Back to work after a week off...What do you go to work for?

Just for money?
Just to socialize?
Or because you chose this caring profession because you care?
I love the people I work with and I AM the true nurse advocate... I hate the politics and knit-picking that so often make it a less caring and toxic environment...the ideologies (what most of my soap-boxes refer to) that just make it hard to do your job.
I love for my patients to feel better and feel secure in the care I provide. In addition, it brings me great joy to give excellent care and my main problem is that I get so frustrated by people who do not work to the same level. I LOVE being able to keep my patient alive and for as much time as possible safe from the four horsemen. It is a powerful feeling, this saving lives business.
And some days it is just making patients more comfortable.
Now, you can never change the fact that some patients may just never get comfortable or they may just be that personality that will never mesh with those providing their care, however, this is the time to just keep that professional smile in place and do your best.
The co-workers who do not measure up are also frustrating and they often make you wonder why they are there. If providing  great care is not the reason, what is? Giving great care means knowing WHY you are giving any care you provide. And being secure that it is the right direction for your patients. It also means keeping up, being organized and thorough, before you need to be. This saves lives and keeps your coworkers wanting to help you...
And lastly, it really helps to work in a place you look forward to going into. Knowing your managers and directors care about your well-being as well as the situations you work in being manageable, not just crunching and/or fudging numbers or providing new mandates that rarely make your job easier. As I have said before, it does not have to be Disney World (the happiest place on earth), but it does not need to be a hellish or toxic environment either.

What Nursing Can Mean--New Followers Re-post

An Article from the Nursing Center--Nurse Staffing and Inpatient Hospital Mortality

 

SPECIAL ARTICLE

Jack Needleman, Ph.D., Peter Buerhaus, Ph.D., R.N., V. Shane Pankratz, Ph.D., Cynthia L. Leibson, Ph.D., Susanna R. Stevens, M.S., and Marcelline Harris, Ph.D., R.N.

N Engl J Med 2011; 364:1037-1045March 17, 2011

Nurse Staffing and Inpatient Hospital Mortality

BACKGROUND

Cross-sectional studies of hospital-level administrative data have shown an association between lower levels of staffing of registered nurses (RNs) and increased patient mortality. However, such studies have been criticized because they have not shown a direct link between the level of staffing and individual patient experiences and have not included sufficient statistical controls.

RESULTS

Staffing by RNs was within 8 hours of the target level for 84% of shifts, and patient turnover was within 1 SD of the day-shift mean for 93% of shifts. Overall mortality was 61% of the expected rate for similar patients on the basis of modified diagnosis-related groups. There was a significant association between increased mortality and increased exposure to unit shifts during which staffing by RNs was 8 hours or more below the target level (hazard ratio per shift 8 hours or more below target, 1.02; 95% confidence interval [CI], 1.01 to 1.03; P<0.001). The association between increased mortality and high patient turnover was also significant (hazard ratio per high-turnover shift, 1.04; 95% CI, 1.02 to 1.06; P<0.001).

CONCLUSIONS

In this retrospective observational study, staffing of RNs below target levels was associated with increased mortality, which reinforces the need to match staffing with patients' needs for nursing care. (Funded by the Agency for Healthcare Research and Quality.)

Is this a surprise for anyone? Really?

I have read many studies that show a correlation between proper staffing an many sentinel events, i.e., not only patient mortality, but, medical errors, patient falls, pressure ulcers, and increase in infections as well.

And, OOPS..by the way, these studies have also shown that proper staffing also improves nurse satisfaction and decreases turnover rates...

My oh My, what a revelation and a shame that such a study is needed.

What Nursing Can Mean--New Followers Re-post

Health Care for the Future of the Aging Population-4

A plan for adding alternative therapies to the comfort measures in place for patients in EOL situations will provide greater options in providing care. The complementary treatments such as music therapy, aromatherapy, massage, and healing touch provide significant levels of comfort. The therapies soothe patients in terminal care conditions, stimulating fond memories through scents and music and promoting pain relief via massage and healing touch. A strength is that both aromatherapy and music therapy can be provided for minimal cost expenditures. Providing both of these touch therapies could be accomplished for low to moderate financial requirements. Healing touch can be an option for patients during any bathing, turning, or moving procedures. Aromatherapy and music can be supplied to the patients at regular intervals around the clock. Massage therapy can be incorporated into the physical therapy regime for EOL patients and healing touch can be taught to the nursing care providers at all levels. An additional strength is that none of the treatments have significant risks nor will the therapies interfere with intensive care unit functions, care provision, or equipment, the staff may also benefit from the comfort provided.

