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NursesTakeDC

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  1. NursesTakeDC

    Report your current staffing

    Nurses RNs & LPNs... Acute care and LTC... This is for you. It's anonymous, simple to fill out, and we can periodically post what is going on countrywide. The guidelines for it include: 1. Only complete this if you are a direct care bedside working RN or LPN/LVN. 2. This is to be completed for the shift you are working. Keep responses to one per shift. ** It's about BOTH ratios and acuity** Thankfully every piece of legislation for safe patient limits INCLUDES acuity. #NursesUnite #NursesTakeDC #SafePatientLimits https://www.nursestakedc.com/real-report-your-current-staffing
  2. NursesTakeDC

    Should Hospitals Set Workloads for Nurses?

    No they most certainly should not!!!
  3. NursesTakeDC

    CEO Says More Nurses Won't Improve Care

    A national survey was completed in October 2018. This article presents the data that was collected from the State of Illinois. The purpose of this article is to show the experiences that bedside nurses are having in Illinois in their hospital staffing practices, as their state has legislation that has been enacted since 2008 called the Nurse Staffing by Patient Acuity Act. #NursesTakeDC #NursesUnite https://allnurses.com/illinois-nurse-staffing-survey-t699288/
  4. NursesTakeDC

    Should Hospitals Set Workloads for Nurses?

    A national survey was completed in October 2018. This article presents the data that was collected from the State of Illinois. The purpose of this article is to show the experiences that bedside nurses are having in Illinois in their hospital staffing practices, as their state has legislation that has been enacted since 2008 called the Nurse Staffing by Patient Acuity Act. #NursesTakeDC #NursesUnite https://allnurses.com/illinois-nurse-staffing-survey-t699288/
  5. NursesTakeDC

