Published Dec 13, 2003
CCU NRS
1,245 Posts
So maybe what we all need to do is bombard the State Boards of Nursing in each state and and demand direct involvement in the setting of limits for safe practice. The Board governs nursing and therefore they can make Laws, regulations etc. that govern Standards of care regarding safe Nurse to Pt ratios, and more lenient time limits for med passes and less stress on time limits for care such as dressing changes providing nurses more autonomy to plan their day.
To Whom It May Concern:
Dear Sirs or Madame
It has recently been a topic of much discussion and concern to all of the nurses who have signed below that we are not recieving fair representation. We understand that the Boards of Nursing for each state govern nursing and have set many laws, regulations, accepted practices, and the strict scope of practice to which we all willingly conform. It is our concern however that nurse to patient ratios have not been properly addressed. We as nurses throughout the United States feel that facilities are continuing to increase our load to extremes. We feel that as our professional representative we must call on you to protect our interests and see that safe patient care is not only performed but is within our abilities to perform. We all feel that we are called upon to perform many more tasks than can reasonably be performed in the allotted time span. We feel that as nurses we are expected to perform well and admirably under such conditions and accept that we are always going to have a certain amount of stress involved in our chosen profession. That is one of the many reasons that many of us chose nursing because we are able to maintian a cool head and perform ideally in such circumstances. It is one of our greatest attributes and one we all prize. The continued increase has understandably taken some of our glory by the sheer fact of overwhelming us to the point of inability to carry out our duties and mantain our fearless countenance. We are currently under too much strain and even a donkey can bear only so much wieght before his back is broken. We further do completely appreciate timed medications and procedures and fully understand that some things must be performed within understandable time limits. We understand for instance that morning medications are passed due to the timing of interacting with meals as most medications should not be taken on an empty stomach. Just as we understand that some medications must be specifically administered on and empty stomach. In the issue of other things such as dressing changes and other procedures that can be safely performed at any time providing they are definately performed within a timely manner we would like autonomy. We beseech you our Boards of Nursing to take up the mantle in this regard and perform for us you charges the implimentation of these wishes.
Yours Very Truly and with Sincerity
Nurse of the United States
live4today, RN
5,099 Posts
I like your presentation, CCU NRS. We could certainly send your letter with our names attached. In addition to a format with many attached signatures, I would also personally continue sending letters from my own personal experiences as a nurse where patient care is concerned (as I've already initiated doing this past week or so).
It is important for the "VIPS" we write, to not only hear from us as a "group", but also individually. I see no reason why both should not be done. :)
mattsmom81
4,516 Posts
I've written my BON quite a few times to explain to the board members the current situation nurses practice in and the need to hold facilities accountable. They have written me back and explained it is NOT their scope...they govern NURSES for the safety of the public. They really do not care about our conditions. We have to go about this differently to get any action.
The fact that there are reams of laws governing the practice of nursing in comparsion to doctors is something my
nurse attorney shakes her head about. Amazing what lengths have been gone to to control us. She went into law to help nurses
and now her practice is solely defending nurses to the BON. She keeps very busy. :stone
Protect the Public by decreasing care ratios does this not make sense to anyone else. They would have to take a more active interest if they recieved letters like this from every state with every nurse in that states signature, we could make it an epidemic.
Originally posted by mattsmom81 .....................they govern nurses for the safety of the public...........................
.....................they govern nurses for the safety of the public...........................
With them stating the above sentence in their reply to you suggest they are talking out of two sides of their mouth. If they are there at the BON to govern the nurses they license "FOR THE SAFETY OF THE PUBLIC" then they ARE responsible for the type of care the public is receiving in an UNSAFE manner. Geez! Who put those people in office in the first place.
I can see the Government.......yep...Big Sam...taking control over the BONS with changes coming starting with them. I smell an opportunity for our government to get their noses further into a political arena where healthcare is concerned now that the word is out and being heard to some extent (Dr. Dean for example).
No wonder girls are choosing med school over nursing today. They are hearing that nurses have lost our autonomy, and in some states.......never had it to start with. Girls are going towards med school.........guys are going into nursing. Perhaps this is the only way for the shoe to be placed on the other foot so change can occur. Who knows. Just thinking out loud here on this one. :stone
Originally posted by CCU NRS Protect the Public by decreasing care ratios does this not make sense to anyone else. They would have to take a more active interest if they recieved letters like this from every state with every nurse in that states signature, we could make it an epidemic.
Clarification: Their role is to protect the public from NURSES.
Whether you think their take is wrong is irrelevant to them, unfortunately.
My point is if the BON ammended the Scope of Practice to include a nurse to patient ratio this would would fall within their purview. In the interest of protecting the public from poor care related to overworked and stressed nurses which possibbly provide less than optimal care. The following is the link to Oklahoma Model for scope of practice.
http://www.youroklahoma.com/nursing/prac-decmak.pdf
I have copied and pasted 6-8 for your consideration.
6. Do you personally possess current clinical competence to perform this act safely?
a. If you answer 'No,' the act is NOT within your current scope of practice until competence is achieved.
b. If you answer 'Yes,' continue on.
7. Is the performance of the act wihin the accepted "standard of care" which would be provided in similar circumstances by reasonable and prudent nurses who have similar training and experience?
a. If you answer 'No,' the act is NOT within your scope of practice. Performance of the act may place both nurse and patient at risk.
8. Are you prepared to accept the consequences of your action?
a. If you answer 'No,' the act is NOT within your scope of practice.
b. If you answer 'Yes,' then:
i. Perform the act based upon valid order when necessary, and in accordance with appropriately established policies and procedures.
ii. Assume accountability for provisions of safe care.
So if you refuse on arrival to take 7 patients claiming safety for the reason and listing the Scope of practrice as you limiting guidance then you can legally refuse to care for more patients than you deem safe.
I am sure that most states have websites you may want to check yours