This Bill is again being discussed...

Did U Know?...

The 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?????????????????????????????

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What are your ideas???

What exactly is short staffing? Is it the too frequent standard of some matrix that only those that manage the staff know about? Too often just having a patient care tech to relieve some of the ringing phones, calling patients, or watching the monitors can make a difference.

Just last week I had to tell a patient who needed help going to the bathroom that I would send in his nurse as soon as I could instead of going into help him myself. I truly felt really bad about it, but my 1:1 patient was losing his blood pressure and I was starting yet another vasopressor and hanging fluids. And AGAIN there was no other help to be had. Short staffing is NOT safe for Patients

A) Like when JCAHO or OSHA or AHCA visit? (Like does safe staffing really matter any other time). Funny how much staff is available when the alphabet soups are expected. How about they show up and see staffing as it really can be. Maybe staffing ratios could be a NATIONAL PATIENT SAFETY GOAL. It truly is, but never gets treated as such.

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, falls, and pressure ulcers. OH so many issues for nurses and patients...and SO many OH NO's from 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)

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What Will IT Take to get Nurses Involved in Protecting their OWN Practice?

It truly is a point and click world and you can be involved and actually keep in contact with your local and state representatives. Many of your state nursing associations can provide the issues and the means of contact. However, it can also be done independently. So many Bills, so little time.

Do not leave how you practice up to the medical associations and hospitals. Do NOT let them be the only ones to decide your nurse to patient ratios. Truly caring about your practice, your license, and bottom-line...your patients...means taking matters into your own hands and having a voice in such decisions.

So many states have actual laws regarding staffing ratios, that protect patient care and your license. Yet, here in Florida the state has yet to allow nurse practitioners full controlled substance prescribing abilities. In addition, it is the last state to maintain this decision. And who other than ARNP's  primarily care for patients in long term care facilities and patients with critical and painful end-of-life illnesses?

Also, many nurses here in Florida just keep taking the nights and days of providing care with budget minimizing staffing with little complaint. Where there are seldom written standards for what constitutes 1:1 acuity. AND NO LUBRICATION for the pleasure of having that severely critical patient paired with another patient.

It is LUDICROUS any time that patient acuity is based on a budget or staffing. By definition Patient Acuity MEANS Patient situation and level of care. And who should decide that but the nurse at the bedside. FINAL ANSWER.

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 (JCAHO, OSHA, ACHA, etc., ad nauseum) to tell me what is right for my patient's...

 

I Want...

 

Nurses that Care...I always start with the idea that I am going to treat this patient the way someone I care about should be treated. With caring and respect and my best effort to make them comfortable... Now, on another note..I would not tolerate any of my family members being an ASS and acting entitled, or that I owe them a particular type of care just because they came in today. 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...

 

I Want...
 

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...It will save your butt and always ensure the care of your patient.

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It is a Point and Click World...

Did U Know?

That in the Florida House there has been a bill related to the 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 DIE in the limbo of government officials. Those who are most affected are the least involved in the process--Patients and NURSES.

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........

 

IT IS a Point and Click World. Nurses can easily get involved by being a part of organizations that work to influence the government and lobby for changes that protect nurses and their practice and work situations. And from being in touch with your representative to voting on bills you find worthy, it can all be done from home. Of course, more involvement is always encouraged and available, but you can be involved from the comfort of your home on the few days you are not working overtime or just dealing with life.

 

GET INVOLVED TO PROTECT YOUR PRACTICE

 

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Love Nursing?

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...

A Wonderful Life

It is a wonderful time for nursing. There are so many opportunities for everyone who chooses this profession. From Nurse Anesthetists, Practitioners, and Educators; the choices are endless. As more and more nurses join the workforce, we need to also protect the bedside nurse. Very many nurses are jumping into going back to school and the new nurses are doing faster than ever before.

SO, what does this do for the nursing shortage,? It certainly does not fix the coming situation.

The new nurses are much less resilient and very much less tolerant of current workplace conditions. They seldom work to fix it, they just see the greener pastures of furthering their education and work towards leaving the bedside. The massive push to quickly graduate new nurses that was aimed to replace retiring nurses, certainly looks to be back-firing. As it gets easier and easier for nurses to choose other pathways, we have to find a way to also encourage and make it beneficial for nurses to stay at the bedside. Do what you can to make changes in the workplace that make it intolerable to stay at the bedside while you are there.

I still love what I do at the bedside, and love giving excellent care. All of the peripherals, politics, and management leaves me cold; because, I seldom truly feel supported to make the workplace a better place to be. Short staffing is never going to improve if the bedside nurses keep leaving. Again, the managers who feel that nurses are so easily replaceable should maybe just shoot themselves in the foot. Because they are not realistic and they drive nurses away from patient care. They keep increasing patient care loads and not for patient safety or staff satisfaction. Making the nursing shortage a continuous cycle. AND...

Many nurses are getting very close to retirement age, these are the nurses that have stayed at the bedside for decades and longer. They are weathering the past storms and they will not be there for the future hurricane coming.

Past, Present and Future--Re-Post with Additions

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...

 

Do you actually speak up when everything about your night screamed UNSAFE in how you were able to provide care for your patients? Was your 1:1 patient paired with yet another critical patient?

Did you actually get to sit down to chart or rest or eat, or even speed to the bathroom to do whatever you need to do??? What a concept... 

