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.
When you're trying to enact changes at an organization, you have to demonstrate how those changes will look like at Your organization. It doesn't do any good to sing about how organization A, B, and C are doing it.
Nurses are smart people. We know what needs to be done. Why can't the C-suite just get a clue? Why, all the latest magazines are writing about it. Or, a famous medical person said that it should be a certain way. Or, .....etc.
Nobody is going to show up at your hospital and hand out a victory in staffing patterns. You're going to have to show them that they are fiscal idiots if they don't change the staffing patterns.
Yes.....you DO have time for that. We're almost hitting 2020. It's time for nurses to show more strength in advocating for patients by speaking the same language as those who hold the purse strings.
They already know that the profits outweigh the risks.
Your corporate masters would rather make the profit on the longer LOS than provide safe staffing. Pts with complications are just collateral damage.
That's a pretty old link.
Especially when compared to the fact that with the implementation of the ACA, it NOW costs hospitals money when patients develop blood stream infections.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I remember from researching a related topic being very surprised to learn the ANA opposes ratios, to the point a number of state branches voted to sever ties with the national association.
I've tried to understand their reasons for opposing what seems like an obvious way to alleviate the stress of the do more with less mentality of profit-minded employers.
In California the ANA went to war against the implementation of ratios. Then, I discovered this interview with noted nurse workforce expert Dr.Peter Buerhaus I surmised he might be influencing opinions across the board.
Starting in "The Caring Attribute" section he begins to share his annoyance at nurse researchers and predicts ratios will be just a little less catastrophic than the Plague.
I do not see evidence that my colleagues (who study the effects of mandated ratios) in nursing research are taking the time to think deeply about this subject. Instead, in their rush to do studies, they have added to the visibility of the issue and perpetuated a notion that ratios are even worth studying.
The idea of applying ratios is absurd, counterproductive,and backward thinking. I believe some people think there is an optimal ratio,†an idea that has no merit whatsoever.
Ratios are a bankrupt idea, and their widespread implementation could slowly bankrupt the profession. I would not want to be associated with a profession that allowed itself to be dummied down to the point where it self-inflicted onto the profession the very notion it abhors: a nurse is a nurse is a nurse.â€
I work in a small hospital with a union that is not owned by a large corporation. We have good staffing ratios. On Med-Surg we typically have 4 -5 patients, 6 at the most, occasionally as few as 3 (true for days and nights). Our house supervisors tend toward supporting nursing staff rather than cutting staff.
I have asked about this because what I hear about most other hospitals sounds terrible (I have a family member who works in a hospital where even the charge consistently has 7 patients, and their acuity tends to be much higher). One thing I heard is that there was a sentinel event that convinced the hospital that better staffing was important.
I don't know if it is true or not. I think our hospital has the deck stacked in the favor of nurses making positive changes, at least more so than a large, non-union, corporate hospital. It would be nice if the people in charge of the money had a little foresight and didn't have to wait for sentinel events to make beneficial changes that are obvious to everyone.
Getting ratios is a hard fought battle that cannot be done with one single nurse approaching management. Your response to her elephant in the room looks confrontational and blames the victim. She's doing her part by going through the chain of command provided to her and raising awareness elsewhere. Next step would be to unionize and that's another battle but gets results5
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I remember from researching a related topic being very surprised to learn the ANA opposes ratios, to the point a number of state branches voted to sever ties with the national association.
I've tried to understand their reasons for opposing what seems like an obvious way to alleviate the stress of the do more with less mentality of profit-minded employers.
In California the ANA went to war against the implementation of ratios. Then, I discovered this interview with noted nurse workforce expert Dr.Peter Buerhaus I surmised he might be influencing opinions across the board.
Starting in "The Caring Attribute" section he begins to share his annoyance at nurse researchers and predicts ratios will be just a little less catastrophic than the Plague.
Oh, goody more blame the nurses rhetoric!
The only argument I heard against ratios is that they don't account accurately for workload. But you have to start somewhere. The bean counters don't give a rip about workload anyway. Might as well start with ratios. Apparently studies are showing that they do have results in California.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
Getting ratios is a hard fought battle that cannot be done with one single nurse approaching management. Your response to her elephant in the room looks confrontational and blames the victim. She's doing her part by going through the chain of command provided to her and raising awareness elsewhere. Next step would be to unionize and that's another battle but gets results5
Unionization is important but I'm not sure if it will help with staffing. When I worked at the bedside I was very active in the union. One thing I was told by the leaders is that during bargaining, management is NOT required to negotiate staffing, according to federal law. They are mandated to bargain certain things, like salaries and time off, but not staffing. So the union was unable to help with that.
But I do agree that one person speaking up alone doesn't help much (ask me how I know that). It was pulling teeth to get most of my colleagues to stand up and I was constantly the lone thorn in management's side. One thing I made liberal use of was the Unsafe Staffing and Documentation form. That went outside the hospital so they couldn't bury it like an incident report. They hated when I used that, tried to hide them, etc. Other nurses faced tribunal-like consequences and were intimidated when they used them.
No offense here but can we leave politics at the doorstep? Not everyone going to agree on a single payer system. Its just too polaraizing of a topic!
S.864 for Federal Nurse Patient ratios was sponsored by Sen Barbara Boxer and Sen Bernie Sanders.
He has been endorsed by National Nurses United as the Democratic candidate for President, therefore it is entirely appropriate and necessary to discuss the facts.
Everyone who comes here to vent about ratios, low wages, lousy insurance and no breaks, needs to participate in this election.
S.864 for Federal Nurse Patient ratios was sponsored by Sen Barbara Boxer and Sen Bernie Sanders.
He has been endorsed by National Nurses United as the Democratic candidate for President, therefore it is entirely appropriate and necessary to discuss the facts.
Everyone who comes here to vent about ratios, low wages, lousy insurance and no breaks, needs to participate in this election.
You mentioned nothing about patient ratios in the post I quoted, you mentioned single payer system. Just because a nursing organization supports a side doesn't mean it counts for the body as a whole. Again, you're in sketchy waters. Politics and religion, keep it to yourself.
Our healthcare is currently run by corporate psychopaths and that is the real elephant in the room.
The nurse's ethical duty to understand and participate in the political process is defined in our Code of Ethics. I will continue to hope that healthcare providers can come together on solutions to these issues.
You mentioned nothing about patient ratios in the post I quoted, you mentioned single payer system. Just because a nursing organization supports a side doesn't mean it counts for the body as a whole. Again, you're in sketchy waters. Politics and religion, keep it to yourself.
APRN., DNP, RN, APRN, NP
995 Posts
When you're trying to enact changes at an organization, you have to demonstrate how those changes will look like at Your organization. It doesn't do any good to sing about how organization A, B, and C are doing it.
Nurses are smart people. We know what needs to be done. Why can't the C-suite just get a clue? Why, all the latest magazines are writing about it. Or, a famous medical person said that it should be a certain way. Or, .....etc.
Nobody is going to show up at your hospital and hand out a victory in staffing patterns. You're going to have to show them that they are fiscal idiots if they don't change the staffing patterns.
Yes.....you DO have time for that. We're almost hitting 2020. It's time for nurses to show more strength in advocating for patients by speaking the same language as those who hold the purse strings.