    Illinois Nurse Staffing Survey

    Illinois Nurse Staffing Survey Catherine Stokes BSN, RN, Jalil Johnson PhD, APRN, Ruth Neese PhD, RN, CEN, Doris Carroll BSN, RN-BC, CCRC, Pamela S. Robbins MSN, RN, Deena Sowa McCollum BSN, RN A national survey was completed from October 1, 2018- October 31, 2018. Survey responses were collected via SurveyMonkey.com. Online outreach occurred through several social media outlets including Allnurses.com, Facebook nursing communities, Medscape Nurses, Show Me Your Stethoscope, and Twitter. The national survey produced 9,498 responses nationwide. These results will show information collected from 508 Illinois nurses. Inclusion criteria for the survey were that nurses should have an active license and be working as a bedside clinician. Demographic information was obtained from the participants. Units identified in the survey include: ED, ICU, NICU, pediatric ICU, PCU, intermediate step down, telemetry, med-surg, mother/baby, labor/delivery, pediatric floor units, float pools, and psych units. Educational demographics include responses of diploma nurses 4.72%, ADN/ASN 31.10%, BSN 55.12%, MSN 8.46% DNP 0.59%. The clinical settings identified by the respondents include: Tertiary/Academic hospitals 23.62%, community hospitals 57.28%, critical access hospitals 10.83% and 8.27% marked the type of hospital they work at as other. Information obtained as to whether the facility that they work at is a Magnet accredited hospital or not include: 45.08% nurses responding yes and 54.92% responding no. The intent of this survey was to see if nurses who work in a state with state staffing legislation which mandates utilization of acuity tools and staffing committees comprised of 50% or more RNs, who provide direct patient care at least 50% of the time, is implemented properly and if nurses think staffing is safe. The survey also explored the differences in nurse staffing between Magnet-designated facilities and facilities without that designation. The state of Illinois has had state legislation for nurse staffing in place since January 1, 2008. The basic premise of that law includes the following: Facilities must post and implement the staffing plan recommended by a committee of nurses (at least 50% direct-care nurses), with broad representation. The plan must include the complexity of nursing judgment required, patient acuity, number of patients, ongoing assessment, unexpected patient needs, time for documentation, and staffing flexibility. Committee minutes must be stored for five years and must be given significant regard in the adoption and implementation of the plan. The plan must outline the process for submitting the committee’s recommendations to administration; the process for providing feedback to the committee regarding unresolved or ongoing issues, which must be addressed at the next meeting. Nursing Performance and Quality data must be reviewed by the staffing committee semiannually. (Shin, Koh, Kim, Lee, & Song, 2018) Data Results for questions pertaining to bedside nurse knowledge of their staffing law are as follows. Nearly 15.87% of Illinois nurses knew their state had acuity based and staffing committee legislation. The rest of the respondents marked “no” or “I don’t know” to the question of having knowledge of the state law that had been in place since January 1, 2008. Over 28% of nurses reported working in a hospital with a staffing committee, 38% of nurses worked in hospitals that do not have staffing committees, and 33.54% of nurses did not know if their hospital has a staffing committee. Composition makeup of the committees was asked of the respondents to further assess proper implementation. More than 20% of respondents work in facilities that are composed of 50% or more RNs who work direct patient care at least 50% of the time. Seventy-nine percent of the respondents either marked “no”, “I don’t know”, or that their hospital did not have a staffing committee. Sixty-two percent of the participants marked their staffing committee does not encourage feedback from nurses related to staffing issues. When asked if their staffing committee re-evaluates the effectiveness of the staffing plan semi-annually, 28.97% of respondents marked “no”, 56.90% marked they do not participate in the staffing committee process. Sixty-nine percent of respondents marked that their staffing committee does not re-evaluate variations between the staffing plan and actual daily staffing. We asked the respondents if the staffing recommendations determined by the staffing committee were implemented in the daily staffing census and 25.34% marked “yes.” The other respondents either marked “no” or “I don’t know” to implementation of staffing committee recommendations. Almost 43% of respondents indicated their hospitals use an acuity tool. When asked if staffing is based on the needs of the patients in the units, 68.26% of respondents said “no”. In response to a survey item asking if adjustments in staffing occur in response to patient acuity on different shifts 65.15% reported “no.” Over 81% of respondents reported their unit does not have a plan for when a patient’s care needs unexpectedly changes and exceeds the direct care nurse resources. More than 60% of the nurses who responded marked that retaliation is feared for nurses who provide input about staffing. Nurses were asked if their nurse to patient ratio in their unit is adequate/safe and 82.09% of them reported “no.” Thirty-nine percent experienced unsafe staffing 50% of the time, 31.95% experienced unsafe staffing 75% of the time, 20.23% experienced unsafe staffing 25% of the time, and 8.74% marked that they experienced unsafe staffing 100% of the time. More than 93% of responses indicated charge nurses were providing direct patient care on their unit. When asked if the charge nurses had a patient assignment, 34.01% of respondents marked “yes”, 28.31 marked “no”, 27.70% marked “sometimes but less than 50% of the time”, and 9.98% marked “sometimes more than 50% of the time.” Nurse staffing based on Magnet hospital status vs non-Magnet status was assessed to determine if there was a significant difference in the relationship between the designated facilities vs non-designated facilities. Over 37% of nurses in Magnet hospitals reported having a staffing committee in contrast to 20.97% of non-Magnet hospital nurses. A significant difference was noted between nurses at Magnet-designated hospitals and non-Magnet facilities, with more nurses at Magnet hospitals 37.33% being aware of the existence of a staffing committee, than nurses at non-Magnet facilities 20.97%. Additionally, nearly 30% of Magnet facility nurses reported “no” to having a staffing committee in comparison to 45.32% of nurses at non-Magnet facilities. A significantly higher difference in non-Magnet hospital nurses saying no at 45.32% vs 29.33% was determined. Respectfully 33%, of nurses in both magnet and non-Magnet did not know if a staffing committee was used. Thirty-three percent of nurses in both Magnet and non-Magnet designated hospitals did not know if a staffing committee were used. In Magnet accredited hospitals, 26.29% of nurses reported that the staffing committee was composed of 50% or more RNs who work in direct patient care 50% of the time. In contrast, in non-Magnet hospitals, 15.31% of nurses reported that the staffing committee was composed of 50% or more RNs who work in direct patient care 50% of the time. Slightly more than 51% of Magnet hospital nurses did not know if the hospital staffing committee was composed of 50% or more RNs who work in direct patient care; compared to 36.73% of non-Magnet hospital nurses. There were no significant differences found between Magnet hospital nurses and non-Magnet hospital nurses in regards to staffing based on the needs of the patients in the unit. Seventy percent of non-Magnet hospital nurses reported that staffing is not based on the needs of the patients. In Magnet accredited hospitals, 66.08% of nurses reported that staffing is not based on the needs of the patient. Magnet hospital nurse response: 82.97% report that their nurse to patient ratio is not safe. Non-Magnet hospital nurse response: 81.36% report that their nurse to patient ratio is not safe. Almost 60% of nurses who work in a Magnet accredited hospital feared retaliation for providing input for staffing. Over 62% of nurses that fear retaliation for providing input on staffing work in non magnet-designated hospitals. There is no significant difference found between Magnet and non-Magnet nurse responses and fear of retaliation. Of the total 508 responses, 496 respondents marked they do have ancillary services including certified nursing assistants (CNAs), patient care technicians (PCTs), unit secretaries, phlebotomy, electrocardiogram technicians, and respiratory therapists. When asked if licensed vocational nurses (LVN) or licensed practical nurses (LPN) were used to provide team nursing, 92.13% of participants reported “no”. Seventy-three percent of respondents indicated that they do not have to stay over their shifts as “mandatory overtime” to cover scheduling gaps. Conclusions Slightly more than 85% of nurses responding to this survey did not know Illinois had legislation in place requiring hospitals to develop staffing committees for safe staffing. Over 68% of nurses reported patient needs were not used to determine staffing in Illinois. There was no significant difference between how nurses perceived Magnet and non-Magnet hospital nurse staffing; and nurses did not believe staffing was based on actual patient needs. Almost two-thirds of nurses in Illinois feared retaliation if they provided input about staffing. Magnet accreditation did not make a significant difference regarding fear of retaliation. Magnet hospitals utilized staffing committees more than non-Magnet hospitals, with 26.29% of nurses in Magnet-designated facilities reporting the staffing committee is comprised of 50% or more RNs as compared to 15.31% of nurses in non-Magnet hospitals. Despite this finding, 82% of nurses felt their assignments were unsafe; and Magnet designation did not make a significant difference in this perception. A law mandating hospitals to utilize a staffing committee to determine nurse staffing has been in place in Illinois for 11 years. Magnet status is considered an important benchmark for the quality of nursing care. However, findings from this survey study show nurses report unsafe staffing consistently occurring in both Magnet and non-Magnet hospitals in the state of Illinois. Reference: Juh Hyun Shin, Jung Eun Koh, Ha Eun Kim, et al. (2018) Analysis of professional health provider need in East Nusa Tenggara until 2019. Health Syst Policy Res Vol. 5 No.1:67
  6. NursesTakeDC