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Nursing Intervention in their own Practice

Nurses need more of a voice in their own practice and to take ownership of how their working situations develop and are maintained. Lemming nurses are not needed in today's economy or workplace. Just accepting all mandates and decisions by management is ludicrous. Whenever changes are proposed consider you workplace situation and how that will effect your practice, question or have alternate ideas ready to make you own situation safe.

 

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...

 

Your state nursing associations are one of the best ways to aid such bills to be passed. The Florida Nursing Association has their own lobbyist and they are always promoting issues for the betterment of your nursing practice. Look into it, students can join at a discount, and I know very many nurses who are back in school. Find out how to better serve your practice and your patients.

Re-Post with Additions--So True still today

Nurses need to Take Care of Nurses

A Nurses View of the Shortage…

As a nurse of over 20 years, there have been many changes.

Nursing continues to be a fulfilling and rewarding profession and one that’s easy to love after all of this time. Taking care of my patients and their families, making them feel better and helping them through the illnesses and life threatening diseases that often bring them to the hospital makes coming into work every day worth it. Their care often includes making snap-decisions that will help save their lives and being proficient in medications and life-saving equipment is only part of why experienced nurses are important. Sometimes the care also includes helping them on their journey to a better place, to “go gently into the night”. There are so many parts of what it takes to make the caring, supportive and knowledgeable nurse.

The decades have continually increased nursing responsibilities, experience and education. Along with this there has been very little compensation, respect or appreciation in a profession that is facing a severe shortage. Understaffing continues to be looked as a “just deal with it” issue, and when concerns arise that patient safety is compromised, many are told, “if you don’t like it you can leave”. That and too many managers seem to feel that all nurses are easily replaceable. More and more responsibility and patient load is added to nurses’ shoulders, and they can barely manage the care they have to give, much less the care they want to give. That extra TLC that can be given when time allows, often when the nurse may not have even had a chance to grab something to eat or drink, or make it to the bathroom, when all shift you have been wishing for a leg bag, is often put on hold for the next crisis taking precedence.

Well, nurses have been leaving for years, and can now leave easier than ever.

This attitude is ever-present and seems to be getting worse with the shortage.

Standards to be a priority and the acuity system should ONLY be based on the patient's dire circumstances NOT staffing or a budget. Great nursing comes from caring and experience, not the new nurses who too often want to jump into situations they do not comprehend. It takes time to learn and develop gut reactions. I will say again...ALWAYS Question and demand respect for what you do.

Re-Post--watch the ER seizure link...So true and so funny

Did U Ever Feel?--5

 

Just a thought,

 

That you just want to laugh out loud at all the people who come in the ER and say they are going to sue (i.e., you, the doctor, the hospital), somebody. More often than not it is the baker act who never takes drugs and only had two beers (odds on a positive urine drug screen), or the drug seeker who only dilaudid works for, or the entitled toothache , chronic back pain, or hangnail, who believes they are the most important person in the ER and should never have to wait.

 

One thing I have learned over the decades that I have been a nurse and the work I have done as a legal nurse consultant, is:

 

1) Damages have to occur for there to be a legal case

 

2) I have yet to see chronic pain or waiting actually kill anybody or cause damages (When I have to Yell clear in such a case, I may rethink the issue, at least after the 2nd time)

 

3) No one has ever had just two beers when they come into the ER, and only the truly psychotic, some diabetics or very critical head bleeds end up baker acted and have clean urine.

 

4) When the patient has an allergy list a mile long mostly consisting of pain medications except dilaudid, then they may really only need time and therapy.

 

5) When the lawyer on speed dial, bet even the lawyer doesn't answer that phone call...

 The best and most true scenario of way too many ER Patients. Usually not even faking a seizure, but some complaint, to encourage the delivery of some narcotic or benzos...

http://www.youtube.com/watch?v=_m64cy1MMPg

Re-post--Is there a NURSE ADVOCATE somewhere???

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.....

So who helps you make it all go the right way...Your charge nurse if you are lucky, then maybe your director, if they are one of the ones who actually will come in and aid the effort to fight off death and the destructive process that many patients suffer from...Is your manager one who will fight the good fight or do they push papers and crunch numbers, not for the betterment of patient safety and standards of care but for the ALMIGHTY BUDGET...

Takes more than sheep to keep death at bay safely...

Re-Post for New Followers and for continuing situations...As a nurse...Do you stand up for yourself?

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 SEE all we are doing 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...

And do NOT....however your night or day may go, say anything that may digress from the status quo...Do not voice your complaints or worries with the poor staffing or lack of standards in your practice.. i.e. criteria for 1:1 patient-nurse staffing ratios

Too many directors and managers Want Sheep...People who keep on taking whatever situation they are placed in and never voice a complaint...They may be frazzled and muttering throughout their shift, they are actually frequently DROWNING...But here comes the BOSS (though I have never truly believed I have one, because you know what??? I was taught very early in nursing school, when dinosaurs roamed the Earth...That you Protect your license by Knowing that you can refuse any ordered action that you believe will endanger your patients...and that includes unsafe staffing ratios) and when the Boss shows up all is sunshine and rainbows and there was never a problem all night...When there was not enough staff for the so very sick patients....And the trends continue...

DO NOT BE SHEEP!