sfn2008

I am a retired Travel Nurse (2008) and in my travels I came across a schedule for 12 hour shift nurses. It was brillient. Every nurse knew months in advance what days she/he was to work. Nurses were possitioned in one of four shift slots. Team 1 day shift and team 2 day shift.Team 1 night shift and team 2 night shift There was a 14 day repeatable schedule for each team. Each schedule started on a Monday. first week two days ON two days OFF three days ON second week two days OFF two days ON three days OFF Never work more than three days in a row. Always have two days off between your shifts. Know months in advance what days you are scheduled. If you are absent for sickness or other reasons a Per Diem staff steps in. Also end of year Holidays would need to be considered so one year you get two of the three holidays off, and the next year you get only one of the holidays off. Question: how many hospitals are using this schedule method? What are the pitfalls of this type of scheduling?

The big IF. But it doesn't look like that is going to happen any time soon. California is definatly more progressive ... but even that is not going to be good enough in the long run. Too many people are focused on hourly wages and not patient care load or quality of care. We can't turn out enough new nurses to fill the need and nursing employers are burning them out faster than even the new rurses can be replaced. The Original Poster got fired because she would not accept an assignment that she KNEW was unsafe. So nurses are taught in school how to TRY and keep patients safe and keep their licenses, but in reality we seem to be trained in vain. If we don't dance to the tune that our employer can financially afford to play, then we are unemployed. Anyone want to take a stab at predicting the future when we get socialized medicine in the USA? Does UK employ Travel nurses at the extent that they are use in the USA? Just wondering. (OK, sorry I am babbeling and thinking out loud... maybe I'll be kinder to the almighty dollar tomorrow.)

nursing school taught nurses to use the nursing process to assess and treat people with health issues under md orders. we were taught that patient safety is one of the highest priorities. protect patients from falls, medication adverse reactions, protect them from md's that give wrong orders and even protect them from themselves at times. the bon (board of nursing) gave us a license to practice what we were taught in school. our license can be lost if we do not follow what we have been taught. if a patient under our care is harmed, we are at risk of loosing the credentials that allow us to earn a living. employers give money to put nurses education and skills to use. employers are in the business of staying in business. our employers need nurses to stay in business. some employers abuse nurses and ask that they work under conditions that are not safe for the patients that they are responsible in protecting. if there is a conflict between patient safety and staffing ratios, the nurse is placed in a dilemma. should they continue to keep the patient at risk and do the best they can under the circumstances? should they leave the patients in one facility and seek another job in the hopes that another facility will be better? should they leave the education and experience that they have acquired and find employment in another field? should they sit back, collect a paycheck, raise their kids, mind their business, wait for someone else to fix the problem and retire when the time comes? lots of questions. few answers

As much as a Union could or couldn't help, that is not the answer. Nurses need the legislation. California is trying to get something going, and granted it is possobly because California Nurses Association and it's bargining power... BUT we need legislation to protect nurses JOBS. Nurses are taught in school how to protect a patient. Nurses are taught how to protect their license from being removed by the BON. Nursing jobs need to be protected.

Any ideas on how to get such legislation?

You are sooooooooooo Right!

Telephone Installer. One of the first females to pass Pole Climbing School.

What people? Who? The nurses at allnurses? The BON? The community where your hospital is located? WHOM are you expecting to stand up and take notice? Hospitals have a Board of Directors. Do nurses attend the meetings? As an employee of a hospital I have never attended a Board Meeting, but maybe I should have.

During a Code all concern and attention is on reviving the patient. I think it makes a difference if the Code is called in the ED, the ICU or the Floor. In many of the hospitals that I have worked someone from the chaplain's office responded to the code specifically to address the NEEDS of the family. I agree with the abirobs post, too much going on for family to witness. I have sat with family members during a Code with the ability to support them in their time of HOPE for a successful recessitation. Families need someone to pay attention to their feelings during a crisis, and inside a room where a patient is being Coded, it is the patient that has the focus of the team. I agree that family should be taken somewhere where the focus can be on their grief, anxiety and hope.

It has always been my thoughts that we do not have a shortage of nurses. We have a shortage of nurses that are willing to work under the conditions that are being presented. Change the conditions and I wouldn't be surprised if you saw nurses come out of the woodwork to go back into a field that they love. Travel Nurses work under a contract. Union Nurses work under a contract. I have always wondered why nurses can't get themselves an "agent" and draw up a contract and hold the managers to it. If Baseball players and Football players can have an Agent and a Contract on an individual basis, why can't Nurses?

A nurse recruiter recently told me that termination under these cercumstances should be referred to as "ethical differences". In other words you and your employer disputed what was "safe nursing practice". This seems to be a reasonable explination if you are terminated or you quit. In essance, you quit when the facility required you to take an assignment that you assessed as being unsafe.

I disagree. I don't identify with the control issues. I feel we should identify and meet NEEDS. Let me ask, how many times would you have liked to just sit and TALK to your patient because you knew that that is what they NEEDED, but you couldn't because you had to pass meds or fill out paperwork? And when you have been able to squeeze in the time to just hug or comfort a patient, hasn't that felt like validation for why you became a nurse? To me nursing is about patient education, (Granted in a LTC that is not might not be appropriate for ALL the patients, but maybe for SOME), quality of care, critical thinking skills and assessment skills. As a nurse I would want my time to be freed up to do more of where our expertise (sp) lies..

True, there are many that NEED a professional to administer medication and deliver treatments. And there is definatly a need to protect one patient from the medication or treatment of another. I agree to this. My question was "what is the percentage of those that don't NEED the professional" for the med administration or treatment. Over the years I have encountered patients that are more than capiable (sp) of administering their own medication while admitted to an acute care or long term care facility. Good grief, there are patients that are fully able to walk to a PIXIS-type machine and have their medication drawer open for them. My point is that unless we start to find some better ways of doing some of the tasks that have been "traditionally" assigned to nurses, we are not going to have anyone at our own bedside when the time comes.