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Content by NursesTakeDC

  1. Nurses comment every day on social media about staffing issues. I just wish they’d take it one step further. Words matter—but action is your true power. Action—as in organizing to educate yourselves. Action— as in showing up to a 2-day event, NursesTakeDC, a Conference with CEs and a Rally/Lobby Day on April 21-22, 2020. Action— as in then meeting with your legislators to convince them why they must pass federal legislation to support nurses staffing ratios—and acuity. Because the complaining on social media just becomes background noise. And I want you to —ROAR. Then you will be heard. Professor Linda Aiken's Study on Nurse Staffing Another way to take action is happening right now in Illinois and New York—nurses pay attention! Could you tell all your Illinois and New York APRN, RN and LPN colleagues to complete Professor Linda Aiken's study survey on the quality of nurse staffing in Illinois and New York? Did YOU complete it? Only 8,361/180+k nurses in IL and 14,226/334+k in NY responded to the email survey as of December 20th. Less than a 5% response rate. I’m quite shocked. And angry. And this is why. Why Should You Respond to a Survey? In Illinois, we’ve had the Nurse Staffing by Acuity Act since 2008 - A law that states hospitals must purchase an acuity tool and form staffing committees comprised of bedside nurses and management. A law without any penalty to somehow enforce hospitals to comply. As a result, few hospitals do in fact comply. In fact, the ANA-IL collected data from nurses to show just how unsafe staffing is in Illinois. And NursesTakeDC completed a survey concurrently with ANA-IL which duplicated similar results for Illinois. How Can Nurses Fight for Safe Staffing Laws? So what is the answer to move us forward? How can nurses fight for safe staffing laws? I believe it’s by mandating safe staffing ratios that include patient acuity and penalties if hospitals do not act in good faith. The ANA and the AHA state its laws are like Illinois’s. Illinois nurses say—No way! We are attempting to pass the Illinois Bill HB2604 Safe Patient Limits Act, similar to California nurse to patient ratio legislation from 2004. Illinois and New York nurses must tell their state legislators their unsafe staffing stories—like I did with the NPR affiliate interview with Philadelphia's WHYY and Chicago's WBEZ. However, how can nurses impact on safe nurse staffing if nurses in Illinois and New York choose NOT to be a part of Professor Aiken’s survey study? An evidenced-based nursing study— which we, as nurses, have a responsibility to participate in. We are expected to advocate, impact and improve patient safety, as well as our own profession of nursing— on healthcare policy in Illinois and New York. These 2 states have pending legislation, HB2604/S.1908 in Illinois and A2954/S1032 in New York. Illinois and New York Nurses Should Complete the Survey All Illinois and New York nurses should complete the email survey, not just hospital-based nurses. Even currently inactive and retired nurses who are holding an active license to practice. Please remember—it as an independent, objective research project— to inform the policy debate about patient to nurse ratios in Illinois and New York. Additionally, a large part of the study is to link your responses with actual patient outcomes. Please complete the study survey, your voice does count. Search Your Email The email survey is from the National Council on State Boards of Nursing and the respective state’s Board of Nursing—IDFPR in Illinois and NYSEOP in New York. Make sure you search your email— all folders including, the junk folder for NCSBN. It was sent to the email you used when you renewed your license. Please do this and be a part of history—evidenced-based research on the quality of nurse staffing in Illinois and New York. You Can Affect the Future of Nurse Staffing Finally, your participation may have implications for the future of nurse staffing in all states. Imagine that. You will be a part of evidenced-based research on healthcare policy and nurse staffing. Here’s your chance now. So—what’s stopping you? And get yourselves to NursesTakeDC. Now. Your inaction is deafening. It silences your voice. Make it heard. Doris Carroll BSN, RN-BC, CCRC Illinois Nurse https://www.congress.gov/bill/116th-congress/house-bill/2581/text https://www.congress.gov/bill/116th-congress/senate-bill/1357/text https://www.congress.gov/bill/116th-congress/senate-bill/1357/all-inf allnurses.com Illinois Nurse Staffing Survey https://www.yumpu.com/en/document/fullscreen/62266590/the-nursing-voice-december-2018/ Bill Status Illinois State House Bill HB2604 NPR - Why Mandated Nurse-to-Patient Ratios Have Become One of the Most Controversial Ideas in Health Care Illinois Nurses Push for Safe Patient Limits, Working Conditions New York State Senate Bill S1032
  2. NursesTakeDC

    How many more decades?!?

    How many more decades must we continue this fight for safe nurse to patient ratio staffing?!?! Remember the “mandated ratio” legislation INCLUDES patient acuity and nurse skill mix adjustment. #SafePatientLimits indeed saves lives. “Nightingale rigorously researched the impact of the introduction of trained nurses on mortality in military hospitals. Once having established an association between trained nurses and reductions in patient deaths, she spent much of her life advocating for these findings to be widely translated into practice to improve the quality and safety of hospital care. The International Year of the Nurse and Midwife in 2020 in recognition of the 200th anniversary of Florence Nightingale’s birth is a fitting time to take action based on the preponderance of evidence to date that good professional nurse staffing results in safer and higher quality hospital inpatient care. “ “All three papers confirm—at least with respect to mortality—that low RN staffing increases the risk for poor outcomes for patients. What is especially important about the confirmation provided by the Needleman et al 4 11 and Griffiths et al 13 papers is that they show longitudinal associations between RN staffing and patient outcomes at the patient level, within hospitals, which suggests that the cross-sectional associations found in studies that use hospital-level RN staffing data and compare outcomes across hospitals, such as the RN4CAST study, are more likely to be causal than artefactual and reflect differences in patient exposures to different staffing levels as well. We provide additional evidence of this in our own recent work” “The findings of the RN4CAST paper on the outcomes of nursing skill mix are closer to those of Griffiths et al than to Needleman et al, showing, for example, that substituting one nursing assistant for an RN for every 25 patients is associated with a 21% increase in the odds of dying”. Credit to authors: Linda H Aiken and Douglas M Sloane Nurses Matter: More Evidence #NursesTakeDC www.nursestakedc.com
  3. NursesTakeDC

