Where are the Nurses? Patient takes his inquiry about lack of nurses in the hospital to Heloise.

[tnbutterfly - Mary]

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.

[rsvbbsn]

Here are some reasons I've seen why there are not enough nurses:

• Baby boomer nurses are retiring.
• It costs $100K - $200K to get a BSN in the United States nowadays.
• It takes 1-2 years for a foreign nurse to get through all the red tape to get licensed in the US.

If patients think there aren't enough nurses they should contact their state nursing boards. Many states have created regulations precisely for the purpose of reducing the number of nurses.

[guest52816]

11 hours ago, AutumnApple said:

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.

Excellent points.

Perhaps it would be wise for the healthcare giants in the US, to study the healthcare models of countries who have better outcomes, higher patient and employee satisfaction scores, and adjust accordingly.

Otherwise, I see the problem remaining the same, for the forseeable future.

Besides telling nurses to pursue another career, I also tell friends and family to do all they can to stay OUT of a hospital.

And if they must be hospitalized, I encourage them to bring along someone who will act as their advocate.

I also tell them to be nice to the nurses because more than likely he or she is doing the best they can, with an unmanageable patient load.

[JKL33]

20 minutes ago, rsvbbsn said:

Here are some reasons I've seen why there are not enough nurses:

• Baby boomer nurses are retiring.
• It costs $100K - $200K to get a BSN in the United States nowadays.
• It takes 1-2 years for a foreign nurse to get through all the red tape to get licensed in the US.

If patients think there aren't enough nurses they should contact their state nursing boards. Many states have created regulations precisely for the purpose of reducing the number of nurses.

I would love to hear more about all of this.

[JayHanig]

13 hours ago, Lil Nel said:

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.

I had my administration tell me never to reveal to a patient what my workload was (consciousness of guilt). I got called into the office for doing precisely that. I told them I wasn't the one who brought the subject up: the patient had and then he asked me directly how many patients did I have that day. So I told him.

My manager reminded me we weren't supposed to talk about that with patients or family members. I told her that "he asked me a direct question. What was I supposed to do? Ignore the question? Or lie to them? Pick one!"

I heard no more about it. If they had told me to never answer the question again, I would have told the patient: "my manager told me to never answer those questions." Why should I be the defender of the policy? I didn't make it nor was I the reason why there even was such a policy.

They knew they were screwing the patients. They just didn't want to admit it.

[CardiacRNLA, BSN]

19 minutes ago, JayHanig said:

I had my administration tell me never to reveal to a patient what my workload was (consciousness of guilt). I got called into the office for doing precisely that. I told them I wasn't the one who brought the subject up: the patient had and then he asked me directly how many patients did I have that day. So I told him.

My manager reminded me we weren't supposed to talk about that with patients or family members. I told her that "he asked me a direct question. What was I supposed to do? Ignore the question? Or lie to them? Pick one!"

I heard no more about it. If they had told me to never answer the question again, I would have told the patient: "my manager told me to never answer those questions." Why should I be the defender of the policy? I didn't make it nor was I the reason why there even was such a policy.

They knew they were screwing the patients. They just didn't want to admit it.

It’s funny you say that. I actually had a similar conversation with HR. I’m in a new position and I had to learn stress echos. When I had less than 2 weeks of training (I really only shadowed a couple), the only other trained RN called out. Mind you, I have no signed competencies to demonstrate my capabilities or back me up. Beyond that, I did not have confidence I could competently or safely conduct these tests with such little training. Also, there was no trained nurse to assist me. My manager did NOT want to cancel patients and just wanted me to “figure it out.”

When I spoke about it with HR, I asked her a hypothetical, “if you were my patient and I said, hi I’m your nurse who has only done this for less than 2 weeks, I don’t have any documentation of competency in this procedure and I’m not confident in doing this. Do you still want me to do this?” Her response proved my point went over her head. She said “that’s not something you could ever say to a patient, that’s inappropriate.” Mind you, I didn’t actually say that. But the point was missed on her and obviously she thinks it’s an rn’s job to defend poor management decisions.

[Missy Mawgadoo]

I left bedside nursing less than a year ago and am so grateful I did otherwise I believe I would have left nursing all together. All of the above comments are correct. Ratios, computers, increasing acuity, those damn surveys, have ruined nursing! I appreciate that this patient recognized the problem because most just get angry and complain to management or give a bad survey which ruins us even more.

If more patients banded together and made a fuss not about bad care but lack of staffing I would hope eventually someone would listen, hell take it to Washington! Because one thing is for certain they Do Not listen to the nurses. I worked for a hospital that if you mentioned nursing staffing and poor pay was a problem, you became the problem and were fired or demoted. So we suffer in silence, be our voice, help us make proper changes so we can give the care we know our patients deserve!

[Wuzzie]

If the hospitals could bill for nursing hours separately instead of including us in the furniture I'm guessing we would have ratios of about 1:3.

[CardiacRNLA, BSN]

1 hour ago, Wuzzie said:

If the hospitals could bill for nursing hours separately instead of including us in the furniture I'm guessing we would have ratios of about 1:3.

Exactly right.

[morte, LPN, LVN]

On ‎3‎/‎19‎/‎2019 at 1:08 PM, MaxAttack said:

"I have every reason to believe it's gone downhill."

As supporting evidence: The nurse "gave me her number and left."

I'd like to approach this from the other side - unrealistic patient expectations. Staffing is an issue, but there's absolutely nothing to use in his statement. He's demonizing a way to get in touch with the nurse? How often was he checked on? Was it a ratio issue or was any time alone an issue? Side rails? Bed alarms? Cardiac monitors? He could've been near the nurses station with passing eyes on his every five minutes. We simply don't know and to say otherwise is speculation.

Blanket critical statements like American healthcare has gone downhill represent the worst kind of uninformed opinion stated as fact.

I realize this comes across pretty strong and I'd love a chance to talk with him to get more detail. As it stands, this complaint comes across more like the guy I had that got mad at me because he got a normal spoon and not a soup spoon for his soup.

does not use of call light still come with admission? the patient was right, he was not well informed and left to deal on his own.

[morte, LPN, LVN]

On ‎3‎/‎21‎/‎2019 at 12:54 AM, AutumnApple said:

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.

McDonald's was never about good food, only fast food, and at that, they are good.

[Persephone Paige, ADN]

I concur! Way too few nurses to patients

[RNinheart]

Interesting that short-staffing is each of the nurses' fault... ?