What Nursing Can Mean--New Followers Re-post

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.

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?

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??).

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.

National Nursing Licensure

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--New Followers Re-post

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.

Because I feel IT--Re-post

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)

Because I feel IT--Re-post

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?

Re-Post

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.

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...

From the ANA Smartbrief

Researchers find almost 50,000 opioid-related ED visits in 2006: Researchers reported in the journal Pain Medicine that opioids resulted in almost 50,000 visits to emergency departments in 2006. According to estimates from the FDA, the number of Americans age 12 and older who abused extended-release and long-acting opioids increased from 29 million in 2002 to more than 33 million in 2007, an expert said. United Press International

And how do you spell Dilaudid? Narcotics instead of alternative pain measures should occasionally be considered, that or 24/7 pain control/management companies.

Re-Post

Just because I still believe in all of this so strongly...

Nursing Revolution: Nursing Revolution: "When will nurses care about their own practice?And get involved?I did this blog 3 years ago and got NO response, so I seldom kept up with it..."

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.

Re-Post

Couple of ideas to revisit...

Nursing Revolution

When will nurses care about their own practice?

And get involved?

I did this blog 3 years ago and got NO response, so I seldom kept up with it, let's see if facebook or twitter help. One thing about the internet it stays around a very long time.

Nurses need to determine how and where their practice goes and how it develops for their own autonomy. Staff nurses should be the ones to decide what is safe for staffing practices. They are the ones at the bedside, they know what patients require and demand. Bedside nurses should be the ultimate in the decision making process for staffing, equipment and other such patient needs.

Here's a question:

How many nurses believe that point-of-care testing should benefit the staff that draws the blood, runs the tests and trouble-shoots the machinery???

I vote for Nursing Revenue from POC testing.

From the ANA Smartbrief

ANA asks Congress to preserve funding for Medicaid
The ANA and its members are lobbying Congress in support of Medicaid, and the association also sent a letter to House and Senate lawmakers voicing its support for legislation to expand Medicaid-covered services by advanced practice nurses. The association launched a website to keep nurses updated about Medicaid. "The fight to preserve Medicaid is one of life and death -- the difference between having access to quality health care or not. It is a battle that we as nurses are ready to take on," ANA President Karen Daley said. Nurse.com (6/10)

I have to ask again...What is wrong with the world? The majority of people who have Medicare have worked all of their lives to EARN it. The many people on Medicaid have not. Even when you exclude those that really need it, i.e., those with lifelong illnesses, true disabilities, and chronic psychological diseases, you have way too many on Medicaid that can work, can earn their own insurance abusing the system. Everyday we have people come in to the ER that have called rescue for non-emergent situations because they have Medicaid. Then they don't have a ride home and expect transportation.
I will gladly buy people some bootstraps so they can pull them selves up and take responsibility for themselves.
Really...the key words for the future of healthcare should be personal responsibility...

Re-post

This too...Fits the mold...

WHO Advocates for Nurses?

Just another day that makes you go HMMMMMMMMM.......

You go to work and think, today will be Good. Things will go just fine...

Then you find a patient slumped over and realize that syncope may be real...

SO much for that telemetry floor she was going to, as you fight to keep her breathing and not intubate her.... Oh so glad she wakes up and is only a little confused...LOL..

Another life preserved...

Calling for help sometimes is another thing that makes you go HMMMMMM....

Do you take the time or just do what you need to do...And GOD help you if the intercom once again does not work and you have just wasted valuable time...

With Brains and Hearts...Time IS Muscle....

Anyway......
LMAO

HMMMMMMMMMMMMM.....

Re-post

This seemed to fit right in with the last article

Monday, January 31, 2011

Nursing Appreciation...

Really? Who does? Many studies find that we are the most trusted profession, but that never stops the impatient patients and families and those that NEVER find all we are trying to do to help them...

ENOUGH

Enough entitled of the entitled society that never says thank you and thinks that we owe them their healthcare and why aren't we handing them the doggie bag of meds while we are at it...Please include the Dilaudid and Phenergan...

Does administration really appreciate nurses? Hey you Nurse...Work another shift of overtime, but you better not be late or take a sick day...and by the way your socks are WRONG...go home and change and work another 12-hour shift...LMAO...LUDICROUS...

From the ANA Smartbrief

ANA voices concern over analysis of nurse labor costsHospitals spend an average of $98,000 annually for direct-care registered nurses, including $55,739 for base wages, according to a study by KPMG. The study found that 76% to 78% of nurses' total labor costs go to wages and payroll. The ANA, however, said the study sample size was small, the salary information didn't reflect current data, and the analysis didn't account for the relationship between nurse labor costs and how the hospitals benefit from them. FierceHealthcare (6/9), Healthcare Finance News (6/9)

Really, being one of the 24/7 nurses whose there at the bedside, making life-and-death decisions, saving lives and making a difference...Yes that sounds like less than they should be spending. I am concerned that there is any question as to how hospitals benefit on a not only daily, not only hourly, but on a minute to minute basis from nurses in their employ...