    Should Hospitals Set Workloads for Nurses?

    Hospitals have demonstrated that they will not put patient safety above their bottom line for decades. Very profitable bottom lines... They have had plenty of time to improve the conditions that contribute to poor patient outcomes. Hospitals should have an accountability system in place to enforce them to invest into staffing and resources that provide better patient care and safety. As of now, there is no real system in place that would hold them accountable. This is why we need national safe patient limit legislation. ALL patients in ALL hospitals deserve the opportunity to receive safe patient care. All of the arguments presented by opposition of the safe limits bill (hospital associations, medical associations, professional nursing associations) is all driven by money and lead with misinformation to confuse the public. Bedside nurses wrote the legislation for safe patient limits. The legislation provides support to bedside nurses to allow us to use our education and skills as we were taught and as we are held accountable to. Our nursing leaders have failed bedside nurse and as a result as patients as they continue the status quo. It is not all of those leaders faults, as they need job security as well. Regardless, them continuing the same staffing or worse behaviors continues to drive nurses from the bedside. And more importantly, it continues to place patients at risk. Over 2 decades of literature shows what we need... better nurse to patient ratios... Studies have shown that ratio based legislation results in improved outcomes, improved staffing, improved nurse retention, improved occupational injury of nurses, and improved readmissions. California also has less maternal death rates compared to other states. Nurses having the time to actually critically think and properly assess their patients saves lives. Not one study that analyzes "staffing committee and acuity based" (without limits) shows that that method of staffing is effective or improves patient outcomes. We have "assessed" this situation for long enough. We have the plan. We have implemented in California, seen that it has resulted in improvements. We have been able to reassess any concerns and strengthen the law. To add penalties to non compliant facilities and to include language to protect all other health care workers. It is time to fully implement and we can re-assess when appropriate. The real reason that safe patient limits legislation is opposed is because of money, period. Money that hospital systems do have to invest. Money that is paid in by patients, insurance companies, and government reimbursements. People pay for a level of care that they should be able to receive... that hospitals have a responsibility to provide. It is fraudulent really that they get away with not providing the proper staffing and resources. Safe patient limits legislation gives "BEDSIDE NURSES" the support that they need to provide the best care possible.
  7. I work in MA and that is why we do need ratios and not just "acuity based staffing". Acuity based staffing is what allows hospitals to manipulate acuity tools. Mandated ratios does not. As of now in MA the only specialty that has mandated ratios is the ICU. And from the hospitals I have worked in... it works.
  8. NursesTakeDC

    Federal Nurse Staffing Bill Comparison

    I don't know how much more clear it can be made with the post that the bill for mandated ratios actually includes acuity. Read the part about acuity. SMH... Anyone who works in facilities that actually follow their staffing committees recommendations should feel very lucky and understand thats not the case for many nurses across the US.
  9. NursesTakeDC

    NursesTakeDC

    NursesTakeDC, is a grassroots movement, in the spirit of NursesUnite, led by thousands of bedside nurses from all around the United States. These nurses call for all nurses, all nursing organizations and the public to come together to advocate for safe nurse to patient ratios. This grassroots movement is dedicated to saving the lives of our patients and the nursing profession. In 2018 nurses from around the United States will gather in Washington DC again to raise public awareness regarding safe nurse-patient ratios; meet with legislators to discuss nurse staffing; and to support the pending legislation. More information at nursestakedc
  10. NursesTakeDC

    Federal Nurse Staffing Bill Comparison

    The legislators may raise the question of another nurse staffing bill nurses are lobbying. It is very confusing for legislators to navigate WHY these bills are different. You can assist them! Our RN Ratio bills S. 1063/HR 2392 has the mandatory minimum nurse staffing ratios. The American Nurses Association bills S. 2446/HR 5052 share the importance that patient outcomes are directly affected by numbers of RN staff, but that is where the similarities seem to end. Bottom line difference is in the ANA bill, no regulatory mandate that the employer to commit to a staffing plan in writing to begin any shift. Look at the Side by Side and you can always read each bill fully to get the flavor of the missing employer commitment to staff even though they agree fully with the research as we do: adequate numbers of nurses and support staff provides the patient with better outcomes. Visit nursestakedc for information on the movement #NursesTakeC ~Pam Robbins MSN, RN
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