RNs underpaid at non-profit, administration rolling in the dough

[RNBSN1000]

We have extremely high turnover and much of that is due to the perception that we aren't valued and we are being grossly underpaid for our skills. In a multi-specialty critical care unit such as this, it can take 1-2 years for a new grad to really be competent. Administration is constantly making us do more with less, chipping away at our benefits, no more extended weekend differential,

I understand that talented "administration" must be recruited with competitive salaries. And I also understand this is a business and we are lucky to be doing so well in this economy. However, do to the constant turnover, patient care is compromised. Overall pay raises and increased pay based on additional skills would do wonders in retaining staff RNs and be more in concordance with supply and demand. I also have a huge problem with knowing that professionals have to rely on some public assistance for their families, while working at a "non-profit" with such handsomely paid administration. In the age of social media, when public backlash caused Mylan to quickly release a cheaper generic Epi-Pen within weeks, do you think the public might take notice to these gross income inadequacies within non-profit hospitals and increase RN wages?

[herring_RN, ASN, BSN]

I'm re-posting what I wrote in the "General Nursing, Nursing Activism Healthcare Politics" forum.

I grew up in Oklahoma and moved to California. I attended high school, college, and nursing school in California.

I think the public will be interested that safe, effective, competent nursing care is being compromised at their facility.

When they find out that in the multi-specialty critical care unit it can take 1-2 years for a new grad to really be competent people will understand why it is crucial to retain competent experiences registered nurses.

Unless the pay is competitive nurses will go elsewhere so they can support their families.

I suggest first getting together with your colleagues and documenting the situation focusing on nursing care, including the coordination and communication RNs do. Get on the agenda to present it at a staff meeting.

Go up the chain of command.

If none of that works a letter to a local paper or other way needs to be found to let the public know what is going on.

Here is an example of how some nurses worked to keep safe staffing in their telemetry unit:

Henry Mayo RNs To Protest ‘Team Nursing' With Candlelight Vigil

Here is a link to an article in the newspaper written after nurses were interviewed:

Nurses challenge staffing

Documentation is #1. Get a journal or diary and write a little about every shift, being careful not to identify a particular patient.

On a shift when you are able to provide the care your patients need you can just right, "OK shift."

When given an assignment that places your patients at risk for an adverse event tell a manager or supervisor. Write the date, shift unit, name of supervisor, and what you said. Then write exactly what he or she said.

You could say, "In my professional judgment as a registered nurse todays assignment is unsafe and places my patient at risk because I'm assigned too many patients for the acuity of the patients."

(When we did this the usual answer was, "Do the best you can.")

This diary can be used as evidence if you are sued or reported to the BON.

[herring_RN, ASN, BSN]

Patients are admitted to the hospital because they need nursing care. There is no other reason.

If they don't need 24/7 nursing care they are outpatients.

In Oklahoma hospital regulations are under Title 310. Oklahoma state department of health chapter 667. Hospital standards.

If in your professional judgment an assignment poses a risk that an RN would not be immediately available to a patient your hospital is in violation of Oklahoma law.

As a patient advocate you need to tell someone with the authority to assign sufficient RN to meet the standard.

Write that conversation in your diary.

310:667-15-3.Registered nurse

(a)There shall be an adequate number of registered nurses to meet the following minimum staff requirements: director of the department;

assistants to the director for evening and night services; supervisory and staff personnel for each department or nursing unit to insure the

immediate availability of a registered nurse for bedside care of any patient when needed; and registered nurse on duty at all times and

available on-site for all patients on a twenty-four (24) hour basis.

(b)The staffing pattern shall insure the availability of registered nursing care for all patients on a twenty-four (24) hour basis every day.

©If a licensed practical nurse or nurse aide is assigned care of patients who do not generally need skilled nursing care, there shall be

a registered nurse supervisor who makes frequent rounds and is immediately available to give skilled nursing care when needed.

This registered nurse shall be free to render bedside care and not be occupied in the operating room, delivery room, or emergency room for

long periods of time.

(d)The ratio of registered nurses to patients and the ratio of registered nurses to other nursing personnel shall be adequate to provide proper supervision of patient care and staff performance, based on patient acuity.

(e)A registered nurse shall assign the nursing care of each patient to other nursing personnel in accordance with the patient's

acuity and the nursing staff available.

https://www.ok.gov/health2/documents/MF%20OAC310-667hospitaleff06.25.07.pdf

Here is a citation for unsafe staffing to an Oklahoma hospital:

HospitalInspections.org | Report Detail