Specializes in Med nurse in med-surg., float, HH, and PDN.
Contrary to what many people believe, the ability of an employment attorney to help most workers in a non-union environment is pretty slim. It's one of the oddities of employment in America, that an employer can't fire you because of your race, age, gender - maybe a couple of other protected reasons - but they usually can fire you for no reason at all.
I've also observed that it's amazing what lengths some managers will occasionally go to to target a particular employee they've decided to get rid of.
If a manager starts checking every single piece of charting you do, starts questioning your patients to see if they have anything to complain about, enlists a couple of her special favorites to follow you around and report back on everything you say, etc, it's amazing what a black picture can be painted of even a very good nurse.
As a union steward at my hospital, I've gotten involved in a number of really bizarre cases. One nurse had an absolutely stellar record over many years until she came under one particular charge nurse who hated nurses of her ethnicity. This charge nurse started questioning her patients about her, and when she found a patient who shared her prejudice, she's say something like this: "You know, she's a really bad nurse, but people are afraid to say anything against her. It would really help us if you would give us a complaint we could use". She finally managed to generate some complaints she could use to fire the nurse. Fortunately, there were counter witnesses, including witnesses to the charge nurse's prejudice, and the nurse ended up with a nice financial settlement.
Fortunately, genuinely unfair managers are rare. But when you run up against a really bad one, sometimes the only thing to do is get out. A strong union can be a big help, but even with that a really nefarious manager who's willing to work at it can still get away with bad stuff.
YOW! This is amazingly similar to what happened to me. The workload was so unconscionable that I ended up having to stay over an hour or sometime two hours to accomplish all the tons of charting/documentation required. I believe that led DON to track EVERYTHING I'd ever done, because when 'they' called me in, part of her strategy was to present me with a STACK of copies of my supposed mistakes.....and I can't tell you the number of times I went to HER and my supervisor to double-check how to deal with something I was unsure of; I couldn't go to a charge nurse because they made me charge nurse, something which I TOLD them I was not ready for. The charge nurse did EVERYTHING and I mean ev-er-y-thing. No ward-clerks, no med-nurses, only 2 CNA's who were also stressed by the sheer volume of patients they had to care for. Think of Lucy and Ethel in the chocolate factory minus the laugh track.
I very MUCH resented MY ethics being called in to question, when the facility felt no/zero/nada/nil compunction about their ethics. Bottom line was that someone wanted me out because they had to pay me for all the time and effort I had to expend on trying to comply with all my responsibilities. I should have realized that the job meant that I had to be an automaton with no consideration that the patients were real people living in an environment where a factory assembly-line approach was the mandated method of 'care'.
Specializes in NICU, PICU, Transport, L&D, Hospice.
Look at what the unions have done to the VA system
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So, rather than answer a question you make a broad generalization about unions and the VA system without any supporting documentation. We will just have to accept that as your opinion based in a narrow world view.
Is there a reason other than nursing care for which a person needs to be admitted to a hospital, are you able to answer this question or are you simply avoiding it because it is uncomfortable for you to contemplate the facts?
Is there a reason other than nursing care for which a person needs to be admitted to a hospital ....
When a student, I was told by my preceptor that vets acted out in the community in order to be sent to the psych unit at the VA hospital in order to have a roof over their heads. When the weather turned nice, they left. She showed me the breach in the fence that could never stay repaired.
Not posting this to enter the conversation. The question popped out at me, and thought I would share this interesting (to me, at the time) tidbit.
Specializes in NICU, PICU, Transport, L&D, Hospice.
When a student, I was told by my preceptor that vets acted out in the community in order to be sent to the psych unit at the VA hospital in order to have a roof over their heads. When the weather turned nice, they left. She showed me the breach in the fence that could never stay repaired.
Not posting this to enter the conversation. The question popped out at me, and thought I would share this interesting (to me, at the time) tidbit.
There are folks here in AK who make it a point to get arrested and incarcerated during the winter months so that they have a warm place to sleep with 3 squares a day. That is decidedly not the way most of us prefer to role but it apparently works for them, so it is said.
There are folks here in AK who make it a point to get arrested and incarcerated during the winter months so that they have a warm place to sleep with 3 squares a day. That is decidedly not the way most of us prefer to role but it apparently works for them, so it is said.
"Three hots and a cot" is the term that one of my instructors used.
I have not ever worked in a union, and I don't even know anything about them. My opinion on this is that it seems to really work for some places. I wonder what the OP had experienced to cause such strong feelings? What happened???
