Shorting us of our NAs---WHY??

DLS_PMHNP, MSN, RN, NP · Jun 30, 2009

I agree with you 100%. It makes no sense, fiscal or otherwise. They are shooting themselves in the foot, and will lose their seasoned nurses, and burn out the new ones that come in. Patient care will suffer too.

Good luck to you!!

Best,

Diane

DeepFriedRN · Jun 30, 2009

Meh. I hear you. I personally think it's because the folks who make the rules either haven't worked at bedside nursing, or haven't done it in a thousand years. They are supremely out of touch, and since they HAVE to have nurses, they cut the CNA's (who aren't "required", because we nurses "can handle all of that"). Because no matter what administrators say about being "patient focused", its about their bottom line. And before I get the old "well, it's a business" speech, let me assure you that I am aware of that. I'm not talking about the hospital's bottom line, I am talking about the administrator's bottom line-cuz they get a big, fat bonus for "saving" money in their budget, and they are all about the cash the goes in their pocket.. to the point of throwing their own employees under the bus. Heard an administrator tell a nurse the other day that "the client is always right." REALLY? So if he wants to eat that super-sized Big Mac meal an hour before surgery, he's right? If he insists he can get up by himself even though he's fallen already, he's right? OK. Keep cashin' those big ole checks, sweetheart. And remember that we all get old, and hurt or sick, and someday, we're gonna afford you the same care you feel is "adequate" for our patients now. Karma is a *****.

vivacious1healer · Jun 30, 2009

I hear ya! It's a set up for failure for sure. Management clearly has no idea what we deal with in bedside nurseing

We just had to attend this stupid inservice about Service Matters" for the patients. And here we have administration crying about budgets, bad economy, no overtime allowed....but they pay us for 3 hours to attend this?!?!?! Seriously?!?! And it's just a bunch of lip service marketing crap. They expect us to now introduce ourselves like this : " hi, my name is _____ and I have been an nurse for over 7 years, and have worked here at ______ for 3 years." I had to hide my eye rolls and laughter.

Service matters, and now we expect you to take a bigger assignment, and over work the nurse assistants with 15+ patients....gimme a break!

Midwest4me · Jun 30, 2009

Hey Jan. I would imagine the reason behind cutting bodies is specifically to shunt money into those building additions, advertising, and hiring consultants! The costs are probably much more than anticipated so deleting staff is their way of dealing with part of the cost....very sad indeed.

I remember as a charge nurse in the nursing homes years ago if we had CNAs not show up for work, we nurses had to take on 1-2 patients ourselves in addition to our workload of meds, tx, MD rounds, etc....then got complaints if we didn't get off work in time! What a crock!

gdsgrl · Jun 30, 2009

I am not an RN yet, however, I have 2 quarters left to go before I graduate. I am working summers at a hospital as an NA. I have been assigned up to 18 pts a day - this is ridiculous to say the least. I had one NA tell me they were assigned 21 pts one day, a pt needed to go to the bathroom and the NA was with another pt. couldn't get there quick enough, the pt. fell and broke a hip. Did this change anything on the staffing ratio, why of course not! I really don't get it. Being pulled in so many directions with so many pts isn't safe, and it is working that NA like a dog, no breaks, lucky to get a lunch and back breaking work on top of it. Is this the way all hospitals operate? I am begining to question my choice to be a nurse. This is a Cardiac Telemetry floor, NA's do all the vitals, accucchecks, Q 15 vitals, check cath sites, get urine/stool specimens, have to chart everything, do I @ O's, have to take the pts out to their cars when D/C'd, in addition to all the basics. I'm not afraid of hard work, but this is just ridiculous. Of course the RN has to jump in when the NA is busy and can't get away. I apoligize if I posted this in the wrong place, I saw the topic and needed to vent.

CrufflerJJ, BSN, RN, EMT-P · Jun 30, 2009

Sounds like some bright young man with a shiny new MBA came up with this "headcount reduction" plan. I'm sure that if you saw all his bright colored PowerPoint slides & graphs of increased profit it would all make perfect sense.

allnurses Guide · Jun 30, 2009

Meh. I hear you. I personally think it's because the folks who make the rules either haven't worked at bedside nursing, or haven't done it in a thousand years. They are supremely out of touch, and since they HAVE to have nurses, they cut the CNA's (who aren't "required", because we nurses "can handle all of that").

