Where are the Nurses? Patient takes his inquiry about lack of nurses in the hospital to Heloise.
A former patient speaks up about the lack of nurses during his recent hospital stay. He expresses the thoughts of many. "There was a time when American medicine was the best in the world. But is it still? I have every reason to believe it's gone downhill."
I was reading through my various nursing news feeds this morning and "Hints from Heloise" popped up. I wondered why Heloise was in a Nursing news feed so I clicked on the link. A man who was a recent patient was appalled by the lack of nurses. So he wrote the following letter to Heloise.
Quote
"Dear Heloise: I was a patient in a hospital recently and was appalled by the lack of nurses on staff. My nurse greeted me and told me to call her on my cellphone if I needed anything, then gave me her number and left. What if I had fallen out of bed, couldn't get up and needed help or possibly had a stroke after surgery and couldn't talk?
"Hospitals charge a hefty amount of money for patient care, but I don't think we're getting the care we need. It's not that nurses aren't trained properly, there just are far too many patients for the limited number of nurses available.
"There was a time when American medicine was the best in the world. But is it still? I have every reason to believe it's gone downhill."
Henry P. in Atlanta
Heloise did not post a response. As a nurse, how would you respond to this former patient? At least he gets the point that "there just are far too many patients for the limited number of nurses available."
If we get enough responses, I'll send them to Heloise and tell her these represent the voices of nurses across the US. It might be helpful for all of you to post what state you are in so Heloise will see that we are a good representation of the best nurses in the USA. You could also post your years of experience and whatever else you want to post.
Let's give Heloise and the public the hint that if you want to hear the voice of real nurses, ask the nurses at allnurses.com.
I look at it this way. There are 60 minutes in an hour. Let's say on a perfect day you are assigned 5 patients, so you get an average of 12 minutes for each patient per hour. Fully 1/2 of that time is documenting, or at the PYXIS, or answering the phone, or gathering supplies. So now you have 6 minutes face to face time, per hour with your patient. Now if anything takes longer (say extended report, stat labs that must be addressed, IV to replace, missing meds) you lose that time. Sorry room 92, I just spent your 6 minutes trying to find your TV show, no time to find colder ice for you. Yes, room 31, I understand you take your metformin precisely with your first bite, but I am waiting for it to arrive (after 3 attempts at 2 PYXIS machines, 2 phone calls and a fax to Pharmacy). Oh, and room 18 wants 6 chairs for visitors. That is definitely going to take your 6 minutes for this hour and next. But of course I have the time. Oh that large crash? And people running down the hall? My phone that never stops ringing? I will look into those things once your 6 minutes is done. You just call if you need anything!
Brilliant breakdown of the time factor in nursing. I wish the desk jockeys would take heed when they add yet another mandatory check off sheet.
Specializes in Tele/Interventional/Non-Invasive Cardiology.
On 3/19/2019 at 9:27 AM, xoemmylouox said:
The patient is right. They aren't enough of us at the bedside. Before I start hearing the nonsense of a nursing shortage, I'll shut it down. There isn't a true nursing shortage. There is just a shortage of nurses willing to be at the bedside. The reluctance is for good reason. It's physically and emotionally draining in ways those who aren't nurses can't understand.
EVERYTHING is on your shoulders. A physician makes a mistake and orders the wrong thing - you better catch it. The pharmacy sends you the wrong dose - you better catch it. The demands are impossible and then you add the large number of patients we are responsible for.. It's simply not safe.
Then add the fact that we are exhausted. We work "12" hour shifts, which often become 13-14 easily. We are picking up extra shifts to help cover the gaps as well. So that means your nurse, who is responsible for every single aspect of your care, may not have had more than 4-5 hours of sleep in the last 4-5 days.
Then lets discuss the abuse we receive from patients and their families. I have been hit, kicked, screamed at, and sexually harassed. I understand patients are hurt, sick, and are at their worst - but that doesn't mean I deserve to be treated like trash. Rarely does an employer support you pressing charges.
Don't forget the charting.. We spend HOURS of our shift clicking and typing. With everything we are expected to accomplish each shift it's amazing we have anyone working at the bedside.
I really could not have said it better myself. Shut it down, this is the winner!
As far as charting goes, when we can get rid of these ridiculous lawsuits, it will help. Medicine is not an exact science. With any procedure, I’ve signed a release stating it may not go perfect and I understand that. Someone needs to stop this way of thinking or it’s only going to get worse
I love these assignments with five patients on a day shift on a med-surg unit. I generally was assigned seven, of which one or two would be discharged only to be replaced sometime mid to late afternoon. Charting was required, using non-intuitive software and then manually (just in case). Since the charting left a trail that missed tasks didn't, you can guess which got priority.
I spent 18 years at the hospital bedside before I made my escape. I retired at the tender age of 56, never to work another shift. I left with good evaluations too, not having been written up in over five years.
What wasn't good when I left was the taste in my mouth. There's no way I would recommend nursing as a career to anybody I liked. That was beaten out of me by a steady diet of overwork.
I stand corrected. There are pockets where there are not enough nurses.. Again - overall there isn't a nursing shortage. If the areas were attractive enough, nurses would move from overly saturated areas to work in those areas where we need nurses. Either marketing for that area is poor or again there isn't enough incentive to bring nurses there.
I didn't mean to offend anyone by pointing out that we don't truly have a nursing shortage nation wide. If we made the job more appealing we should have enough nurses. There will always be areas where this is not true. Just like there are areas where there are such an abundance of nurses, that even crap jobs are hard to come by.
