Wade21

You might want to reconsider about stepping down to something like Med/Surg. considering your physical condition. It's true that the level of acuity is lower than ICU, but you'll be loaded down to up of 8 pts, and a number of them will require turning/repositioning with the good chance that you won't have techs.

When we did bedside reports, it was part of a plan for the hospital as they worked towards Magnet status. I think its ridiculous, too

If you have a supervisor you can be straightforward with and honest, then there's no problem with this procedure. But the potential is there that if you apply and you don't get the transfer, then your supervisor, and asst. supervisor, know your not happy with your unit. How will this affect you at evaluation time? To the one response who thinks we may work in the same hospital;what do you think is their reasoning for having the transfer approved by your present supervisor first? Is it possible that the hospital does not want transfers? I had even asked the asst. administrator about this and he stated that he was not aware of this procedure, but he would check it out and get back with me. That was 4 weeks ago and have not heard anything as of yet!

I considered transferring from my unit to another unit. In the past, you would submit a transfer request, then the supervisor of the unit you applied would interview you and , if the supervisor wanted you, would then submit that request to your supervisor for their approval. The purpose of that would be so your present supervisor could determine when they could get you replaced so you could make the transfer. NOW, I found out, that if you submit a transfer request, your present supervisor has to make the approval before the request is even submitted to the unit you are requesting! Is that right? I see problems with this. Why would this policy be changed as such?

I work on PCU and it was what would be considered a stepdown from ICU, but, it has since mored to another floor which holds more beds. Since this move, I find myself being assigned more pt.s who are more suited for MED/SURG. Is this the way hospitals are going? Did the hospital make this move to charge the pt.s more for being on PCU, rather than being on MED/SURG? I've noticed that since PCU's more to this floor, that the MED/SURG unit has less pt.s!

I work in a nonunion hospital where a union has been trying to get voted in. I personally do not want to be part of a union, but I can understand the appeal to the other nurses at this facility. This union, if voted in, promises several things, including the implementation of a nurse/pt. ratio based on levels of acuity classification(which is a great idea). If hospitals want to keep out the unions, then they need to address the problems in nursing care in their facilities that are presented to them by the nursing staff, rather than hiring consulting groups that recommend implementing a "Rounding w/ a Purpose" program where nurses will make q hr rounds(which my hospital plans to do). By the way, this hospital is in Texas and it is HCA.

I think, w/ our charting, placing our telemonitoring strips in the charts, charting, giving medications and dealing w/ pt.s that require high levels of nursing care, that this q hr rounding is going to be difficult to do, if not near impossible. I can understand the hospital not wanting to go to a nurse/patient ratio based on levels of acuity classification because that would mean spending more money, but I think this would provide better care for the pt.s! Plus, the labor union has wanted to get in to our hospital and has placed a nurse/patient ratio, among other things, on the table as a selling point in why we would want a union. You would think that the hospital would consider implementing this level of acuity classification if they wanted to keep out the union, rather than this q hr rounding!

The hospital where I work will start a "Rounding with Purpose" program later this month. We are assured that this will improve pt. care, less call lights, and better pt. satisfaction, plus, give the nurses more time to do our paperwork. Is this the Studer Group? Does the hospital think this will really work?

When we attended the orientation for this new "Rounding with Purpose," we were told that if we came to a room, during an hourly round, and the pt. was out for a procedure, we are to place a "sorry we missed you" card in their room. After the orientation finished, we had to sign a committment paper stating we would follow this program. Why is that? Is this the Studer Group? What is the main purpose in a hospital doing this? Do they really think this program will work?

I have been informed by the hospital I work that we will be going to this "Rounding with Purpose" program and it will start Set. 29th. The hospital assures me that this program will result in better pt. care, less call lights going off, and, overall, better pt. satisfaction with the nurses having more time to do their paperwork. The hospital also states they have research that shows it really does work. Even though this looks good on paper, and looks like a good concept, I have my doubts about this as nurse who works the floor and lives in the real world. Could I hear from those who work in a hospital which recently went to this program and relate your experiences working with it? I still think the best approach would be a nurse/patient ratio based on a level of acuity classification system(which I know my hospital would not do).

I understand what you are saying, but I think that customer service is a good thing, IF you have the time! Our unit plans to have the nurses make hourly rounds to each of our pt.'s rooms and sign a board in each room that we were there. This is to insure that each pt.'s needs are met, including the customer service. This sounds good in theory, but our unit is a busy one( blood transfusions, cardiac drips, bladder irrigation...) and there will be plenty of times that this practice will be impossible!