Some weaknesses of the plan will include resistance and opposition by staff members to an increase in the workload if the plan does not incorporate the time required by the touch therapies. Aromatherapy and music therapy should not increase work requirements as long as the supplies are available. Another weakness may be in the lack of understanding by patients, families, and staff of the benefits of these treatments. Seeing them as giving up or encouraging death will be some views of the therapies and palliative care that will need to be addressed. Educational programs will be one of the significant costs to implementing the plan.

Opportunities of the strategic plan to implement complementary therapy into palliative care programs of ICU’s include the chance to educate the healthcare providers, public, insurance providers, and the community as a whole. The education should include not only responsible decision making for EOL health conditions but being able to choose the comfort measures desired when a terminal situation arises. Preparedness is a better measure for the increasingly sick population that will be seen in the coming years. Implementing these simple and noninvasive alternative measures into the comfort care of the dying will open the doors to integrating other complementary therapies into more healthcare situations. Here will be a chance to educate administrators and upper management about alternative treatments that often are paid for out of pocket by clients and that patients seeking these therapies will provide revenue to the facility.

Re-Post--What do you want from NURSES of the FUTURE?

Do you want sheep? Followers who never question? Never Wonder?

Why Oh Why are hospitals going crazy about No Wait ER's? It is an EMERGENCY ROOM. NOT a doctor's office, NOT a clinic. ARRRGGGHHHHH.....IN Emergency Rooms, emergencies happen...Oh My!
And that now emergent hangnail may actually have to wait, and why would it be encouraged to STRAIGHT Back complaints that are in No Way an emergency?????

NO Wait ER's validate using the ER as a clinic or doctor's office. Validate stupidity and a waste of resources.
Many of these people should be #1 managing their symptoms at home, #2 using community resources including their local pharmacy for meds to treat nausea, vomiting  and diarrhea, fever, cough and flu symptoms, all of the basics covered in the local pharmacy aisles (OOPs, you may have to pay for that, OH and pregnancy tests can be done at the dollar store), and #3 go to your family doctor or clinic, (yes you may have to wait but that does not make the ER the appropriate place for your problem). And yes you are expected to pay for your ER visit too, though tooooooo many come in with NO intention of paying.

This is an area that all of these wonderful administrators and politicians need to focus their healthcare reform:

1) Personal responsibility for healthcare choices: you must live life to the fullest, but stop expecting people to cleanup after you, if you smoke accept the consequences, if your choose to drink to excess, do not expect a liver transplant, be compliant with your healthcare or have your palliative care plans in place. (My first book will be "Party Like a Rock Star, But Sign Your DNR")

2) Public education regarding use of the ER, hospitals, doctors offices, clinics, etc.: i.e. you can throw up more than once without running to the ER, unless its a bucket of blood. That may be impressive. And wait more than a half-hour after throwing up ONCE to call Rescue to take you to the ER. And when you call rescue, have a way to get home, your transportation is YOUR responsibility.

3) Community resources need to be expanded to 24/7 clinics with a pharmacy when overcrowded doctors offices are not available or cannot keep up, they should also be taking extra patients instead of sending everyone to the ER. Pain management centers should also be available 24/7, with pain contracts that must be honored.

4) Public education of the proper use of Fire/Rescue. Do Not call them for non-emergent situations while your family that could have brought you in beats you to the ER.

5) Here is a BIG ONE Politicians: Prisoners, especially death-row inmates, have lost their rights to vote, yet they seem to have access to the best education and the best of healthcare. This is wrong when, today, people in the community who contribute and work hard can hardly afford to provide healthcare for themselves. People on death-row should have DNR on their healthcare records and never, NEVER get a transplant...LUDICROUS. Treat the active community first, you could probably set up accounts from all the free stuff for prisoners...Dialysis for child molesters and rapists...Really??? Why not let nature take its course in all of these instances. Instead, because payment is fast and certain, doctors jump at treating these UN-Fine people over people who actually contribute to society.

