Sunday, 1 March 2009

Is there anything I can do? I have the time.

Check this out!!

Excellent excellent blog post. I wish this nurse would continue blogging!! He/she managed to explain in one post what I have been trying explain over 58 posts! If you read any thing on my blog please read this non militant medical nurse post. If you think that the issues she is talking about are unique to the US states that are not enforcing ratios, then think again. A British Nurse could have written much of this. Anyway, what the Americans do today, we do tomorrow. The nurses understand the deal and are fully aware that unless we wake the public up things are going to get worse. A lot worse. I'll paste some excerpts below in coloured text.

The new trend in hospital satisfaction is called “scripting.” Hospitals seemed to have paid some company to do a survey on patient satisfaction and it seems that people have stated that they feel that the nurse doesn’t have time for them. The answer to the problem? Nurses are now mandated to script to patients with the last sentence being “Is there anything else I can do for you? I have the time.” Some institutions have even changed policies to force the nurses to all wear the same color for example a drab boring dark blue. This was in response to other complaints that people do not know who the nurses are. Hospitals have become competitive within the realm of “customer service” and actual patient care is a vintage act. Instead of focusing on safe patient care, they are more concerned with images.

Patients and families are fully aware that nurses spend very little time at the bedside doing patient care. Some people are under the impression that it is because of the new wave of computer technology. They see nurses at the computers charting and they believe that is what is taking them away from time with the patient. Other people may be convinced that their nurse is lazy and is off reading a magazine somewhere. While every job classification may have the “magazine reader,” this is not the problem.

The truth behind this scene is that patient care has become more complex and the resources have decreased equally if not more for nurses. Hospital settings have become a revolving door for employment with a new concept revolving called “Magnet Status” which means that employees are happy so the care will be better. Basically, this is another administrative forced expectation that encourages employees to vote to help their hospital receive this “Magnet Status” when in all reality there are still underlying issues within employment and job satisfaction.

Nurses have a wide multitude of expected tasks throughout an eight or twelve hour shift. They are expected to exchange report on their patients, check patient’s orders, medications and labs, sometimes immediately start their shift following up on a task that was passed on to them by the previous shift. They are supposed to start their shift off by checking on, meeting and assessing their patients. If everything is going well, they begin to pass medications which requires applying experience, skills and training because specific laboratory results or patient conditions may require a change in any given medication. Throughout the day there will be expected and scheduled treatments which include dressing changes or repetitive assessments to keep a patient stable. The reality of nursing is that on a “medical/surgical” unit with a nurse being responsible for 5 patients, her tasks alone can easily consume an eight or twelve hour shift. Now add interruptions with phone calls, water, blankets, bed changes, assisting patients to the bathroom and even waiting on families and visitors who seem to think that nurse is another word for “waitress.” In a regular eight to twelve hour day the nurse finds herself behind on the important tasks of patient care trying to maintain “customer satisfaction” with a smile while addressing interruptions. Using the words; “I do not have the time right now” can send the nurse right to the unemployment line with absolutely no reference for any time spent on the job.


While these corporations insist that there is no money in their budget for your direct care such as nursing, they have many other “services” or merchandise to offer you in exchange for profits. They will go so far as to put up new buildings with new d├ęcor, new televisions and offer you more treatment options and diagnostic services to get your business. Over the years, the area of direct personal care such as nurses, case managers, social workers, assistive personnel and other departments are working with limited resources including the number of employees needed to assure that you receive the skilled and specialized care that will actually promote a better recovery. They insist that the funds are not available for this “merchandise.”

Statistics have proven that medical errors result in an average of countless thousands of deaths with many of the errors not being reported and that number being hard to determine. It is also proven that the new terminology referred to as “short staffing” has a direct relation to this number of fatal events.

Short staffing is a term used in the field of direct patient care that is deceiving. It leads the public on into believing that corporations are not able to find the correct number of staff to provide one of the most important parts of care that you should receive as a “customer” of their services. That is not the case. Their “staffing models” are set up for profits with your care and safety being at risk. Nurse to patient ratios are at unsafe levels while corporations are raking in the profits for salaries and more “merchandise” to lure you in. Professionals that speak up for your welfare and better working conditions are faced with being slandered and tarnished as “bad employees.” Not only do these corporations have the money to decorate, build and purchase, they have the money to employ large legal firms to protect their actions in proving that these employees were released for justifiable reasons as stories are developed or twisted and supplied within their personal files. The fear of such actions keeps professional caregivers under control to participate in the vicious circle of profits for health care while trying to feed their families and pay their bills.

The terms “short staffing” and “nursing shortage” are used as generic “titles” for this dilemma but in all reality neither of those terms are appropriate because “short staffing” implies that they are actually missing the number of nurses needed to completely staff a unit in order for the appropriate care to be provided and “nursing shortage” implies that we actually have a shortage of nurses in the field. In all reality, “short staffing” is a term that nurses have began using in their every day life of explaining why they have more patients they can handle.
Over the years, expectations, tasks and documentation have increased along with the number of patients a nurse will manage. The mix of the expectations, tasks and documentation is more than an eight or twelve-hour shift can handle. Safe nurse to patient ratios have been mentioned for years as the “nursing shortage” increases and nothing is being done to actually address “safe patient care.” There are hundreds of thousands of licensed inactive nurses that are not working with over 50% specifically stating that it is because of the unsafe conditions. There isn’t much data to report the number of nurses that are actively working in patient care but are unhappy with the unsafe conditions. This is partly due to the repercussions of administration – if you get caught speaking up, you will find yourself one of many nurses looking for employment without a reference.Unfortunately, the public seems to be fairly educated about the conditions for nurses but in their attempts to speak up, more demands fall upon the nurses to hush the public and hide the problem within the facilities.
No wonder nursing care is getting shittier by the minute.


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