Love Nursing?-1

WOW...So many things to Love about this profession...Just a few

1) Making someone feel better is often its own reward, most especially when that patient improves enough to know you have truly helped them..Often that help is in the form of medication, sometimes even education...

2) There is something powerful about saving lives and making a difference..Many of us make a joke of it, but when you know you have the knowledge and the ability with one or two actions to pull a patient from the cliff of death...It feels great when it works and sometimes even when it does not and you just know that you have done all that you can

3) Satisfaction is another factor for nurses and patients...It just feels good to know that you have comforted and bathed and pampered a patient, to know that if that was your mother, father or child, this is how you would want them cared for...

Nurses need to Take Care of Nurses-1

Planning for secure retirement is just one way...As one of the largest workforces in the country that provides caring and professional services to all communities, we deserve a retirement plan. We work long and strenuous hours with tremendous responsibilities and stressors and are justified in seeking this plan.

Planning for daily autonomy and safe practice is another... When decisions are made regarding changes in practice...Nurses at the bedside should always question the change..

I.E. A Current trend is the NO WAIT ER...

Again...How does one spell Ludicrous, because the hang nail and toothache in the ER really should be seen immediately and the life threatening possibilities are endless...

The triage nurse in some of these situations is now expected to treat patients and discharge patients while continuing to manage the triage area...TRIAGE should focus on triage and all that can occur there, not otherwise without a nurse specific to treating and streeting triaged patients.

What is endless is legal issues in such a situation...Many legal issues are present and problematic..

The STANDARD of CARE will be what a lawyer will address...IS it the National or Local Standard of Care for the triage nurse to not only manage triage but greet, treat and street patients in the waiting room or even a room close by...REQUIRES an additional nurse...for my standard...

What pressures does the change place on staff nurses workload and ability to practice safely?

Does the change effect the current staffing patterns and needs in your facility?

Is it safe for your patient?

Is it safe for YOUR License?

QUESTION...

QUESTION....

QUESTION!!!

Did U Ever Feel?

Like your voice is never heard?

I recently heard from a co-worker that spoke up at a meeting that she was really trying to be a voice for the staff...Yet again a Novel idea... And she felt like she was not heard and made little difference...

Sad thing is that this happens way too frequently in the face of administrative and bureaucratic managing (another bit of BS to me)

When patients and safe practice are the issue, the bottom line needs wiggle room and the SUPPORT of OUR SO-CALLED leaders...

I would love to hear how many NURSES

DO?

or

DO NOT?

Feel like they are supported in autonomy and safe practice for their patients?????

Is you voice heard by your administrators or leaders???

WOW...For me this is Workplace Bullying and Harassment--to not be allowed a Voice that is Heard...

Laws that NEED to be Enacted in FLA--3

Another recent bill that has yet to see the light of day...

Is the bill to make it mandatory for bedside/staff nurses to be part of decision and change processes....

WOW...another NOVEL concept...to actually involve the nurses that provide the comfort and care to the patients--24/7. This often includes life-saving measures...BTW..those that make these decisions...ON A DAILY BASIS....

Really what a shame that lawmakers need to promote what should be obvious...

BUT ya wanna guess who would be the MOST against this bill being passed...

???? Hospital Associations will be against being made to do something that should already be a standard....AGAIN...one of my faves...LUDICROUS....

Come on nurses...get involved....YOU can make the difference..BE a VOICE for your own advocacy...

Did U Know?...2

That in the Florida House has been a bill related to safe lifting of patients...
It is a great idea and aimed at protecting not only patients but nurses backs...Wow, an issues that promotes the health of nurses???(A shame that nurses need such bills)
But even in some bariatric facilities nurses cannot get the proper tools and lifting equipment needed. Forget the normal sized patients that may be immobile, just double or triple that and the need for many nurses needed for the lifts and turns. (So we do need bills passed into laws)
Really novel...and need I say, Finally??? But it has not been passed.
Not enough nurses were made part of this process nor have they been involved or encouraged to be involved in even knowing that bills are proposed and voted on regularly. Bills that die in the limbo of government officials, who are most affected to vote by those that are most present in the support of bills to be passed.
Many of these bills never see the light of day because it does not suit the purpose of the AMA or the Hospital Associations, and not near enough nurses get involved or are even aware.
It could make such a difference...What a Voice nurses could have if we just get involved...In my city alone there are more than 14,000 RN's that is power...That could be one of the greatest voices senators and congressmen have ever heard...
Think about the changes that could happen........

