Our directors are very fond of saying "evidenced based practice" when telling us what to do..like hourly rounding, bedside report, safety huddles, etc. etc. I usually have no problem with any of this. I'm a "go with the flow" type of person.
Next up is a mandatory report sheet we have to use to give bedside report, in the SBAR format. Again, I'll go with the flow and I helped create one for our floor and sent it for approval (but they lost it and it's not saved..doh). A director was talking to our unit about it, siting "we're modeling ourselves after the airline industry that greatly improved safety over the years. Hospitals have the worst safety record of all industries. Evidences shows lack of communication is one of the things that cause mistakes and evidence shows this SBAR report will help with that."
Me: "I have one word to say: ratios. Evidence based practice over and over shows this improves safety and outcomes".
They want it all...safety, great customer service scores, high profit, but don't address the one elephant in the room.
'The call lights really should never go off if you're doing your job properly'. That's insane. What are we supposed to be, mind readers? (And before someone says it, yes, if we do our job well, the *number* of call lights should be reduced, but to say they should never go off is ... crazy).
'The call lights really should never go off if you're doing your job properly'. That's insane. What are we supposed to be, mind readers? (And before someone says it, yes, if we do our job well, the *number* of call lights should be reduced, but to say they should never go off is ... crazy).
All RN's should organize and form a strong union to address concerns. If you keep doing what ya been doing you're gonna get what ya been gettin'. In my state one of the few unionized hospitals had concerns about staffing, management told them to get over it. They stuck to their guns and started to shut the hospital down. You guessed it, staffing improved. Where I work now management complaining about quarterly losses, you guessed it lay-offs and hiring freezes. What will that do to ratios? RN's are for some reason averse to standing together in a union.
'The call lights really should never go off if you're doing your job properly'. That's insane. What are we supposed to be, mind readers? (And before someone says it, yes, if we do our job well, the *number* of call lights should be reduced, but to say they should never go off is ... crazy).
Yeah, there is something to be said for "anticipating patient needs," but COME ON.
It's really all about priorities. My employer just finished re doing the hospital lobby and announced construction is about to begin on a new parking garage for the doctors. Meanwhile my department has 7 unfilled nursing positions.
It's really all about priorities. My employer just finished re doing the hospital lobby and announced construction is about to begin on a new parking garage for the doctors. Meanwhile my department has 7 unfilled nursing positions.
All RN's should organize and form a strong union to address concerns. If you keep doing what ya been doing you're gonna get what ya been gettin'. In my state one of the few unionized hospitals had concerns about staffing, management told them to get over it. They stuck to their guns and started to shut the hospital down. You guessed it, staffing improved. Where I work now management complaining about quarterly losses, you guessed it lay-offs and hiring freezes. What will that do to ratios? RN's are for some reason averse to standing together in a union.
There was a very sad attempt at a union here years ago. Meanwhile we watched a union form at a nearby local hospital and they seem rather impotent, and even barely survived a vote by the nurses to get rid of the union. There doesn't seem to be any incentive for that movement to spread. Maybe the next generation of nurses, the millennials, who are now entering nursing in droves around here, can change things. But right now they seem to be just quitting and searching for better things.
I just did some rudimentary math and came up with a figure of approx. $300,000 (plus or minus a bit) that a facility/hospital may save per year by not adding one staff to any given unit per shift. Say it's a fairly small hospital and they are saving that per unit for a few units.....that adds up.
Needless to say, administrators (especially non-medical administrators) tend to be the bean counters and look at the numbers, not at our daily anxiety levels at feeling poorly under staffed and feeling helpless. I can feel your frustration at them throwing out the "evidence based practice" hard ball when it fits their narrative. I've been in this business for 35 years and it never seems to change. But having said that, please don't discount the need for great communication. She was correct....poor communication can be deadly.
Tweety, BSN, RN
36,267 Posts
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There are times I don't speak up and I could do better.