I have worked with polite and disruptive doctors. If I need to call a doctor in the middle of the night because of a change in a pt.'s condition, the last thing I'm going to be concerned about is if the doctor is going to "chew" me out for bothering him! To me, that's the worst thing that could happen! I look at the bright side and think "at least I have not, as of yet, worked with a Dr. House!

That's a thought! Though, I doubt the CEO is going to get the pt. a sugar free soft drink.

At my hospital, the nurses, and techs carry cordless phones so that the front desk can contact you or the tech if I pt. calls them for a need. The hospital made a policy of placing a billboard in pt.'s rooms listing the their nurse's and tech's phone #s with the nurse's # at the top of the list. Guess who gets called directly first for every little thing.

All these past messages are thought provoking and accurate! With pt.s that require care to recieving admissions from the ER,OR, and direct admissions which is a process that is time consuming. Add to that, recieving admissions at the start of the shift which compunds the situation when your at your busiest! We had an admission nurse who did nothing but admissions for all the units which was money well spent, but the hospital cut that out due to fiscal responsibility. Include into this when providing for your pt.s becomes hampered when you have a tech. shortage and your also providing total pt!

Grammyphyl states it exactly! Her message covers it all for this forum!

I understand this situation well! Once I had a patient who had a paid sitter in the room and their job seemed to be calling a nurse in to care for the patient every 5 minutes while they watched tv! The best thing to do is to cool down so that you won't say anything "hateful" to the family and have your charge nurse, nurse manager, or even the unit supervisor speak with them in regards to the difference between a nurse and an indentured servant. If they are of no help(which may have been in your case), then grin and bear it until the end of the shift, then inform the nurse manager that you do not wish to be assigned this pt. again due to an inabilty to meet the expectations of the family; you do have that right! In a case like this, its the family who need more care than the pt.

That is unfortunate!

I work on a PCU and our ratio is 1:5. On the MED/SURG unit its 1:6. What makes all this in "numbers" secondary element is LEVELS OF ACUITY! Numbers matter not if you have 5-6 pt.'s that are total care and your spread thin. My hospital, like a lot of hospitals, look at numbers. "Well, you only have 4 pt.s so we can give you another admission" even though the 4 pt.s you have require high levels of care. What needs to be done is not ratio, but pt. load based on a classification of levels of acuity in the determination of how many pt.s a nurse will be assigned. (Levels 1-4, as an example). I am in agreement with the last post about preventing a tragedy but you can have 6 pt.s who require light to moderate care and your able to provide them with a proper level of nursing care and then be loaded with 6 pt.s who require higher levels of care and be spread "too thin" with the result of pt.s recieving inadequate care ; the pt.s suffer and so do you(with your license).

Something else to note along these lines, I have seen nurses who have the skills and knowledge of good nursing, BUT, lack the compassion and empathy needed. In fact, I have seen them be down right rude to patients, in spite of their great nursing care! They, obviously, wanted to be somewhere other than at work.

I agree with an earlier reply, being that what matters is what kind of nurse they become. It is true that some that start out in nursing only for the paycheck turn out be become great nurses because they find that they enjoy it. Thru experience, though, I have found those that go into nursing only for a paycheck and job securiy, and continue to keep that thought, quickly leave the field, or quit while in training!

Not all facilities are like that. It is best to protect your license. Believe me, you will find another job with a better working environment. I had a simililar situation years ago where I was let go so that the DON could get her daughter, a nurse with a drug record, a job there. I have since gone on to better things.

I was turned into the nursing board for something about a year and a half ago. I first responded to this in the beginning with a complete explanation of the situation, and my innocence, in a letter to them. Since that time, to the present, I have recieved a letter from the board about every 3-4 months stating that they would eventually get to the investigation( I am paraphrasing). Is this normal procedure for the board or is this an indicator of something else that I am not aware of? This is a first time for me dealing with the Nursing Board. Thanks!

If any of you want to know how a Universal health care system would work in the USA. all you need do is look at the socialized health care systems that now exist and how they operate. I speak of the VA health care system and Medicaid. Keep in mind that these systems provide for only a SMALL percentage of the US population. I need say no more.

I know how you feel. I work Med/Surg 3 12 hour shifts a week and I do look forward to my days off. This is not to imply that I do not enjoy my work, but it is demanding. Our hospital, like other hospitals, has the official policy that the number of pt.s a nurse is assigned is based on acuity, but the real practice is maximum number of 6 to a nurse, no matter the acuity. With that practice in place, some days are demanding, some days are near impossible. The irony of it, if the census is below a certain number, then the hospital calls some nurses not to come to work that day in response to ratio(so much for the policy of acuity).