What do you want from NURSES of the FUTURE?

I Want:

Nurses that care about being nurses, that are PROUD of what they do and what they can manage

with all of the limits placed on them...

Nurses that automatically place what is best for their patient's 1st!!!. For me that should be the ultimate in basics for nursing....I have always thought that it is UHHHMMMM...Ludicrous that all of these alphabets are needed and SAD, because caring for your patient is why you are here, WHY you exist, that care, comfort, and life-saving elements ARE the basis of Nursing... I DO NOT NEED

Alphabet Soup to tell me what is right for my patient's...

Nurses that Care...I always start with the idea that I am going to treat this patient like I would want someone to treat my family... Now, on another note..I would smack one of my family members for being an ASS and acting entitled, or that I owe them a particular type of care, be a DECENT HUMAN and treat people with common courtesy (Esp your nurse, they want to help you)..When a patient or family drops that ball, I will kick it back at them...Stress, pain, etc..DOES NOT MAKE it OKAY to be a JERK...

Nurses that are NOT Here Just for a Paycheck, the bottom line is...that it is great to make money...but LIVES are at stake here..

My #1 Rule is..Know why you are doing whatever you may be doing for a patient, Never do anything just because you may have seen someone else do it...If you do not know ask...

Just a few thoughts about what I want from all of these nurses..that schools are pushing out way too fast...KNOW the reasons you are treating a patient...

What are your ideas??? (1)

What exactly is short staffing? Is it the new MTO (Oh and suck it up-like it or not)/not necessarily when needed) staffing?

A) Like when JCAHO or OSHA or AHCA visit? (Like does safe staffing really matter any other time)

B) Like when the budget says so? (But hey lets not look for ways to actually encourage money-making ideas for the workplace) Just cut the staff short instead.

C) NURSING SATISFACTION STAFFING???? OH my those are the wrong words to use, because nurse satisfaction is so often the first consideration.... (I can dream)

D) Study after study shows that safe staffing improves not only nursing satisfaction, longevity, security, etc., but actually promotes patient and family satisfaction, promotes better patient outcomes, patient safety and less sentinel events, and reduces medication errors. OH so many ANDS for nurses and patients...and SO many buts fro those that really should care but too often

consider the bottom line and NOT the bottoms of their nurses and patients....

Again, I really do not place patients after nurses, I just really consider the Patients and families have the WHOLE freakin alphabet advocating for them...Nurses do not even have the ABC's (another day for my BLOG on the one organization that really does care, just a quick hint...FNA)

Day Off

Off Day...

Here's to all Nurses

Keep safe practice and promote the well-being of your profession...

Did U Know?...

VThe American Nursing Association has issued an opinion about the potential effects of federal budget proposals on the nursing work force.

Republicans in the House of Representatives have proposed significant spending cuts as part of a budget that would cover the rest of the 2011 fiscal year. Among the affected programs, according to the ANA, are Title VII Health Professions Programs and Title VIII Nursing Workforce Development Programs.

Title VIII provides funding for nursing education programs and recruiting, including in critical shortage areas, while Title VII covers healthcare practitioners in general.

According to the ANA, the budget proposal currently under consideration would cut funding to these programs by 29% compared with 2010.

“At a time when the nursing shortage threatens to impact the quality of care, we need to continue to invest in nursing programs,” said ANA President Karen Daley, RN, PhD, MPH, FAAN.

“Our patients are our first priority, and without an adequate supply of nurses to provide care, and adequate funding to implement the reforms of the Affordable Care Act, our healthcare system will not be able to meet its growing demands.”

While the budget for the rest of fiscal year 2011 remains to be determined, President Obama also has proposed a budget for 2012.

