I have recently found myself going home feeling increasingly frustrated, I am working as hard as I can, working up to 15 hours, with up to 8 pts and discharges of several and four hour added pts from nurses going home and getting to new admits, when I have not been able to do more than see the pts. It seems the hospital feels they have to take more pts in, even if that means were are unable to come near to adequately caring for the 8 to 10 we have already. Management is telling me they don't feel it is right to turn pts who need care away. I have been checking into Union which I think we don't have any in our state, and the State Board of Nursing Association. I really would like to find some answers even if it is for small improvments. I have talked with many other nurses and they all feel the same way I do at this time. We are training techs now, and hope they will be future nurses. I believe their are lots more nurses who have already stopped nursing altogether because it is getting so unsafe. I would like information or advice or encouragement.
I was told Florida had a Union for Nurses and now the pts just don't get to come to the hospital. Is this true. Help. Judyd
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I understand how frustrated you are. Unfortunately, I don't think there is an answer. What can you do? It's a pretty tough situation, and you are right, that is why many are going into other areas of work. I think it will get better, but it will get much worse before it does. Sometimes I think it is going to take something drastic to happen before people realize the problems. Until then just keep on keeping on I guess ?...
It does seem like a losing battle and in some respects it is, but...I know I just can't stop trying! One thing that can't hurt is information. I know you don't have time for yourself except driving to and from work but this could help. I don't know where you are (state). Be familiar with your hospital's policies. Set up an appointment with your hospital's risk management nurse and ask for advice. We have a Division of Facilities Services in NC and they will come in unannounced to see if proper care is being given including a safe environment. Check with your state board of nursing and ask for a clinical support nurse and possibly a legal nurse consultant. Sick patients deserve care but not at the risk of injury due to unmanageable acuity. Your license is ultimately on the line. Document each step you take in attempting to correct the problem. Dates, times, topic and with whom you speak. This will help you organize your thoughts, see just what you are living in and help you problem-solve as well as support that you have tried to improve your situation. Hope this helps. Keep us posted on your situation.
I am so glad you replied. I am talking lots. I am joining the Kansas State Board Of Nursing and the ANA, I think it looks like the United American Nurses may be a part of that. I do plan on documenting in the future all the people I have talked to about the problem. It does seem to be a national problem, bigger than just our facility. Just knowing I am going to not be alone in this very dangerous territory is helpfull. Hope to stay at least one step away from the quick sand. The nation truly needs enlightened.
Very good Nurses in good positions of leadership and still going to school in the nursing classes for masters are feeling my same frustrations. I would not know in what a good group I am in if I had not started gathering information."Keep the cards and letters coming folks" Thats what Dean Martin used to say. Maybe we can help us keep on keepin on. Thanks Judyd
Hi!
I live in Florida and I am not aware of any nursing unions here. Too many patients is why I would not work in a hospital. HMOs are in the business of making money for the big guys at the top. They don't seem to care for their patients or their nurses. There have been many articles about patients dying because they can not get proper care because of patient to nurse ratios. How does JHACO rate your hospital? In homecare, I can spend as much time as necessary with my patients. The nursing shortage is getting worse. I wonder why
Minniemouse love that name. The shortage is not the problem as they send nurses home to keep us short. The system facility, economy, public values, politics, it all needs fixed. I wanted to work home health and did some with agency, years ago; but they had their problems too. In Kansas their were loads of new home health agencies about 10 years ago, and they had to do so much documentation to cover the work they did, they were no able to make ends meet and many went out of business with in two years.
I am still trying to work from with in the system to make some improvements. The pressure to get out of work on time is improving some lately. Would love to get out on time, but would love to feel i did a good job by my patients too. Am interested in visiting more with you. Thanks Judyd
Hi Minni and welcome to UltimateNurse.com., clearly the best site on the net! I worked in Home Health in tandem with my OR career. I needed something to let me know that I could make a difference and that was home health. The public is so wonderful and thankful to have a nurse come into their homes. But, alas, I had to retire from Home Health when in one week I was working with the police dept., adult protective services and child protective services. I came home with PAC's and chest pain. But...I wouldn't trade it for anything!