Re-Post about how we do a disservice to our patients

Dis-Service to our Patients

It is and will always be a DIS-SERVICE to our patients to treat them as clients or customers in a service industry.

This is a life-saving, health education providing, caring profession, but more sugar or lemon for their tea is not a priority. The customer is FAR from always right in this instance. In fact, they are often wrong, thus their many health issues and repeat performances and returns to the ER and hospital re-admissions.

Medicare is looking at not paying for re-admissions for the same diagnoses. Now how are the powers that be going to fudge the data on that to get paid? CHF is one of the most common re-admitted diagnosis of patients coming back. Wound treatment is right up there and often that is due to in-hospital acquired occurrences. Come-on, it is 2014 and wounds obtained in the hospital should not be happening. As falls and medical errors should be exceptions...Are they?

Education is the key to staff, patients and families. Choices exist for all. But, Responsibility for those choices should be the most promoted part of the education process...

READ PAST PUBLICATIONS to see more...

New Followers Greatly appreciated...

I am on vacation, visiting my son...
Will Re-post some older blogs for the new  and old followers...
Thank you all for following...

Pride in what we do as nurses

Every day, every decision we make as nurses can affect any patient we have. Knowledge and autonomy often saves the patient from harm and protects your license. Knowing why you are making decisions in the care of your patient not only provides them comfort and security but in many instances can ward off the evil spirits or four horsemen following them around. Many professions have hidden superstitions. "Tying the ends of the sheets" can keep your patient alive until the next day or shift and on the big holidays, it's a practice I've utilized, as much for the patient as the family. Nothing is harder than holidays without your loved ones. And sometimes, it's worked. In addition, the theory that death and trouble comes in threes, has yet to be unproven.
Going the extra mile is so important. And when there is time, I make every effort to make it part of my day. So many patients have told me I spoil them and the bottom line is that I really hope that some other nurse will care for anyone I love in the same manner. And I rarely consider it spoiling, I am frequently all about better living for the patient through comfort and chemistry. I am not going to change or fix someone hooked on narcotics or highly anxious or just the patient needing some extra TLC in the few hours or days I care for them, but alleviating their pain or anxiety through medication or just freshening and fluffing that pillow can make all the difference. And my night goes much better when the patients are comfortable and they feel more secure.
Being really good at what I do is as important or more so than the money we can make as nurses, and except for the exceptional few, I am seeing way too many new nurses coming out thinking it's ALL about the money. They often have little pride or true caring about the patients they provide care for. And this is THE CARING profession. You have to care about the patients to do your best for them. The money is an after thought when you are using all of your Knowledge and skill just to keep someone alive. The money should always be an after thought when you have Pride in what you do every day whether it is in saving lives or just tucking someone in with a warm blanket.

What does nursing mean?

As one of the most trusted professions, many nurses have earned this distinction. Through providing competent and knowledgeable care, patient's are comforted when their nurses are confident in the education and care they provide. We have to know why we do the things we do. And, if you do not know, always question the why's of the care we provide. Do not just do it because someone else, whether doctor, manger, or co-worker, tells you to. Or better yet, because you saw them do it. Know the rationale behind ordered treatment and chosen therapies.
This is just one of the many ways to develop the gut feelings that will guide you through keeping the four horsemen at bay. Learn and understand WHY you are doing anything for your patient. Whether it is simply providing comfort or making the decision to treat a low BP with either fluid or vasopressors, knowing what you need before calling a doctor with a problem can ward off their frustration and often earn their respect.  And first and foremost, your patient's will always be safer this way.

Who Advocates for Nurses?

When you walk into work do you look forward to being there, knowing you have enough experienced staff to handle whatever situations occur? Does all of the equipment function regularly? Do you feel valued by those who direct and or manage your situations?

SO much of every day is about the people you work with, but nurses deserve to have someone watching out for their needs on a daily basis. Who does that? Is there nursing advocacy, a dedicated representative who helps fix issues in the workplace?