Although Obama’s budget features an array of spending cuts, the ANA was happy that it included a 28% increase for Title VIII programs. As with the 2011 budget, Obama’s budget is subject to change after congressional debate and negotiations.

“It’s heartening to see the Obama administration continues to recognize the invaluable contribution that nurses make to the delivery of care,” Daley said. “This proposed budget represents a substantial commitment to addressing the nursing shortage and ensuring access to care for all. Increased funding for Title VIII programs is vital to reducing avoidable complications associated with the nursing shortage — saving lives and reducing healthcare costs.”

THE ANA FOLLOWS MANY OF OBAMA'S PLAN'S BUT ARE THEY REALLY GOOD FOR NURSING...DOES

IT REALLY PROMOTE THOSE AT THE BEDSIDE..THOSE TAKING CARE OF PATIENTS???

WHAT DO YOU THAT ACTUALLY TAKE CARE OF PATIENTS THINK?????????????????????????????

Laws that NEED to be Enacted in FLA

Did you know???

There are many bills in the FLA Legislature that can promote the improvement of nurses workforce situations, that can protect the health and well-being of nurses, and that can promote nursing autonomy.

Many bills just never get the support they need to be passed into law.

In the recent past there have been bills that make it very important to include the staff nurse (aka: nurse at the bedside) in the decision making process regarding changes and new procedures and protocols in the workplace.

WOW, What a novel concept to include the one doing the work and providing the care (24/7) in the decision making process. It could be great progress to include these nurses in the process of changes rather than just expecting them to add something new (without their input) to already stresses workloads. And how much safer could it be? For patients and staff????

Things that make you go HMMMMMMMM.....

Laws that NEED to be Enacted in FLA

Do you ever wonder why the Southeast often seems behind in nursing practice issues.

Florida is the last state to STILL refuse to pass the LAW that allows ARNP's to write all levels of narcotic prescriptions...

How do you spell Ludicrous?? FLA??? ;-)

Come on and make the change FLA, time too loosen the strangleholds of the AMA and the AHA,

Join the rest of the country and let ARNPs, BE all that they can be...

Think about where many Nurse Practitioner's Practice, Have a Clue??? In Nursing Homes and special needs facilities, including long term care...WHERE PEOPLE NEED all levels of pain relief and pain management...

Not only does NOT Passing this law limit the care nurse practitioner's can provide, it makes pain relief more slowly provided than necessary to patient's, NOT RIGHT...

Law Maker's In FLA--Get over the delay and PASS the BILL...

Please folk's write the Senators and Congress of FLA, Let them know what you think of such backward progress...

http://dlis.dos.state.fl.us/fgils/government.html

What Nursing can Mean Part VI-Final Part

Many nurses want to work at facilities that offer all of this and more. Where one can find the time to play with a little girl who is feeling better, or comfort and soothe a dying woman and her family, and when the time comes, one can pull a man out of the claws of the four horsemen’s grasp. It may not be smooth sailing every day, but the face of nursing is changing and attitudes towards nurses need to evolve more. Every patient family and staff member should be able to walk into the halls of any facility and know that in this place, someone cares and that someone will be there when needed.

What Nursing can Mean Part V

More forums need to be in place to allow front-line nurses the chance to help make some changes. This gives the nurses at the bedside the opportunity to voice concerns and if they are wise, they will come with ideas for changes needed, not just the issues themselves but a way to make it better. In addition to the changing views that many facilities are embracing, there needs to be changing views among the nursing-at-the-bedside staff. With professionalism encouraged at every level in facilities, it should no longer be the directors versus those at the bedside; it should be us (being every one of us) for them (being the patients and families that come through the hospitals doors). Through increased education, taking pride in being autonomous, improving the collaborative way in which we practice, taking command of our professionalism, and working hand-in-hand everyday for the betterment of our nursing culture, will we be able to improve nursing satisfaction. With these measures, we can ensure patient safety and satisfaction and decrease patient mortality and morbidity.

One other issue to be considered in the face of this looming crisis is that nurse’s work in alphabet soup. JACHO, OSHA, and AHCA are just a few of the alphabet telling us how to do our job and often how wrong we are doing it at varying levels. Where is the alphabet that helps us not work in jeopardy, with unsafe staffing ratio? Where is the alphabet soup FOR nurses?