Specializes in Med nurse in med-surg., float, HH, and PDN.
..
So, rather than answer a question you make a broad generalization about unions and the VA system without any supporting documentation. We will just have to accept that as your opinion based in a narrow world view.
Is there a reason other than nursing care for which a person needs to be admitted to a hospital, are you able to answer this question or are you simply avoiding it because it is uncomfortable for you to contemplate the facts?
They are codified in hospital license requirements:
Title 22. Social Security Division 5.
Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies
Chapter 1. General Acute Care Hospitals Article 3.
Basic Services (Refs & Annos)
22 CCR 70215
70215. Planning and Implementing Patient Care.
(a)
A registered nurse shall directly provide:
(1) Ongoing patient assessments as defined in the Business and Professions Code, section 2725(b)(4). Such assessments shall be performed, and the findings documented in the patient's medical record, for each shift, and upon receipt of the patient when he/she is transferred to another patient care area.
(2) The planning, supervision, implementation, and evaluation of the nursing care provided to each patient. The implementation of nursing care may be delegated by the registered nurse responsible for the patient to other licensed nursing staff, or may be assigned to unlicensed staff, subject to any limitations of their licensure, certification, level of validated competency, and/or regulation.
(3) The assessment, planning, implementation, and evaluation of patient education, including ongoing discharge teaching of each patient. Any assignment of specific patient education tasks to patient care personnel shall be made by the registered nurse responsible for the patient.
(b) The planning and delivery of patient care shall reflect all elements of the nursing process: assessment, nursing diagnosis, planning, intervention, evaluation and, as circumstances require, patient advocacy, and shall be initiated by a registered nurse at the time of admission.
(d) Information related to the patient's initial assessment and reassessments, nursing diagnosis, plan, intervention, evaluation, and patient advocacy shall be permanently recorded in the patient's medical record.
Note: Authority cited: Sections 1275 and 131200, Health and Safety Code. Reference: Section 2725(b)(4), Business and Professions Code; and Sections 1276, 131050, 131051 and 131052, Health and Safety Code.
Here are selected parts of CMS Federal regulations required for all hospitals participating in Medicare and/or Medicaid
State Operations Manual
Appendix A -Survey Protocol,
Regulations and Interpretive Guidelines for Hospitals
482.23 Condition of Participation: Nursing Services
The hospital must have an organized nursing service that provides 24-hour nursing services. The nursing services must be furnished or supervised by a registered nurse.
482.23(b) Standard: Staffing and Delivery of Care
The nursing service must have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed.
There must be supervisory and staff personnel for each department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient.
Interpretive Guidelines 482.23(
The nursing service must ensure that patient needs are met by ongoing assessments of patients' needs and provides nursing staff to meet those needs. There must be sufficient numbers, types and qualifications of supervisory and staff nursing personnel to respond to the appropriate nursing needs and care of the patient population of each department or nursing unit.
Semantics... The facility will not function with nurses alone... Who will write the orders? Take rads? Labs? It may be "nursing" care by regulation but nurses are not rendering all of the care or even most of it... Again.. we are not the center of the universe.... We work in the field of medicine. We are ancillaries
No Stars In My Eyes
5,627 Posts
YOW! This is amazingly similar to what happened to me. The workload was so unconscionable that I ended up having to stay over an hour or sometime two hours to accomplish all the tons of charting/documentation required. I believe that led DON to track EVERYTHING I'd ever done, because when 'they' called me in, part of her strategy was to present me with a STACK of copies of my supposed mistakes.....and I can't tell you the number of times I went to HER and my supervisor to double-check how to deal with something I was unsure of; I couldn't go to a charge nurse because they made me charge nurse, something which I TOLD them I was not ready for. The charge nurse did EVERYTHING and I mean ev-er-y-thing. No ward-clerks, no med-nurses, only 2 CNA's who were also stressed by the sheer volume of patients they had to care for. Think of Lucy and Ethel in the chocolate factory minus the laugh track.
I very MUCH resented MY ethics being called in to question, when the facility felt no/zero/nada/nil compunction about their ethics. Bottom line was that someone wanted me out because they had to pay me for all the time and effort I had to expend on trying to comply with all my responsibilities. I should have realized that the job meant that I had to be an automaton with no consideration that the patients were real people living in an environment where a factory assembly-line approach was the mandated method of 'care'.
Shame on ME? HA!