"The New Style" of education.

[eriksoln, BSN, RN]

Anyway, on to the real topic:

A comment I made on another thread concerning pt. education got me thinking. Seems to me that a great challenge us nurses face as we try to deliver the care we always envisioned the medical field should is the "Knowledge Deficit" of our, ahem lol, customers (Patients).

Oh please slap me, I just used a nursing diagnosis.

What I am referring to when I mention the knowledge deficit is how we as nurses are often placed in no win situations by the leaders of healthcare (administration, politicians, insurances......lets face it, they are the decision makers) and when we are not able to walk in and save the patients from said leaders poor management, we are made out to be the bad guy.

Administration continues to make cuts to staffing and rarely has all the pieces in place for good care (resources.......ie support staff and supplies) but we work very hard hiding these flaws. When we can't, the patient becomes upset (rightfully so) and complains. The same admin. who are responsible for the poor care then go in, as though they had no clue such things went on in their facility, and turn us into the bad guy.

Politicians desperate to look "involved" in what they are dealing with make new law after new law, but they are frequently off target and their efforts to improve healthcare are polluted by behind the scenes deals (kickbacks). They refuse to address the fact that too much profit from healthcare goes into the pockets of those not even directly responsible for giving care (admin. and insurances) instead of being circulated back into the system to make improvements so facilities can grow and foster. On one hand, they will make laws the are supposed to create the kind of healthcare the general public wants......by making care personalized again and giving the power back to the patient. On the other hand, they continue to allow standards of care to match car mechanics..........insurances are allowed to give a set time for hospital stays based in diagnosis. COPC means X amt. of time will be paid for, regardless of how long it takes............leg fracture means Y will be paid for regardless of what other complications are present. Folks, this is the business model for car mechanics........this does not promote personalized care. This model, more than any survey they send out, shapes how people are treated.

Insurances have been allowed to run wild, do whatever they please and are the biggest crooks of them all. They can withhold payment at a whim, and often do. They jeopardize pt. care by bogging it down with form after form that must be completed to collect payment to the point where.........said care AND proper documentation is simply not possible and of course the patient is the one seeing their time (with caregivers) suffer.

So, since we are supposedly "educators", lets educate. Get the general public on board with what really is killing the healthcare field.

1. Make the charts for staffing used at most hospitals public knowledge. Explain to patients "I'm sorry, but there are not enough staff today to fluff your pillow and fetch tea. See, although we have VERY acute patients, they sent home the CNA because, well, we have 27 instead of 28 patients THEN FOLLOWED SUIT by admitting three more patients to us, but the CNA is gone for the day (even though we should have them here now) and we are busy doing admits and making sure the new diagnosis diabetic gets the insulin training needed. Hope tomorrow works out better for you." Take ourselves out of the middle when administration's poor staffing decisions lead to impersonal care and make them answer for it. Also, when the staffing charts used are public knowledge, just as with PG scores, people will compare when deciding where to go.

2. Eliminate this idea that we are "Just sitting at the desk doing nothing." Often, our documentation and the endless list of forms we fill out are used to collect for pt. care. Just as with the staffing charts, make the amt. of paperwork required for simplistic care common knowledge. Inform patients when we are "filling out the forms so you have oxygen at home" and such. If the general public had any idea how silly some of the paperwork required of us by admin. and insurances, we again would remove ourselves from the middle and allow them to take the fight to where it belongs.

3. Go public with or create a site where the many many new nurses not getting job interviews can list where they have applied. That way, this idea that there is a nursing shortage can go away. Institutions LOVE that avg. Joe thinks hospitals can't get workers and that is why they fall short on pt. care.

4. Educate the general public more on how to complain about a facility and not leave the door open for the nurse to be thrown under the buss. A nursing committee with legal experience can educate a pt. on what to expect, where the shortcomings in care occurred and what truly lead to whatever incident they are unhappy about. Hospitals have a nice system of throwing their nurses under the bus when there is a system failure. Detached admin. and lawmakers rest on their laurels while major system defects go ignored year after year. When something happens, pull out some long ago written policy that may or may not have anything to do with the problem at hand, nail the nurse for it and wash your hands of it. Unless the fight is brought to their door, nothing will change.

The thread I was speaking of was "Time to Call a Duck a Duck". I believe nurses are a labor or a skilled trade, not a profession. A profession would do things like I am suggesting to protect itself. A profession can stand up for itself, avoid being trapped in a no win situation. We continue to play the game by their rules and trap ourselves in a situation where no amt. of effort will create optimal care for our patients or keep us from taking the fall for it.