Organizational Change Proposition-Part 2

To go gently into the night is an option often withheld from patients in intensive care units (ICU’s). Palliative care measures, which include comfort care and end-of-life (EOL) therapies, are seldom included in the care plan of dying intensive care unit (ICU) patients. Introducing such measures to the ICU’s of Jacksonville is the purpose of the organizational change project. The following proposal will include the history, mission, vision, goals, and objectives that many facilities strive to achieve. In addition, the description will outline the proposed change, its rationale, and suitability to the organization’s culture. Included in the discussion are the needed steps, change theories, and resources for implementation, monitoring, and evaluation of the proposed change as well as plans to measure the outcomes.

Organizational Change Proposition-Part I

The American population is aging every year. The elderly community is also suffering the more life-threatening complications of physical failures. Offering the option of a death with dignity to cancer patients is a standard of care, but few facilities offer comfort care or end-of-life therapies to patients in intensive care units. Many older patients have often reached the end of their organs’ abilities and frequently endure painful and costly life-saving procedures with limited promise of changing the prognosis. Several studies have shown the growing need for offering comfort-based end-of-life therapies throughout intensive care units. Introducing palliative care in such areas is a proposed organizational change project for a local facility. The discussion includes support and rationale for the proposal in addition to determining steps and resources to implement, monitor, and evaluate the proposed change. The change theory used and plans to measure the outcomes are included. Providing the opportunity for a comfortable and dignified ending is an important option for the growing elderly population throughout the country.

Political Possibilities

POLITICAL POSSIBILITIES

Everyday in the practice of Nursing, I see RISKS. Nurses across the country work in precarious situations, not only a danger to patient safety, but to their licenses and livelihood. These situations occur due to staffing issues and patient acuity. The population is aging and health is deteriorating for many of these individuals. The responsibilities of nurses are increasing everyday and the higher acuities make it worse and more dangerous for nurses to provide even adequate care.

The nursing shortage is already at dangerous levels and is only going to increase. The changes are not occurring rapidly enough and they are rarely directed in the right paths.

I propose and hope to see in my lifetime these changes and I am HOPING that you will HELP me.

1) A federally funded nursing retirement plan: This could not only improve the influx of people into the profession, but also be a great benefit to nurse retention, especially if it includes past service and years of experience. This could bring nurses back to the bedside; if they were assured of having a dedicated plan for the years of service (Nurses who have left the profession after i.e. 12 years of service come back for eight years and have a full retirement). AARP recently noted that less than 60% of nurses have retirement plans. This federal plan would be portable from job to job. Facilities could enhance retirement benefits or provide other inducements to the profession with the funds currently in use. IF railroad employees, teachers, firefighters, and police officers can have full retirement after 20 years, WHY have nurses been left out? The nurses I have presented this idea to most frequently ask me that question. WHY is this idea not already in practice?

2) Increased political awareness and interest for nurses. Facilities should have a dedicated position related to nursing politics. I have talked to many coworkers and they agree that knowing more about how their local, state, and federal politicians vote on issues regarding nursing would affect not only their voting participation but how and who they voted for. (i.e. IF you believe patients and families have a right to know what SAFE staffing ratios are and how those ratios affect patient safety and care, in addition to how the facility they are currently admitted to staffs their floors, then a politician votes against a bill that promotes these issues, Would you vote for that politician??).

3) An agency that monitors the dangers and RISKS that nurses are often subjected to: to have written protocols and standards of what constitutes patient safety in relation to acuity and ratios. (i.e. What constitutes a 1:1 patient, a 2:1 patient, a 4:1 patient???). One that monitors how often those standards are not met and why. How to make it better to keep nurses at the bedside.

4) National Nursing Licensure

5) Better Health Care Coverage—since we provide so much of it, it should be a reward.

