"Best Practice" would be to have more nurses.

[Emergent, RN]

We got a memo that we are going to be inconvenienced with a new policy, in the name of "best practice".

Yet, administration, and the regulatory bodies, all seem to turn a blind eye when it comes to safe staffing.

Out of touch hypocrisy, as usual. The ivory tower overseers strike another blow against common sense, turning the workplace into an obstacle course, while ignoring the elephant in the room.

[ThePrincessBride, MSN, RN, NP]

What kills me is that they are so focused on saving pennies (because that is a nurse's salary in comparison to the profit these hospitals are pulling) when they are losing billions per year on events and injuries that could have been prevented with more staffing. Add to the fact that high staff to patient ratios cause high turnover, the hospitals have to spend more money on orienting people.

[kalevra, BSN, RN]

Does your hospital or facility have a DNP that is in charge of policy and procedure?

I ask because most of the senior leadership hold an RN license. Perhaps the RN leadership are not properly informed or not aware of the inconvenience these new "best practice" interventions are causing. I highly recommend communicating you message to senior leadership so as they may help facilitate with work flow. I recommend putting it in writing and in terms that a child will understand, not to insult anyone, but rather to deliver a clear concise message that cannot be distorted.

[joanna73, BSN, RN]

We are forever auditing various aspects of care, or preparing for yet another audit at work. If only they would hire the staff to actually provide care, we could decrease the audits and the endless forms.

What a novel idea.....!

[Karou]

Administration is always having fancy ideas about new policies and adding tasks without putting any thought into the time and amount of staff required to do it.

Not that long ago a poster started a topic about customer/patient satisfaction. It was interesting when they mentioned that about 1/3 of our shift consists of charting. That really got me thinking about time.

Let's say they in a 12 hour shift, I have 4 hours of charting (1/3 of the shift being charting). That leaves me with 8 hours. Minus a 30 minute lunch. Minus 30 minute report/hand off. 7 hours of nursing care for how many patients (5,6?). That leaves me with a TOTAL MAX of 84-70 minutes per patient per shift.

Not to mention calling physicians, rapid responses/codes, transfers to ICU, new admissions, total care patients, bathroom breaks for myself, and everything else.

We aren't actually superheroes. We can only be in one location at one time. So how can we do it all? The only solution I can think of is adequate staffing to increase the amount of time that a nurse has available to spend with each patient. But that costs money...

Then as theprincessbride mentioned, the hospital loses money on core measure fall outs/HAI's, patient satisfaction scores, because of inadequate staffing to do all that is expected of us.

It depresses me. We're asked to do more, but not provided the resources and staff to accomplish it. It's a guaranteed failure. Basic math shows how much time we have for each patient, and it's not enough...

[LadyFree28, BSN, LPN, RN]

Don't forget-educated nurses...

A lot of errors would not occur if nurses also had the tools to be knowledgeable about their practice; I just had this conversation from pool nurses that are "regulars" on the unit, and we equally complain that our management NEVER gives enough education hours; there a newer nurses and no education, sometimes setting up for near misses and errors.

[Penelope_Pitstop, BSN, RN]

What kills me is that they are so focused on saving pennies (because that is a nurse's salary in comparison to the profit these hospitals are pulling) when they are losing billions per year on events and injuries that could have been prevented with more staffing. .

Six years ago or so, my floor had the most falls of any department in the healthcare system during the month of January or whatever month it was.

Everyone was interviewed by management to determine the cause of all of the falls.

I said, "oh, staffing! we need more techs and nurses. That's why we can't get to the patients in time."

I was told, "no, it can't be that, can you think of anything else?"

K...

[mrsjonesRN]

Less staff equals less patient satisfaction as well. Which in turn causes low reimbursement per Medicare's new standards.

At our facility, a person is paid to "teach" nurses how to "round" on patients. We are tested monthly on the "key words and phrases" which are on the press Ganey surveys.

It's s 15 minute spill and the fakest bull hockey I've ever had to say in my life.

One sentence we are required to say is,"Have you had to use your call light today?" Then the nurse is supposed to ask why, because we are supposed to keep the patient from hitting their call light because all needs should be met during "hourly rounding."

If they'd get rid of this person teaching me how to read scripts, the money left over could pay for us to have another nurse on our unit to actually meet those "best practice" standards set forth by management.

For one, I didn't go to college to become an actor. And two, patients in my neck of the woods usually don't know what the heck the word rounding means!!!

[Nurse SMS, MSN, RN]

Not to mention patients and families aren't stupid. If we are all saying the exact same phrase shift after shift after shift patients will feel less cared for and less individual.

As pointed out above, the basic math shows the impossibility of the expectations at the bedside.

[guest64485]

During a meeting where staffing was brought up we were told by the manager that we had too much overtime to allow funds to hire more staff......

......

...

[joanna73, BSN, RN]

Six years ago or so, my floor had the most falls of any department in the healthcare system during the month of January or whatever month it was

Everyone was interviewed by management to determine the cause of all of the falls.

I said, "oh, staffing! we need more techs and nurses. That's why we can't get to the patients in time."

I was told, "no, it can't be that, can you think of anything else?"

K...

We realized that a large percentage of our falls occur at shift change, and pointed out that perhaps extending someone to work the floor or have a float during report would be helpful.

"Yes but are there other factors?" No, not really. We need adequate staffing.

[mrsjonesRN]

During a meeting where staffing was brought up we were told by the manager that we had too much overtime to allow funds to hire more staff......

......

...

....and you probably have so much overtime because there aren't any extra nurses....