I enjoy where I work, more because of the great people and so many times that makes it okay. However, many days, times are tough, for staffing and the standards in care.
If we matter, changes should be part of the process. Nurse-to-patient ratios should be part of the policy related to patient acuity. This can guarantee not only the best way to provide the best care for our patients but also to protect nurses and maintain their ability to provide focused and able care without the stress added by insufficient staffing, poor equipment or other poor work situations.

Standards should be in place when the nurses have all of the patients that they can safely handle. It is unsafe practice not to. When bad days out number the good, who fights for you?

I know many managers claim to do so, but it is a very fine tight wire they walk. So far, I have seen few who can manage to keep the BUDGET and the ever-changing goals and rules intact. In addition, they seem to find it very difficult to make nursing satisfaction an equal ideal. And my most favorite response to nursing dissatisfaction is LEAVE if YOU do NOT Like it...You are Replaceable..
Can they guarantee your replacement has your experience and education? NOT in so many cases, that that attitude is not only ridiculous but shows you really seldom matter.

How may times have you had all the overtime and more that you can handle, for long periods of time? Only to be later told (after you've become very comfortable with that income), that there will be no more OT, and that can often go on for a very long time, where they are even bringing in less experienced nurses so they do not have to pay overtime. (Perhaps another topic for another day)

Has anyone ever had a true nurse advocate?

Why I LOVE Nursing and feel we deserve....

Autonomy, Respect, and Standards in the work place to protect our license and the care we provide every patient.
I wrote this several years ago and part of it was published in the Florida Nurse, through the FNA:
It is still true today and some of the main reasons I am still at the bedside and as much as I may rant and rave at current situations, I TRULY Love what I do and always strive to excel:

Nursing and All of Its Possibilities and What the Future is Bringing

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? 

    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.

    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.

    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.

    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. JCAHO, OSHA, and AHCA are just a few of the alphabets 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 ratios? Where is the alphabet soup FOR nurses? Who ADVOCATES for Nurses?

    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.

Looking to the Here and Now so we have a Future

The day is past dawning for changes in the profession. We need controlled workplaces and improved benefits. We need to have a voice in all decisions that affect our practice. Nurses need to be involved at all levels of the decision making that affects their work situations. There are so many options to be involved now and many of them are in a point and click manner. Be aware of the many state-level and national issues affecting nursing that are discussed regularly by your representatives. There are many bills that have never made into becoming a law because nurses will not get involved even at the simple, do-it from your computer level. Some examples are: lift-laws, staffing ratios, making bedside nurses a main piece of the decision making process in hospitals, and in my state, the last one to continue to restrict ARNP's from prescribing level three narcotics. Be involved in your nursing associations, they often have their own lobbyists that help to protect your profession, and give you the opportunity to be a part of deciding the best options for your practice.

What makes you want to come into work every day? Do you look forward to starting your shift knowing that standards are in place for your staffing and patient ratios? Even better they are honored regularly. That's the way it should be... Is it where you work?

Specialty Nursing Certification--Benefits you if you work in the right place

Organizations and articles show that specialty nursing certification benefits nurses through improved continuing education and benefits patients in this way also. As one of the most trusted professions, certification provides a sense of stability and comfort to patients in the advanced knowledge these nurses attain. Employers also benefit from the respect and security felt by patients who are cared for by certified nurses and can feel secure themselves with highly trained staff.
These sites offer more information:

http://www.aacn.org/wd/certifications/content/benefitstoptempnrs.pcms?menu=certification

http://www.medscape.com/viewarticle/717805

The Medscape article claims that a 2006 survey showed certified nurses made $7300/year more for said specialty certification.

http://www.nursingcertification.org/pdf/white_paper_final_12_12_06.pdf (2006 survey)

This survey shows that close to 2500 surveyed offer NO Incentives. It also cites lack of institutional incentive and support as barriers to certification. May be a CLUE... or do they just need the board game.

Do you know where?

I plan to look, because many places in my state don't seem to offer such incentives. Yet they seem to think the certification which often requires many more CEU's to renew is okay to expect and/or mandate that you do. Incentives and salary differentials seem like a better plan. I suspect one day such certification may be mandatory in some workplaces, as well as higher levels of education, which few facilities reward. This is especially true for experienced nurses who have reached the cap of the payroll limit for their years of service (Yet again, another topic for another day). Here is the CLUE, for all of the places who find incentives beneath them. Make it....WORTHWHILE, it costs time and money, continuously.