So much more, these are only a few of the issues I would like to see instituted and implemented and truly believe it will affect the future of nursing. So many agencies and groups protect patient safety and there are no real protectors of nurses and their work conditions. Such an agency will only enhance patient safety. The CAN (Center for American Nurses, part of the ANA) is a start, but so far, no one is really affecting change in workforce conditions, thus the NURSING SHORTAGE.

What Nursing can Mean Part IV

These are only a few of the pressing issues that need to be improved and examined to waylay the oncoming shortage and the danger this presents to the increasingly sick population coming into facilities around the country. Staffing is an issue unto itself and needs extreme measures and policies implemented to ensure patient safety, satisfaction and the care they deserve. Tied to this is nursing satisfaction. Patient safety and satisfaction decrease with decreased nursing satisfaction. Research has noted that patient mortality and morbidity, that is their deaths, increases with nurses unhappy in their situation. Safe staffing ratios can be found throughout nursing studies; many have shown that a nurse with more than two patients in a critical care area compromises patient safety and care, and the nurses on the floor should have no more than four patients to care for and ensure their safety. Some states have even mandated that hospital units advertise their staffing ratios so patients and families know what they are walking into.

Attitudes are changing; hospitals across the nation are adopting more nurturing and less punitive demeanors. Nevertheless, they seem to have missed the realization that as the nursing shortage continues; the value of a skilled and professional nursing staff that feels appreciated is paramount to the stability of any facility. NURSES will continues to leave this wonderful profession for the same reasons that they have left for the last many decades. NEW NURSES will LEAVE for the same reasons because the issues are not being repaired; the problems with this profession are not being fixed. These newly educated nurses are walking into seriously compromised staffing situations and viewed with many of this younger generation’s work ethic, they will not stay as long as the nurses currently in place.

What Nursing can Mean Part III

As noted above, nursing is one of the most compassionate, rewarding and enjoyable professions in this world. It is also demanding of knowledge, experience, and the ability to make life-altering rapid-fire decisions and all of the stress that that can entail. Nursing often requires more than adequate amounts of time, the time to assess patients’ thoroughly and accurately. In this way, nurses are more likely to note a deteriorating condition before it becomes life threatening as well as perhaps having the time to interview patients more carefully, thereby, determining issues that may present problems while they are caring for them.

More and more what a patient deserves is going to be in the manner that they are going to be lucky to get only what they need the most. Numbers show that in 10-20 years there will be a shortage of at least 800,000-1.2 million nurses in this country alone. Nurses continue to leave the profession or are moving into areas away from the bedside, sometimes through increasing education or taking jobs in other, often, less critical areas, or moving out of the profession altogether. Many facilities seem to be pinning their hopes on graduating nurses who have no experience or gut feelings that can prevent patient events. The fact of the matter is that without experienced and satisfied nurses the mortality and morbidity of patients will only escalate. Admittedly, more nurses graduating and getting experience will help with some of the increasing shortage, but working to keep and satisfy nurses who have been loyal and committed to a workplace should also be a high-level goal. Due to past business crises, many hospitals have decreased or eliminated the benefits that nurses received in the past and may be looking to decrease them further. This is the time to improve benefits and tuition reimbursement if these facilities want the better-educated nurses at the bedside. Better retirement packages should be implemented, whether on a hospital-to-hospital level or at the state and national levels. Increasing the salaries would also be of benefit. There should be no salary cap for nurses who continue to be educated. On not only a yearly basis but also many are back in college, obtaining higher levels of degrees and certification. Facilities should be just as concerned at rewarding their loyal and experienced nurses as well as encouraging new nurses. There should be no limit on how many years a nurse can earn a raise; they have only continued learning throughout their career. The fact that many new nurses are paid very close to the same salary as a nurse with 20 years of experience says a great deal about who hospitals and other facilities value.

