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Should Hospitals Set Workloads for Nurses?

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Melissa Mills has 20 years experience as a BSN and specializes in Nurse Case Manager, Professor, Freelance Writer.

11 Followers; 123 Articles; 26,333 Profile Views; 286 Posts

Who should decide how many patients each nurse is assigned during a shift?

Some states are taking this power out of the hands of nurses and administrators and creating laws to follow. Discover one nurse's thoughts about Illinois HB 2604. You are reading page 2 of Should Hospitals Set Workloads for Nurses?. If you want to start from the beginning Go to First Page.

Melissa Mills has 20 years experience as a BSN and specializes in Nurse Case Manager, Professor, Freelance Writer.

11 Followers; 123 Articles; 286 Posts; 26,333 Profile Views

16 hours ago, Hematocrit13 said:

I'm with her.

I agree!!! 

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Melissa Mills has 20 years experience as a BSN and specializes in Nurse Case Manager, Professor, Freelance Writer.

11 Followers; 123 Articles; 286 Posts; 26,333 Profile Views

8 hours ago, Tdmoudry said:

It is baffling to me that states can dictate how many perfectly healthy children a daycare provider has in their care at any given time. Yet when we're speaking in terms of medically unstable individuals, requiring frequent assessments and interventions ranging from zero days to 100+ years old we are just gonna wing it and hope these money hungry CEOs do the right thing by our loved ones? 

Very interesting comment. Other industries have so many regulations, yet when it comes to safe staffing - we do leave it up to people who have often never been in the middle of patient care, much less a code or other emergent situation. Thanks for the input on this convo! 

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2 Followers; 2 Articles; 25 Posts; 1,294 Profile Views

Hospitals have demonstrated that they will not put patient safety above their bottom line for decades. Very profitable bottom lines... They have had plenty of time to improve the conditions that contribute to poor patient outcomes.  Hospitals should have an accountability system in place to enforce them to invest into staffing and resources that provide better patient care and safety. As of now, there is no real system in place that would hold them accountable.

This is why we need national safe patient limit legislation. ALL patients in ALL hospitals deserve the opportunity to receive safe patient care.

All of the arguments presented by opposition of the safe limits bill (hospital associations, medical associations, professional nursing associations) is all driven by money and lead with misinformation to confuse the public.

Bedside nurses wrote the legislation for safe patient limits. The legislation provides support to bedside nurses to allow us to use our education and skills as we were taught and as we are held accountable to.

Our nursing leaders have failed bedside nurse and as a result as patients as they continue the status quo. It is not all of those leaders faults, as they need job security as well. Regardless, them continuing the same staffing or worse behaviors continues to drive nurses from the bedside. And more importantly, it continues to place patients at risk.

Over 2 decades of literature shows what we need... better nurse to patient ratios...  Studies have shown that ratio based legislation results in improved outcomes, improved staffing, improved nurse retention, improved occupational injury of nurses, and improved readmissions. California also has less maternal death rates compared to other states. Nurses having the time to actually critically think and properly assess their patients saves lives.

Not one study that analyzes "staffing committee and acuity based" (without limits) shows that that method of staffing is effective or improves patient outcomes.

We have "assessed" this situation for long enough. We have the plan. We have implemented in California, seen that it has resulted in improvements. We have been able to reassess any concerns and strengthen the law. To add penalties to non compliant facilities and to include language to protect all other health care workers. 

It is time to fully implement and we can re-assess when appropriate.

The real reason that safe patient limits legislation is opposed is because of money, period. Money that hospital systems do have to invest. Money that is paid in by patients, insurance companies, and government reimbursements. People pay for a level of care that they should be able to receive... that hospitals have a responsibility to provide. It is fraudulent really that they get away with not providing the proper staffing and resources.

Safe patient limits legislation gives "BEDSIDE NURSES" the support that they need to provide the best care possible.

 

 

 

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15 Posts; 281 Profile Views

And what about Nursing homes where in Virginia where there is NO set patient load and keep bringing them in...Tube feedings , some Ivs, wounds, severe dementia....this is why I dislike my job so much for years.

