Tuesday, June 10, 2008

Do Nurses Have The Time?

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.

Another dilemma that nurses face is the concept behind “assistive personnel.” The actual job that the nurse has to perform is increased due to the fact that they are supplied with various levels of “assistive personnel.” One of the common problems with this is that the “assistive personnel” may be extremely busy or rebellious towards the nurse resulting in the nurse taking on more of the interruptions and other tasks that takes the nurse away from her expected duties and patient care. Often times, there is a great imbalance within the “assistive personnel” where there might be one reliable tech to every unreliable tech. This not only increases the demands on the tech but the nurse as well. Another imbalance is the experience of staff where there is a mixture of inexperienced new nurses and new techs due to the “revolving door” effect from either job dissatisfaction or movement within the field. This is an on-going event in facilities. Some facilities will have the techs responsible for 10 to 20 patients while nurses care for 5 – 8 or even 10 patients. In all reality, with a patient load that heavy a nurse can easily spend her whole shift practically just trying to pass medications. Add the interruptions and…well…customer satisfaction goes down and the facility administrators come up with more “tasks” to improve the “customer satisfaction” but not the quality of care.

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.

“Magnet Status” seems to be ironic with many facilities trying to obtain the status while being staffed in large numbers by “supplemental staffing.” If the facility were such a great place to work, you would think they would have adequate staff to cover their needs without the need to utilize outside agencies or even internal supplemental staff to fill the holes.

While many nursing unions or groups have mentioned safe nurse to patient ratios, nothing seems to be happening to make the change towards what we consider “safe patient care.” Instead, we will continue to “shop” for medical care with the hospitals competing against each other with bigger flat screen televisions and nurses waiting on unimportant demands from the “customers” while struggling to provide safe care to their patients. The data to support the fact that the more patients the nurse manages increases the likelihood of mistakes and poor patient outcomes seems to mean nothing in the competitive world of health care. Numerous articles and statistics have reiterated this problem for years but nothing is changing except for the number of tasks and patients that the nurse is responsible for and that number keeps getting bigger and bigger.

Seems the only thing we can do as customers within this outrageous scenario is to stay educated, keep yourself healthy, try to avoid hospital stays and keep a very close eye on your care.


Health Blogs

11 comments:

Anonymous said...

A form of false advertising?

medteam said...

I appreciate your eye-opening post; this latest obscene exercise in greedy Corporate Healthcare doublespeak is very disturbing. What a sick con to ask exploited, overworked Nursing staff too pretend they have time to attend to additional patient comfort demands. I had heard about "Magnet Status;" but did not know the parameters for awarding this highly sought after accolade. The shocking thing is that my former Hospital, the Hospital who fired me for speaking out about understaffing, the same Hospital that has continued to fire the best and the brightest among their OR staff, had acquired that "Magnet Status." I once lived in Maryland and worked at "America's Best Hospital" until I was fired as a Whistleblower after I reported what I believed was a danger to patients in the OR when I was left stranded contentiously scrubbed into Surgery without a break for 8, 10 and 12 hours at a time. Situations like this are not safe for patients, but staff are easily silenced when they are fired without cause. .

Deliberate Negligent Understaffing is the single most serious issue endangering patient care today. Those who attempt to report this dangerous situation are targeted, persecuted and fired just as I was. My Blog: MedTEAM.Wordpress.com The "T.E.A.M," Transparency for Equal Accountability in Medicine, was set up to focus on ending these negligent practices with the C.U.T! Campaign to CONTROL UNDERSTAFFING TODAY. I believe in universal access to Healthcare, but this will never become a viable reality without correcting the bad Management driving the "Nursing Exodus." My emphasis on transparency is an attack on the type of fake patient safety and reassurance cons that proliferate in the "for profit" US Healthcare industry. Despite being forced to leave the US after loosing my home, I remain deeply committed to changing the system that sabotaged my career in America. Please visit my Blog and get in touch,

Keep up the good work in exposing the harsh realities of US Healthcare',

Kim Sanders-Fisher

Anonymous said...

Do hospitals think that patients and families are ALL idiots?

This is definitely false advertising as already stated.

nurse advocate said...

I really appreciate your post and the attempt to get out the truth. I am a firm believer that nurses are not valued and not shown the respect they deserve. The scipts like the one you describe are designed to keep patients and their families from the truth. Weas nurse should be able to tell our patients I am sorry it has taken me so long to get to your pain I have 7 patients and am doing the best I can. This may cause them to write letters and vote for change when the issue comes up. The hospitals want the patient and their families to believe it is our fault. I have been in management and have said my share of sorry. The truth is the system is broken.

I would like to invite you to view my blog at http://nurseadvocates.blogspot.com as I believe we are like minded activist. I will be posting a link to your blog at my site.

Thanks

Anonymous said...

I voted in the poll and said that "I am a nurse that speaks up about staffing" conditions. This vote is ironic because I am a nurse who is unemployed because I have spoke up about bad staffing. Matter of fact I have been fired twice over speaking up about bad staffing. It is OK, I am not angry. I can look in the mirror at myself without loathing myself for knuckling under. Besides bedside nursing has become impossible, work loads and conditions are impossible. New grads are walking out the door almost as quickly as they are hired, oldtimes are leaving in droves. I am better off sitting at home.

Anonymous said...

Sorry about your employment status. You are not alone...not that it helps your situation or any one else's. This is bound to get worse before it gets better. I find it very hard to support working under conditions that are in total opposition of what nursing is and stands for and jeopardizes safety and lives. Also, it is unfortunate that we have to remain anonymous to protect ourselves when we are in the right for what we are saying.

黑色幽默 said...

成人圖庫,口交技巧,成人18,自慰方法,Fleshlight,情色自拍貼圖,成人情色貼圖,少婦自拍,一夜情聊天,本土av,色情av,av圖片,色情聊天,成人情色網,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,080視訊聊天室icandy,情色少女貼圖,免費視 訊聊天網,av女優18,免費線上視訊fm358,avdvd免費AV女優,女優王國,做愛,無碼影片,情色交友

剩沒底天 said...

尋夢視訊聊天a漫a片a圖一夜情一葉情人妻激情情色寫真美女自拍辣妹自拍正妹自拍美女走光辣妹走光正妹走光脫衣秀脫衣走光色情自慰自拍成人全裸打炮打手槍打飛機巨乳巨奶女優大奶性交性愛淫蕩淫慾

怪以 said...

Haste makes waste...................................................

火吟 said...

how do u do?

鄭明宏 said...

以簡單的行為愉悅他人的心靈,勝過千人低頭禱告。........................................