Yesterday I worked an agency nurse shift for a hospital I had never been to. This was my first shift for the second agency I just signed up with. I was supposed to be telemetry, but was sent to Med/Surg. I started out with 7 pts, ended up with 8! The charge nurse doesn't even sign off orders there. There was one CNA to 12 pts, you had to write your own new medication orders on the MARs, and the place was a zoo!
I worked with a really nice CNA who said it's always like this, and that the agency nurse from yesterday, who had gone to hospitals all over the state, said this was the worst hospital she's ever been to. It's a for profit hospital, I was told. I told the agency that I'd never go there again. All the nurses there said that all agency nurses said the same thing.
One thing I noticed is that there are mostly foreign nurses there. They were from various places, India, Philippines, Africa. I had never seen so many foreign nurses.
Yes, I'm convinced, the importation of foreign nurses is a means to undercut the bargaining power of the American nurse, keep working conditions sub par, and keep profits margins up.
Let me add that I have nothing but respect for foreign nurses, but nevertheless I'm opposed to the importation of them for a nursing 'shortage' that only exists because American nurses won't work in deplorable conditions such as I saw yesterday.
Specializes in Medical and general practice now LTC.
When I worked on a surgical ward, we had 1 :16ratio on nights. I did my meds pass, repositioned patients, did all my obs, had nervous breakdown etc. I think it is probably like this in all NHS hospitals.
I even remember working in the UK on a general ward of 28-30 patients with only 2 RN's and 2 health care assistants and we will did everything and this was on afternoons and morning there would be 3 RN's but generally the 3rd was the sister/charge nurse and they didn't take any patients
Most of the floors at our hospital do team nursing. Our floor fought for a change and in April of this year we started doing Total Care with a 5:1 ratio, all RN's. Plus a charge nurse and we were to have 3 PCT's for 30 patients. One of the questions we kept asking was would they stay with the 5:1 and 3 PCT's and we were assured that we would. Well, last week there was a mandatory meeting after some chopping block consultant came in to assess where we could cut costs. Now we are going to 6:1 and 2 PCT's. We are a heavy Neuro unit that gets ICU over flow. Most all our patients are total care and critical. It is hard to do 5 patients, much less 6. I predict that within 6 months we will be at 7:1 on lots of days.
But what do I do? I live in a rural area and this is the closest hospital at 35 miles one way. I'm the sole support of my family at this time. I can either do my best or look for something better, which doesn't exist unless I can commute 100 miles one way each day. This is a non profit hospital. The For-profit hospital is under new management for the 3rd time in a year and another one is closing their doors the end of the month for lack of money. Our hospital is laying off nurses at this time.
For a long time, most of us have been nursing against all odds. Our new grads are constantly in tears. Many have quit.
Yesterday I worked an agency nurse shift for a hospital I had never been to. This was my first shift for the second agency I just signed up with. I was supposed to be telemetry, but was sent to Med/Surg. I started out with 7 pts, ended up with 8! The charge nurse doesn't even sign off orders there. There was one CNA to 12 pts, you had to write your own new medication orders on the MARs, and the place was a zoo!
I worked with a really nice CNA who said it's always like this, and that the agency nurse from yesterday, who had gone to hospitals all over the state, said this was the worst hospital she's ever been to. It's a for profit hospital, I was told. I told the agency that I'd never go there again. All the nurses there said that all agency nurses said the same thing.
One thing I noticed is that there are mostly foreign nurses there. They were from various places, India, Philippines, Africa. I had never seen so many foreign nurses.
Yes, I'm convinced, the importation of foreign nurses is a means to undercut the bargaining power of the American nurse, keep working conditions sub par, and keep profits margins up.
Let me add that I have nothing but respect for foreign nurses, but nevertheless I'm opposed to the importation of them for a nursing 'shortage' that only exists because American nurses won't work in deplorable conditions such as I saw yesterday.
I don't think so. I would like to see some numbers that show a correlation with increasing numbers of foreign nurses and worsening working conditions. I would be shocked if anyone could find any.
The problem with your theory that the use of foreign nurses is a means to "undercut the bargaining power of the American nurse" is that nursing is still predominately composed of white American females! This perceived lack of power and poor working conditions has been an ongoing problem since the beginnning of the profession, it's rather convenient to lay it at the feet of foreign nurses don't you think??? It's always been bad since I've been in it, why is it now their fault?
Since nursing is still composed of greater than 90% American nurses, then it is still not too late by any means to turn this thing around if you believe that foreign nurses are to blame for deplorable working conditions. By the way, I've worked in areas that were worse than what you describe and there weren't anyone but good old American-born and bred nurses working there. American nurses won't work in "deplorable" conditions? Please, they do it every single day, then turn and ask for more.