CCRN-CEN??? DO they make it worth it?

NOT just in the monetary sense, that is a topic for another day. BUT, just FYI, there are actual facilities and states that pay $/hour for being certified in your training specialty.

Today, consider the critical patients you care for on a daily basis and how safe or unsafe you feel in your practice. Especially when they are handing you the responsibility of even another patient when you can barely get out of the room of the current TTD (trying-to-die) patient.

DOES the place you work have formal guidelines for what constitutes a 1:1 patient? It is more than just treating a patient with an IABP or running CRRT or ECMO, or initiating a hypothermia, TPA, or sepsis protocol. These are the DUH factor, but how many other patients get paired or more? Every area with any standards should have policies that protect the patient with such guidelines. And safe staffing should be maintained.

Many organizations have statements and standards relating to what constitutes 1:1 care and 1:2 care and so on. They provide guidelines for what protects your practice and constitutes safe care delivery.

As your director or manager encourages you to be certified in your specialty by such entities (i.e. AACN or ENA), think about whether or not they honor the standards recommended by these organizations.

Give thought...should you have time, when the next shift you have the crazy busy night and you know you are just lucky if the patients all survive, much less get the care they deserve and the care you chose this profession to give. The night you are thankful to grab a sip of some refreshing beverage, maybe from the sink in the room (YUCK) if you are allowed, and again very happy to actually make it to the bathroom, some times that day or night. These are the times to just give it a thought. Is the certification worth it, if they cannot even HONOR standards for those TTD's?

FYI--Drinks at the Nurses Station---NOT a JOINT COMMISSION MANDATE

Ever felt Dehydrated saving your patients lives? Felt like you are dying of thirst and may need a leg bag because you do not have time to urinate either? This is after you have spent hours on your feet keeping one or many critical patients safe from the four horsemen? And now you are told that even cups and bottles with those refreshing, invigorating liquids, and even just the fluids that keep you going and keep your patient alive and HAVE SECURE lids are NOT allowed. AT the NURSES Station which is NOT where you treat patients. I am not saying I am going to dribble my coffee that I NEED so much onto my patient while I change his dressing. But, yes I do NEED to be able have a beverage for hydration or energy within a reasonable range. Too many nights I can barely leave the actual bedside of the very critical patient, much less go to a completely different area where I cannot monitor or get to my patient in the often continuous life-threatening situations that occur in a 12-hour period. The nurses station is that spot and ad nauseum a Place where my patients are not being treated.  I also should be able to get to the bathroom as needed, but that is also frequently very difficult. Maybe they can mandate that I have to go to the bathroom on another floor also, just to make life and the work situation even easier...
And they often blame these rules on JCAHO...
Hope they know they are getting all the blame...
SO: For the record...

From the Joint Commission Website

http://www.jointcommission.org/mobile/standards_information/jcfaqdetails.aspx?StandardsFAQId=87&StandardsFAQChapterId=69

Q:  Are food and drinks for staff members allowed in patient care areas?

A:  The Joint Commission standards do not specifically address this issue.

 

However several other points apply:

• Standard LD.04.01.01 requires compliance with applicable law and regulation. The OSHA Bloodborne Pathogen Standard prohibits food and drink in areas where contamination is likely. For example, if lab specimens are handled in a work area, the OSHA standard would prohibit food and drinks if contamination might occur.
• Under the same LD.04.01.01 standard, many states prohibit food and drink in clinical areas, requiring that they be consumed in break areas.
• Many organizations have policies that prohibit this for infection control, risk management or even public appearance purposes. These are often established after conducting a risk assessment, as required in standard IC.01.03.01. Organizations must be in compliance with their own policies.
• An Environment of Care risk assessment should be performed to address potential patient safety issues, per EC.02.01.01

BY policy at my facility: Food and Drinks are not allowed in clinical (by definition an area where patients are cared for) or patient care areas. The Nurses Station is not where I provide care for or treat my patients and I bag their body fluids in the room, not where I eat or drink. Lab bags in the Room...OH MY...What a thought....