    Witchcraft resurgence

    There seems to be a lot that you don’t know. Please lose the judgement before you get educated for any healthcare position you get.
  4. NursesTakeDC

    Over 70% of Nurse Staff Turnover is Due to Bad Leadership

    I would like to see actual researched data to confirm that claim. Not just a leadership class work book.
  5. NursesTakeDC

    Male Nurse Disgusted by Female Nurses

    He is correct. Even if you are lucky enough to work some place that has good staffing, there is no reason you should not be advocating for it in all hospitals. Seeing the apathy of our profession on this for the past 4 years has been discouraging a lot of times. But I keep advocating for the patients. ALL patients in ALL hospitals in ALL states deserve the opportunity to receive safe patient care. www.nursestakedc.com
  6. NursesTakeDC

    Safe Staffing Survey Results

    See results from the survey we did this past October 2018. Thank you to allnurses for your support, and for assisting us to reach the nurses who responded to the survey. Link to the complete article is below. "Results from an October 2018 national survey of over 9,000 registered nurses in hospitals across the United States provides important new evidence to inform this debate. Survey responses indicate that workplace outcomes for nurses and patient care are better in California, the only state that has enacted safe patient limits for nurses, than in Illinois and other states. 47 percent of nurses in California report that staffing levels are based on the needs of patients in their units compared to just 32 percent in Illinois; 66 percent of nurses in California care for between one and four patients at a time during a shift compared to just 35 percent in Illinois; The average nurse in California has 4.3 patients at one time while the average nurse in Illinois has 5.2 patients at one time; 40 percent of nurses in California report that the patient-to-nurse ratio in their units is safe compared to just 18 percent in Illinois; and 55 percent of nurses in California fear retaliation for providing input about staffing in their units compared to 61 percent in Illinois. As the only state with safe patient limits, California’s staffing standards and workplace safety have fostered an environment where more nurses feel that staffing is based on the needs of patients and more nurses feel that the patient-to-nurse ratio is safe. By reducing patient-to-nurse ratios, enacting a safe patient limits law in Illinois could improve occupational safety, increase nurse retention rates, and promote better health outcomes for patients and have little to no negative impact on the financial performance of Illinois’ hospitals. " https://illinoisepi.files.wordpress.com/2019/08/pmcr-ilepi-do-nurse-staffing-standards-work.pdf
  7. Your goal... contact your legislators once a month for one of two things. Develop a relationship with them. 1. If they are already sponsor/co-sponsors: Thank them for supporting S 1357 and HR 2581. We want to keep them reminded at the importance of the legislation and show appreciation for their support. 2. If your congressman is not yet a supporter, they need to hear from you(their constituent) the importance of co-sponsoring the legislation. Personal stories are best. An action site that can easily assist you to your legislators is at https://www-nursestakedc-com.filesusr.com/html/6004d0_2ed35ee2fb8ab9833cd60448c91cb3af.html#/ You can email, tweet, FB post and call. Just type in your address. Remember that there is no need to fear repercussions as your boss will never know that your contacting them.
  8. NursesTakeDC

    ICU Nurse Fired For Refusing 3rd Patient

    Honestly, it is not our position to question her decision making on that day. If she felt it was unsafe then it was. She is not a new nurse who lacks critical thinking. Us accepting these occurrences is what is allowing admins to make 1:3 in ICU a normal behavior. Often those patients are really still fragile but downgraded to make room for an impending admit. Patients being charged for ICU level of care, and interventions like continuous monitoring that are not getting that level of care is fraud... period. The best nurse ever can only do so much. We need to stop criticizing each other and hold hospitals accountable to their responsibility of staffing properly. This is why we need #SafePatientLimits www.nursestakedc.com
  9. NursesTakeDC

    Know who supports what.

    Please help us continue to grow and get nurses and patients educated on the importance of patient and nurse advocacy. www.nursestakedc and https://www.facebook.com/nursestakedc/ Anyone can follow and support this cause, as unsafe staffing is a public health issue... it is not just a nursing issue. Every person will one day be a patient and have loved ones as patients. Everyone has the likelihood of being negatively impacted by unsafe staffing. Support #SafePatientLimits Support S 1357 & HR 2581 #NursesUnite #PatientSafety #NursesTakeDC
  10. 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
  11. NursesTakeDC

    Should Hospitals Set Workloads for Nurses?

    No they most certainly should not!!!
  12. 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
  13. 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/
  14. 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/
  15. 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.
  16. 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.

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