On the nursing shortage, I think that the economy is dictating the demand of nursing service and that may explain why there seems to be no shortage. The accuracy and truth in my opinion is that we do have a shortage of nurses but there are cut backs in some areas which mimic the opposite. I have been interviewing for a job in the past two weeks and there are plenty of them out there. Back to something I said earlier though, you must cross-train yourself to be marketable. It has helped me loads.
Frustration and fear, two of the largest problems facing nurses today. I left the acute care setting last week when I was assigned 10 patients, six of whom were fresh post op pts, three of whom were confused and combative,(without sitters) and one in leather restraints. That kind of load is not safe for one nurse to handle, and it was the straw that broke this camel's back. I have been in acute care for 20 years, and have tried and tried and tried to effect changes within the system, and frankly, it ain't gonna happen. Patients will die, lawyers will settle and the whole spiraling system will continue on until there are no nurses willing to put with the crap that is shoveled on a daily basis in acute care. I am going into occupational health and education, and hope to do my best to keep my clients out of the blasted hospitals.
I understand your frustration, I work in an Emergency room and also for a staffing co. Last week I was sent by the staffing co. to a hospital to work a med surg floor. When I got to the hospital, which was the first time I had worked in that facility, I was given 11 patients. You talk about frustration, I was so stressed when I left there I called the agency and told them I would not go back because of the high acuity, inadequate staff and overwhelming responsibility placed on my shoulders. I have 21 years nursing exp., and made it through, but it is not something I want to do again. Not only was I stressed by the job, but by also knowing that the patients did not receive enough care for my shift. I was lucky just to get the medications passed on time.
Hi, Judyd. I don`t know about the hospitals - I am in LTC - I know that here in Kentucky, the nurses are being worked to death! There are no minimum staffing standards here, and as a result the care is mostly the very minimum - we simply have too many residents to care for!
The nurses need to get together and work on getting the MSS passed. We can do it! As the 2nd largest workforce in this country, we can certainly do it - if we try!
I recently walked out on a job before accepting my assignment. While other issues were involved nurses were told that they must be out on time no matter what. Then staff was cut to a minimal ghost staff. This cut was due to corporate owners of brandywine insisting that profit level although existent were dot desirable and there was to be no ot . requiring don to give daily reports on hours worked by staff. Now let me explain here, about the bullshit that was pedalled to pts and family, regarding the ever present "nursing shortage" it was not the case that adequate staff was not available for work, merely that they would be overtime hours and thus reflect poorly in don report and evaluation. Many night I had 20-22 pts on a sub acute unit, very ill patients, who require much better observation and evaluation than was available. I would literally be running some nights and would not even see a chart until 1230am. I pride myself in being a very competent,hardworking, dedicated to pt. needs, and i will not be neglegent. i had to face these pts the next day. i did not want overtime. i have 4 small children and my income is helpful but not necesary to keep a roof above us. but plenty of staff were willing to put the time in when short and were told to go home. on top of this pt load the unit secretary we had for 1/2 shift was taken and somedays on top of this pt load we would have discharge and admissions which as we all no require alot of time and paperwork, thrown in . absolutely unnescary madness. with no regard to pt safety, and nurses being held accountable when an issue was raised.I know there is a true shortage of nursing but it is not the explanation for everything. as usual someones pocketbook is. Its so easy to take this as the be all end all of answers to the wrongs in healthcare system. I refer to it as the "REAL FLEECING OF AMERICAN PUBLIC" acutely ill pts being sent out of hospitals to ill- equipped, undertrained LTC facilities, these pts for the most part are fighting to stay alive, and they are not aware of just how endanger they are. When I left this facility was taking on oncology pts. staff was given nothing but an inservice on guiding these pts to in-house hospice care which low and behold was a branch of corporate. People are desired for fast turnover like a waitresses table at lunch time. These patients represent a high quick revenue andf when these services are tapped for payment from insurance pts are supposed to be guided to choose to give up fighting for life. While I advocate and support any personal decision of a terminal pt, I do not appreciate and wont participate in a protocol that is designed to push a decision go one way or the other.,so that a bed is free to start it all over again.Can you imagine the big corporate pow wow that comes up with "profit margins are not high enough here,we need to cut the corners that weve already stripped them, and gosh darnit these pts are lingering around too long,they are not cost-effective(this facility is trying to do away with there brain injury program for this reason.)we want a pt that ships in makes the maximum deposit and ships out fast, turnover gentlemen, turnover is the name of the game here. PROFIT PROFIT PROFIT." I ONLY HOPE CORPORATION FALLS AND AND THOSE WHO VALUE THE QUALITY OF LIFE OF OTHERS SO LITTLE FIND THEMSELVES IN THE SYSTEM THEY HAVE DESIGNED. Although the rich will always recieve optimum health care. Its the working middle class that wiil suffer, and i mean suffer in the literal sense. People need to wake up to whats going on . unfortunatly people don't discover the horrendous things awaiting them until they are there, and the time left that they have becomes so valuable that crusading the cause isnt a priority and probably shouldn't be . Ive often thought of writing to local papers to open discussion and broaden community knowledge of what really waits for them god forbid tragedy should strike them. I'd appreciate return views and opinions. slimjll2@aol
How are things going a year after you made that first post Judyd?