Again really??? There are seldom any real perks to the nursing profession anymore. Insurance costs are higher and higher annually, for those people at the bedside around the clock. Medical companies can no longer offer the fun gadgets they used to provide for listening and learning about their medical drug or product, and they were things we actually used to provide care...WOW what a tragedy they gave us little items that might have made work easier and we got to learn too... SO many changes, not for the better, and so many more responsibilities that are just to be taken for granted...Like nurses across the country...

Come on Nurses, get involved and aware of what you need to do to make the profession yours and not the hospitals and governments....

Re Post...From the early days

Get Involved...Only you Can Protect Your Practice

Did you know that there have been Bills in the Florida Legislature to make it mandatory that bedside nurses are part of the decision making process, that they share and contribute to how changes and policies take place?

It's time for those that actually care for the patients to be the main part of that Decision Making Process. This can affect staffing ratios in addition to the actual practice policies and procedures.

Be a Part of what happens to the way you Practice..Be a voice and part of the Say SO...

Re Post...From the early days

Nursing Appreciation...

Really? Who does? Many studies find that we are the most trusted profession, but that never stops the impatient patients and families and those that NEVER find all we are trying to do to help them...

ENOUGH

Enough entitled of the entitled society that never says thank you and thinks that we owe them their healthcare and why aren't we handing them the doggie bag of meds while we are at it...Please include the Dilaudid and Phenergan...

Does administration really appreciate nurses? Hey you Nurse...Work another shift of overtime, but you better not be late or take a sick day...and by the way your socks are WRONG...go home and change and work another 12-hour shift...LMAO...LUDICROUS...

From the ANA Smartbrief--Interesting Articles

Freestanding EDs compete with hospital units for patients
Health systems are opening freestanding emergency departments in suburban areas that already have good access to care, creating competition for hospital-based EDs. Data from 2009 show a 65% increase in the number freestanding EDs spread across 16 states over a five-year period. Kaiser Health News (5/31)

Right now we are busy almost everynight and this seems like a great answer...

3 hospitals recognized for work hours, employee wellness programs
Working Mother magazine, in its 2011 Best Companies for Hourly Workers, recognized University of Wisconsin Hospital and Clinics and Bon Secours Richmond Health System in Virginia for having flexible work hours, offering health insurance to part-time employees and promoting higher education to nurses. Meanwhile, UNM Hospitals in New Mexico, the third hospital recognized by the magazine, prioritizes the health and wellness of its staff through nutritional counseling and health coaching, among other programs. NurseZone.com (5/31)

The Wow factor for healthcare facilities that actually seem to want to retain their knowledgeable and experienced nurses...Yeah...Need more across the country...

From the ANA Smartbrief

Nurses feel empowered to make decisions with shared governance
Adopting shared governance helps empower direct care nurses in decision-making, according to this article. Diana Swihart, a nurse expert on shared governance, names four important factors in creating this environment, including a committed nurse executive and a strong management team, and said that a design team composed of nurses and interprofessional teams is needed to make the transition to shared governance. HealthLeaders Media

The present and future nursing shortage can make our lives a lot harder than it needs to be.

We can make the difference in how the future unrolls and how our workplace issues worsen or improve.It does not have to be a union. It does not have to be anarchy. It just has to be enough nurses with enough voices to make the difference.
I want so much more for nurses.

Shared governance is the answer to many nursing issues, but it requires an administration and management that truly cares about maintaining nursing satisfaction, autonomy, and workplace safety.

From the ANA Smartbrief

Wow...Some interesting articles

CMS issues Medicaid nonpayment rule for "never events"
The CMS announced Wednesday that it will stop paying hospitals and health care providers under the Medicaid program for reasonably preventable health care-acquired illnesses or injuries, such as those caused by an air embolism for blood incompatibility. States have until July 2012 to comply with the rule. "These steps will encourage health professionals and hospitals to reduce preventable infections and eliminate serious medical errors," CMS Administrator Dr. Donald Berwick said. "As we reduce the frequency of these conditions, we will improve care for patients and bring down costs at the same time." Kaiser Health News (6/1), Nurse.com (6/1)

Can you say wound prevention and fall protection, not to mention medication errors?...Again
This could be a big WOW for the future...
Standards for Nursing Homes should also be a primary factor for this decision. Like higher levels of qualified staff and improved levels of care.
Majority of these incidents occur in Nursing homes.

Hospital patients' phones more likely to carry bad bacteria than staff's
About 40% of mobile phones belonging to patients and their visitors contained pathogens compared with 21% of phones owned by medical staff, according to a Turkish study in the American Journal of Infection Control. The study of 200 phones also found that several phones that belonged to patients tested positive for drug-resistant pathogens, but none belonging to staffers did. HealthDay News (6/1)

Very interesting. What happens to these phones?

HHS review of rules could benefit hospitals, others
HHS will review its regulations as part of a broader effort to streamline federal rules. Among the expected changes that could affect hospitals, as well as other providers, are credential rules that ease the use of telemedicine and fewer requirements for participation with the CMS. Nurse.com (5/26)

Technology is the future and we need to be prepared for the changes that it will bring to the increased needs and decreased nursing staff of the future...