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As a unit manager I am struggling to obtain adequate staffing and I am literally tired and burned out to hear every day the same thing: " we have 6 aids scheduled for 60 patients". Needless to say I am managing dementia secured unit and not too long ago there were 6 aids and a whole monitor, which they took it away. My unit has 9 private pay residents, and they benefit of poor care due to the greediness of the corporation. The nurses said that previous company that owned them for years staffed 8 aids and 2 whole monitors, and the care was excellent. I have to add that 2 days out of 5 I am working short, because they pull my aid for different appointments, or they are short staffed on other floors. I think the situations now in nursing homes is horrible and whomever decide to put their beloved ones in a nursing home should do a moral introspection prior, because the care is not adequate although I have the best aids that go above and beyond to provide the best care.  The greediness of corporations affect not only the staff financially ( lack of any incentives for working overtime, they use and abuse you), but the safety of the residents. Something needs to be done ASAP. I was wondering what does ANA do  for nurses? Pretty much nothing! The payment nowadays is less than 15 years ago, whole the inflation and cost of living is very high!

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

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On 4/30/2019 at 10:11 PM, Leader25 said:

Until it didnt.The outgoing supv would put it all on the outgoing charge nurse and ask if staffing was ok,regardless of whether it was or was not.When the next incoming charge nurse would protest the poor  staffing,the answer was always .."well, your co-worker/charge nurse  said it was ok ."

This happened over and over again.The lying,supv,management with no accountability.

I meant just changing pt lists, not decreasing staffing. This was pre-ratio Onc so we did have pretty good staffing most of time.

But I see your point about admin changing/decreasing staffing without mandated ratios in place!

Edited by Daisy4RN

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SmilingBluEyes has 20 years experience.

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Hello Fox? This is the henhouse calling. Can you come take care of  us?

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erniefu has 6 years experience as a BSN, RN.

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Hospital administrators always say that acuity based staffing ensures adequate nursing staff. But the reality is that they game the acuity assessment system such that they can hire less nurses. I have never heard of hospital administration reassess acuity once they get the numbers they want, despite increasing patient complexity, increase in documentation needs, or change in patient acuity. Acuity based staffing is a sad joke until legislation forces hospital administration to hire more nurses based on current patient acuity. 

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brownbook has 35 years experience.

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I guess I was management? I was the 11 pm to 7 am House Adminstrative Nurse in a smallish county hospital.

My fellow HANs and the Nurse Adminstrator did know how hard working the floor could be. We made rounds at a minimum twice a shift. In between rounds we help with deterioration in a patients status, sudden influx of admits, emergency post op surgerical patients, etc. 

I, we, felt quite confident and comfortable planning staffing for the next shift.

Honestly blanket statements about management doesn't care is  like name calling or labeling someone, it's impossible to prove or disprove and doesn't help the problem.

 

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OUxPhys has 4 years experience as a BSN, RN and specializes in Cardiology.

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40 minutes ago, brownbook said:

I guess I was management? I was the 11 pm to 7 am House Adminstrative Nurse in a smallish county hospital.

My fellow HANs and the Nurse Adminstrator did know how hard working the floor could be. We made rounds twice a night. In between rounds we help with deterioration in a patients status, sudden influx of admits, emergency post op surgerical patients, etc. 

I, we, felt quite confident and comfortable planning staffing for the next shift.

Honestly blanket statements about management doesn't care is  like name calling or labeling someone, it's impossible to prove or disprove and doesn't help the problem.

 

That’s great that you helped with admissions and other things, however, my old employer and my current employer the nursing supervisors do no such thing. It is nice that my assistant and nurse managers both help when the floor gets hectic which is a blessing.

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

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3 hours ago, brownbook said:

I guess I was management? I was the 11 pm to 7 am House Adminstrative Nurse in a smallish county hospital.

My fellow HANs and the Nurse Adminstrator did know how hard working the floor could be. We made rounds twice a night. In between rounds we help with deterioration in a patients status, sudden influx of admits, emergency post op surgerical patients, etc. 

I, we, felt quite confident and comfortable planning staffing for the next shift.

Honestly blanket statements about management doesn't care is  like name calling or labeling someone, it's impossible to prove or disprove and doesn't help the problem.

 

Sounds like you were the exception to the rule!! I have never seen a nurse manager or house supervisor pitch in and help. If more did there would probably not be so many negative perceptions about them. But you are correct, we should not judge all based on the bad ones.

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A national survey was completed in October 2018. This article presents the data that was collected from the State of Illinois. The purpose of this article is to show the experiences that bedside nurses are having in Illinois in their hospital staffing practices, as their state has legislation that has been enacted since 2008 called the Nurse Staffing by Patient Acuity Act.

 

 

#NursesTakeDC #NursesUnite

 

https://allnurses.com/illinois-nurse-staffing-survey-t699288/

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