What Nursing can Mean Part II

Many nurses find themselves in this situation today. Patients are increasingly sicker when they come into the hospital, with greater demands in regards to their care and needs. Their potential to arrest or just begin the often agonizingly slow spiral towards the light is when they need nurses with the time to assess and re-assess their situation. Time that can make the difference with an experienced and astute nurse caring for this patient, this nurse can maybe delay or prevent a sentinel event from occurring. This nurse uses years of learning to know the signs that indicate a significant occurrence is heading towards this patient. Often it may just be a gut reaction, but the chance to head off disaster is in the hands of this nurse who knows the warning signs and what to do to keep the pending arrest at bay and turn the tide when provided the time to care for this patient in a safe and uncompromised manner. This is the time that many nurses rarely have in an age where staffing ratios have not changed for the better in well over a decade. Most facilities’ ratios are built on the budget and the decreasing number of nurses, not the increased acuity of the worsening patients’ health characteristics. Standards need to be set based on the patients’ level of illness and the increased workload that illness places on the nursing staff to give them the care they need and deserve.

What Nursing can Mean

Nursing is many things to many people. It is often a profession, a career, a calling and to some, just a job. To love this job is to learn early on that when the rewards do not outweigh the negatives it may be time to re-evaluate. In the current nursing shortage/crisis, whatever some may call it, many are re-evaluating what this profession means to them. Every day they drive to work, often wondering, what the day may bring. Each day is often very different.

Will you have those few patients that make it all worthwhile, the 2-year-old that, once her fever has broken, follows you around holding your hand? She lets you know with her innocent trust, that you helped her feel better and that she has just made your shift a brighter piece of time, this is the one, that while you may not really have the time to play, you decide it’s a good time to make time. Is it the older woman with multiple organ disease and a loving family, who just wants her to be able to go gently into the night? Her family understands her desires and needs for a peaceful end; so, you soothe her with cool cloths and keep her as comfortable as possible, leaving the family the chance to share her final moments in time. While this may not be a physically busy patient, the emotional investments it generates, play a different havoc with your coping mechanisms on a busy shift. On the other hand, will it be that man, that, though seemingly sailing along on the road to recovery, the inexplicable occurrence happens. You find yourself and many others on the medical team, fighting to save this man from the circling four horsemen, whose dogs are nipping at his heels. When you pull him back from the breach, will you have the staff to cover his increased level of need? Will it have been another day of coming in only to find that there are not enough nurses on the floor and that the intensive care unit is currently full, but they are trying to find a bed?

Who Cares?

Who cares really?

Do those you work for really care?

I just want you nurses and those that claim to care to really CARE...

Those days that you are working to yet again save the life of your patient, whether they be the loving grandmother of soooo many children or the DOC lifer who may also be a child molester...Who's will is it to beg the difference???? My OH my...who's to decide who deserves better care?

But while you are working so hard to keep this person alive...PLEASE manage to discharge one patient and get to the bathroom another patient... and PLEASE...also get to all of the other computer work and paper work...LOLLLLLLLL. Is there new time on the clock? Has some magical power added a new day?

REALLY???

Make me a promise you can keep OH great administrator.....

Nursing Revolution: Change process for nurses

Nursing Revolution: Change process for nurses: "WE Need to be the change....Any nurses Feel like they get true support form their directors and administrators?I always feel like the last t..."

Nursing RevolutionSurvey for nurses interested in a federally funded retirement planis being considered.Those interested please post...The purpose of the study, and how the results will be used.This will be a quantitative study using survey research. The purpose of this study is to discover if a federally funded nursing retirement (a program that will guarantee 50% of retirement income after 20 years of service, and an additional 25% for every ten years of service, up to 100%. This will be pro-rated as decided later.) could help to bridge the gap in the nursing shortage for Northeast Florida. Would it promote nursing retention, longevity, and security for nurses currently working as well as prompting nurses to return to the profession? The results will be used to seek the aid of local, state, and federal politicians in organizing and instituting a nursing retirement plan. As one of the largest workforces in the country that provides caring and professional services to all communities, we deserve a retirement plan. We work long and strenuous hours with tremendous responsibilities and stressors and are justified in seeking this plan.

Change process for nurses

WE Need to be the change....

Any nurses Feel like they get true support form their directors and administrators?

I always feel like the last thought is how any change process affects nurses, including the effects the change places on a nurse practicing safely and the additional workload on already stressed situations...True autonomy and safe practice needs to come from the nurses at the bedside. Staff nurses should be at the forefront of the decision making process when any change process begins....NOT...and afterthought...