[ImThatGuy, BSN, RN]

Is there a cliff notes version? lol

[eriksoln, BSN, RN]

Is there a cliff notes version? lol

Genius doesn't come in small packages.

<_>

>_>

And neither do rants.

[netglow, ASN, RN]

[llg, PhD, RN]

I don't always agree with your rants, eriksoln ... but I am pretty much with you on this one. We need to educate the public about what is really happening.

[mspontiac]

Great post! I looked especially close at #1; I am in my last semester of nursing school and instructors drill it into us that we should never suggest that RNs are short on time because of the patient load. We're supposed to make them feel as if they are the only patient. I suppose it's because it may make the pt feel as if they aren't getting optimal care if they know the floor is short-staffed, but I have always wondered...what could come of that? Some hurt feelings? Or would there be more lawsuits if pts thought they didn't get the attention they feel they deserve? I don't have the answers but you have put up great food for thought here.

[CaptKris]

Is this like arguing that the garbage man has to pickup smelly trash. And Sometimes it's really heavy and it's raining. And the johnsons put out 4 cans this week.

[ImThatGuy, BSN, RN]

instructors drill it into us that we should never suggest that RNs are short on time because of the patient load.

They try to drill into us that nurses are the reason people seek medical assistance. lol Yeah, ok.

[eriksoln, BSN, RN]

Is this like arguing that the garbage man has to pickup smelly trash. And Sometimes it's really heavy and it's raining. And the johnsons put out 4 cans this week.

Eh, garbage men don't get surveyed to see if they smiled while they picked up the trash nor do they get asked to go inside and carry the garbage out for people.

Thats was I'd say its like..........the environmental service all of sudden wants to be about "customer service" and he now has to go into the house to get the garbage.........but still is expected to run the same complete routes he did before.

[eriksoln, BSN, RN]

Great post! I looked especially close at #1; I am in my last semester of nursing school and instructors drill it into us that we should never suggest that RNs are short on time because of the patient load. We're supposed to make them feel as if they are the only patient. I suppose it's because it may make the pt feel as if they aren't getting optimal care if they know the floor is short-staffed, but I have always wondered...what could come of that? Some hurt feelings? Or would there be more lawsuits if pts thought they didn't get the attention they feel they deserve? I don't have the answers but you have put up great food for thought here.

This policy to me seems to follow the "its the image of care, not that care that matters" philosophy. I know many managers and, unfortunately fellow nurses, who are better at smiling their way through the BS and at being car salesmen than they are at the actual care.

[eriksoln, BSN, RN]

I don't always agree with your rants, eriksoln ... but I am pretty much with you on this one. We need to educate the public about what is really happening.

Oh, you love my rants. You know you do. You need my rants so rational people like you have something to be compared to.

[lindarn]

In order to be able to educate the public about the mess that their health care is in, nurses must FIRST secure a stable work area, in terms of not having to be afraid to, "blow the whistle".

Nurses, you cannot do that without a powerful UNION, BACKING YOU UP!! Forget the wishful thinking, that, "I can speak for myself". Yea, right. If that is the case, why haven't you done it yet? Because, you are afraid that you are going to be fired, and blacklisted from employment.

I don't care what your feelings about unions are, and yes, nurses should not have to resort to unions, seeing that there are over 2.5 million nurses in this country. BUT, we refuse to stick together, to join together to fight for a common cause. Everyone is too concerned about, ME, not their co workers who have different issues than we do. And no one wants to bother to stick up for each other, because, again, I am only concerned about ME!

This is wrong, and nothing will ever change until nurses will to join together, to speak as one voice, to fight for our profession, and our patients.

Look at what the California Nurse Association has accomplished in a short time. They have staffing ratios, they have pensions they can retire on, they join together as one, to fight for the COMMON GOOD. That is what this country was founded on. The needs of the many outweigh the needs of a few. Look at what happened when there were issues in Northern California hospitals organized by NNU. They were ALL GOING TO GO ON STRIKE AT ONCE. The hospitals backed down, knowing that the NNU meant business.THAT is the kind of power and influence that the NNU has, and what nursing needs.

Is that wrong? Of course not. Hospitals join together to keep nurses under their power. Nurses need that kind of power ASAP.

Nurses, take a long hard look at where you work, what is wrong with it, and how you can change it. Call the NNU, and get a unionizing drive going, and take control over you profession.

JMHO and my NY $0.0.2.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

We need to join the NNU,