r=36&s=1 And now, get yourselves fighting to make this change happen! Here’s some fighting music and info on NursesTakeDC. https://vm.tiktok.com/ZMdCLuPKh/ I just retired to FL to care for my 87yo mother. I miss the fight. But I’m in FL so I’m happy to take up the battle here now instead!
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While I agree with you about staffing, I disagree about what you say about “union heads”. I’m a nurse of 37 yrs, work full time in academic Ambulatory clinic, and am the VP at state level and Chief Steward at my hospital for my union. Those 2 union positions are unpaid. I volunteer my time. I give back to nursing and am passionate about safe staffing. I’m fighting every day with management to get nurses and patients what they deserve. Better staffing. Improved outcomes.