And never mind the the folks makings these decisions to cut back are NOT the folks the patients see nor care about. But these decision makers, no doubt, will cont. to keep their jobs and cont. to receive their bonuses.

A customer-oriented shop cannot expect to keep customers w/ poor service. These hospitals cannot either, if they are marketing themselves like that sort of business.

They also don't grasp that what the service hospitals provide is optimal pt health. We provide good health... NOT sugar-coated feel-good-about-your-poor-choices-bull****.

And it's funny, when it comes to raises or bonuses, much needed repair or replacement of equipment and adequate staffing, they will always say it's not in the budget. If you point out they appear to have the money in the budget to advertise, remodel the cafeteria or paint their a**es gold, you will always be told that is a SEPARATE budget and is not available...

Hmmm... but our cutbacks on the floors can bolster these separate budgets and float stupid unnecessary projects.

How does THAT work????

Crap, now I'm crabby!!!

perfectbluebuildings, BSN, RN · Jun 30, 2009

And it's funny, when it comes to raises or bonuses, much needed repair or replacement of equipment and adequate staffing, they will always say it's not in the budget. If you point out they appear to have the money in the budget to advertise, remodel the cafeteria or paint their a**es gold, you will always be told that is a SEPARATE budget and is not available...
Hmmm... but our cutbacks on the floors can bolster these separate budgets and float stupid unnecessary projects.
How does THAT work????
Crap, now I'm crabby!!!

I hear you... Doesn't make any sense to me either.

pink2blue1 · Jun 30, 2009

They are doing the same thing at our hospital. I work on a busy surgical floor. We have 90 beds. Back a few years ago, we would have 3 CNA's to cover our floor. They would do the vitals for us, do baths help take them to the bathroom, help with I&O's etc. Then about 5 years ago, they took away ALL night shift CNA's. So the night shift has had to do without them. After a bit of complaining, they decided to do a 9a-9p shift with the CNA's and an 11a-11p shift so at least the night shift would have SOME coverage. Then our most recent change.....as of last December, the CNA's now only work 8 hours, so from 7a-3p. Some days we get only ONE CNA to help us. Also the nursing administration speaks of some staffing matrix. But it seems this matrix exists only when they feel its necessary. For instance, last weekend we had 15 patients on our floor, so they decided we didn't need a CNA. But the 3 nurses that were working, had 5 patients each. So we still had our full load. We did have a charge. Our secretary doesn't come in until 9a on the weekends.

Our CNA's also do NOT do vitals for us. They are only to do baths. That's it. They are putting more and more responsibility on the nurses and all fo this is the middle of adding a new computer charting module which is taking us a while to get used to. Everything is now computer charted. Vitals, blood sugars, frequent vitals, I & O. So once the CNA's leave at 3p we are on our own to finish our shift, chart checks, I&O, take people to the bathroom, medicate etc. But there are nurses that are getting overtime. We get yelled at for overtime. We scream back that we need our support staff. No one listens. It's a battle we are losing and the patients are suffering for it.

greeniebean · Jun 30, 2009

At the LTC I work at (CNA) There is One Nurse for 42 residents. I can't imagine how they would have time to do CNA duties while doing all their treatments, etc. We have 3 CNAs on days and second shift, and 1 one nights.We aren't allowed to do vitals even though we are trained how to do them. The DON said the nurses have to do them because they don't trust the CNA's to properly record them. Our nurses are stretched to the limit! I feel so bad for them on those hectic days. I doubt any of them would stay if they cut the CNAs.

Tait, MSN, RN · Jun 30, 2009

Because, as the people with the "license" we are constantly defaulted to, abused and overlooked.

Last night I had a tech who was talking about people "pulling their load". She stated that she wasn't going to do "that persons job too". I told her it was wonderful for her to have that option, because as an RN we don't. If it doesn't get done, or that patient fails, we are the ones that lose our license, job, home, life in the end.

I will formulate a plan some day to protect our lively hood, and give us the option to NOT be the scapegoat for everyone else.

Tait