Being a LTC RN most of my days...I have found that nurses have found other areas of work due to the high stress and increase in the amount of patients that they load on you. Our staff is dwindling..........most quit due to the stress and intense physical and mental demands on the job. And I feel LTC shouldn't be a high level stress job.....elderly need a routine established and my place doesn't seem to care. Only profit and beds being filled all the time
I work in a for profit place which the ADON or DON seems to never come to the floors to see the actual happenings going on
. I have many physical problems now due to extensive lifting , pulling and doing Aide work most times and I am not a spring chicken anymore..
. My facility just wants the money...and they keep hiring nurses and Aides only to see them leave due to the workload and stress and computer work is outrageous!!!!. I have been there for over 5 years...and I cannot stand it anymore. Now with vision loss In one eye..optic nerve damage...I am being wittled down to a mere TO BE in the near future patient soon. I cant have this.. And I cant work with a unit manager who has communication skills that are all one sided as when you give your input and they want it their way or no way. I have been seeing a severe downhill for years.
But, why a shortage and poor working conditions? Yes, some proximal facts were given, but behind those?
Who controls setting wages, lobbying and paying off OSHA, Congress? Who negotiates for nurses? We won't strike. We're scared of administration, of crazy martyrs, of DHS Mn, of prosecuters. Rightly so.
The public knows little of the realities found in this thread.
I concur with another poster that brought up the time away from the patient devoted to mindlessly clicking off items on a computer. Computers will make your charting go faster they said. It's way more efficient than paper charting they said. Sure, maybe at first it was, until they started adding and adding more things that needed to be charted on! No joke, I must spend at least 2-3 hours of my shift at a minimum just charting. It embarrasses me to be seen as that nurse that just sits at the computer charting all day instead of being the nurse that helps the residents and assists the CNA's when they are busy. Heck, even the CNA's are getting an ever increasing charting load. It's way, way to much busy paperwork now.
The computer is just a glorified cash register and they have taken nurses away from patient care in order to make us cashiers.
But, why a shortage and poor working conditions? Yes, some proximal facts were given, but behind those?
Who controls setting wages, lobbying and paying off OSHA, Congress? Who negotiates for nurses? We won't strike. We're scared of administration, of crazy martyrs, of DHS Mn, of prosecuters. Rightly so.
The public knows little of the realities found in this thread.
I disagree.
The public does know.
I have had multiple patients at my facility tell me that we are short-staffed.
Patients have eyes and ears.
Sometimes my patients ask how many patients I am caring for, and I don't lie; six, seven, eight or nine, whatever the number is.
Like another poster, I tell nursing students to RUN to another career.
And nursing is a second career for me, as I have only been licensed for coming up on three years.
My friend has been a nurse for 21 years, and has had enough. Her house is nearly paid for, and once that happens, she is out.
Specializes in M/S, Pulmonary, Travel, Homecare, Psych..
It's all a symptom of the bigger picture in my opinion.
Consider for a second: McDonald's.
Super giant of the fast food industry. The measuring stick of every other fast food franchise. Yet, how many of us really think what they are selling is good food?
It isn't good food. Not on any level. It's overly simplistic, unhealthy, cheaply made, processed and is generally just not that great tasting.
Yet somehow, year after year, they thrive and succeed in the business despite being horrible at the service they provide. It makes no sense what so ever. It's like a sports team who never wins drawing the most fans every year. How do they do this?
Simple. Their primary purpose is not good food. It's sales, business and profit. Marketing, convenience and a core knowledge of how to make impulse sales keeps them ahead in the industry...........not good food. Hence, the majority of their leadership is business oriented, not culinary. I don't know any chefs who work for McDonald's in any capacity. I'm sure they have plenty of MBS grads in their administration though. (Actually, I'm willing to bet its primarily MBS graduates).
The healthcare industry so desperately wants to be McDonald's.
But it does not work in our industry. Never will. I've spoken at length about why the "business" and customer service model doesn't suit the healthcare industry.
So, we end up with a healthcare industry that is lead mostly (primarily) by business oriented minds and......................
The outcome is very different for us. The flaws in our leadership and the decisions they make are exposed on a daily basis.
Anyone at this point in time care to recall the nursing homes who were shutting off hot water on weekends to save money during the recession? That's just one of a million examples of how our administration and the leadership in healthcare drags us down.
Hard to soar like an eagle when you're chained to a bunch of turkeys.
Speaking of the recession, at that point in time more than any other, a light was shined in the weaknesses of healthcare administration.
Everyone was suffering with low census and having trouble making ends meet financially and no one had an answer for it. They couldn't remedy the problem because they only knew business. They didn't know how to solve any of the healthcare delivery problems they were facing.
So, ER wait times skyrocketed, return admissions numbers went through the roof, patient satisfaction scores plummeted and their solution was to...........
...............increase the price of flowers in the gift shop to hopefully make up the difference in lost profit.
For McDonald's that style of management is fine. Healthcare requires more than that.
McDonald's thrives despite it's goal NOT being good food. The healthcare industry can not mimic this approach and succeed when it's focus is anything other than good healthcare delivery.
To remedy the issues the former patient talked about in his letter, you need better leadership. Until the healthcare industry stops trying to be like McDonald's, problems like the ones he addressed will continue.
Emergent, RN
4,303 Posts
Brilliant breakdown of the time factor in nursing. I wish the desk jockeys would take heed when they add yet another mandatory check off sheet.