In NY, I don't think nurse/patient ratio of 8:1 is an issue. I did a short term PRN job thru an agency at one of the magnet hosp in NYC and the ratio was 8:1, 2 CNA's for 40 patients. Nurses may start with 6 or 7 patients and end up with 8 by the end of the shift. Most of the nurses -maybe 70% were Americans, the rest were immigrants who have been here for donkey years.
I feel sorry for the nurses that come from other countries, alot of them don't realize that what they are being asked to do here in the US is not right. I've met some nurse who have said that being a nurse in their country is one of the lowest jobs you can have. And the hospitals that bring them here and give them 8, 9 10 patients and pay them less ( because most places have policies about talking about wages) because they can. Until there is a federal law that stops this practice patients will be the ones that pay the most. And in the long run nurses will pay for either with thir license, their health or worst their mental status. Until the public and health care provider stand together and demand a change it will never happen.
It doesn't matter where the nurses come from, providing they are appropriately credentialed. It the willingness to work under less then favorable conditions that is the problem It doesn't matter if that willingness is from lack of knowledge i.e. foreign RN's or those "native" schooled RN's who have a martyr complex. Or who are simple stuck geographically and can't/won't relocate and are geographically stabilized (or captured) and businesses will take advantage of this.
Eventually, with the changes in reimbursement coming from Medicare and private insures following, the institutions that provide poor working conditions will continue to do so and their quality of care will suffer. As this decreases their income the business will either change and treat employees or it will go out of business. Either way it will be an improvement.
An additional thought. If employers don't respect their employees how then can they be trusted to respect their patients? Would you use a facility that you couldn't trust?
Specializes in Med Surg, Nursing Administration for SNF.
of course it's dangerous.
this is precisely why we remain disrespected.
sadly and yes, there will always be those who agree to working in such conditions.
as a result, it keeps working conditions unsafe, pt safety a non-issue, and our wages suppressed.
leslie
Oh how right you are Leslie. I have said this over and over and over, "IT IS WHY I LEFT BEDSIDE NSG!!" I cd not keep going home exhausted and feeling like I must have forgotten a dozen things I was supposed to have done. I cd not keep telling myself that things wd get better. Every day I vowed that I wd get it right today - I wd just get better organized - but only seemed to have time to throw meds at pts, while running from rm to rm, doing this and that, never taking lunch, etc. I quit and many others followed suit. I got into nursing to nurture, not go nuts. The year I left, the news got out that the hospital was "importing" over 500 Philippine nurses - go figure. Trust me, I am NOT prejudiced against foreign nurses either. Who can blame them for taking advantage of what is prob the best opportunity they've ever had. What is the solution then? Less than fortunates will always continue to cross picket lines. This is what I wd like to know.
RosalindRN;3108943]Your assignment didnt sound half bad to me. Atleast you had a cna and a charge nurse. I do the same every night on a tele floor 7 to1 pt ratio, the charge nurse has 6 to 1, a cna is a rare treat, no secretary to answer call bell, and you watch the monitor yourself. Needless to say we have problems when pep brady down and noone is at the desk to hear or see it. Consider yourself blessed.
Had to reply to this one.
Didn't sound half bad??? Consider yourself blessed???? Wow!! They have you right where they want you!!
Here's what bothers me when I read these kind of replies... Bad conditions are bad conditions. Period. So what if your unit is a hair worse. Both are still bad. I would not want to be a pt (or nurse) on either of these unsafe units.
The floor I work on, I feel is unsafe and our ratios are "better." But, I was still stuck at work 3 hrs late last night, almost started crying numerous times d/t complete frustration, and felt so anxious most the day. If I had 1 more pt it would have driven me over the edge.
As far as the importation of foreign nurses contributing to the lack of bargaining power of the American nurse, and keeping working conditions sub par...I do think that is a very small factor. There are much larger contributors, and unfortunately the average American nurse is to blame as well. We can't even come together on the floor I work on and stand up, advocate for ourselves (and pts) and tell management "We will not tolerate this anymore." If we can't do that on 1 unit, how do changes even get rolling... to the rest of the hospital, city, region, country?? Also, the "consumer" is to blame as well. The public needs to be educated and needs to stand up for their health & safety. But the larger contributors (in my opinion) are... greed, management, politics/government, insurance companies, etc, etc.
Consider yourself blessed???? 
Silverdragon102, BSN
1 Article; 39,477 Posts
I even remember working in the UK on a general ward of 28-30 patients with only 2 RN's and 2 health care assistants and we will did everything and this was on afternoons and morning there would be 3 RN's but generally the 3rd was the sister/charge nurse and they didn't take any patients