Christ! It has been a long time since I started this thread, Just stumbled across it again. I am a member of ANA now. Did not get elected though. I was ask to lead UBC and am on NPC. Nurse Practice Council has given me knew energy. I do feel like I can be a part of a solution. We are working toward the goal of Magnet status, and I am proud to be a part of it. I also have really came to a deeper understanding of the cross training that that All41 talks about. I try very hard to remain cheerful and help the most frustrated hard working staff if I have any caught up time. I believe that makes me very valuable as an employee and get lots of comments of being missed when I am gone. I broke my arm and am just now able to go back on workmans comp and help out what I can. I do know fellow staff truly appreciate me. It was very hard on me to stay home and need help from others. I am so glad to be back even for light duty, and do appreciate the benefits from my place of employment. I plan to hang in there and keep trying to be a part of the solution. I have copied off thing from this site and plan to share with others for brainstorming. I still definately have my days of frustration. recenetly seem to be getting very aggrivated when I get a Dr's order to transfer a pt to MICU or CCu and the bed crunch has there staff coming to my floor to assess and pick the pt they judge to be the most deserving to live. But I am still working on the inside. Glad for all the input here.
It's very frustrating when we turn in "acuity levels" in the ICU-- but nursing management never seems to actually read them and make staffing adjustments accordingly. Do you guys think we will ever see mandatory staffing laws that link staffing to patient ration and acuity.. and will be enforcable?? Will it ever happen?
I think the AHA will always manage to block laws like that- or make sure there are so many loopholes in them that they'll always work nurses & hospital staff like dogs.. is there any hope?
God help us all (in medicine as staff and pts) I hear more and more hospital staff becoming increasingly miserable with their jobs, unable to do a good job due to rapid admissions and turnovers, and acute pt needs in out of specialty areas just to fill the bed. But where will the pts go if they are not allowed a bed? I really believe there are lots of nurses out there who would gladly return to a hospital setting if they were allowed to work at a more relaxed caring pace. Yet we do still have nurses on the work force that are so relaxed that the main thing they do is find out what did not get done before they came on and spend the rest of the shift sitting at the desk and complaining about that. I have always strived to keep it real, will keep trying...
OMG, You are so brave; yet so correct. This is such an important reply and I hope that everyone reads it. Nurses are intimidated daily by their supervisors to take on unrealistic and dangerous assignments. They prey on your compassion to "stick it out" for the sake of the patients. Well, just you let one thing go wrong and you will find yourself out on a tiny branch with no net. It is so important for nurses to understand that they can refuse an assignment without being sited as abandonment. You may catch the wrath of your facility but you will not lose your nursing license!! If more nurses would exercise this right, maybe more would be done to adequately staff a facility. What do you guys think?
I understand your frustration. I do not work acute care, but am in LTC and my ratio is 1 nurse, 2 CNA to 42 residents. I work a dementia unit and the behaviors i.e. aggression, falls, etc. is on a daily basis. In addition to medications and treatments we are trying to end run the behaviors and I feel that I am just not providing the kind of care and environment that I went into nursing for.
I think we all feel the same way..no matter where we work...but I don't know the answer either
