5.12.2007

Nursing ratios

4:1 nursing ratio...sounds like a good idea on the surface.

Basically, nursing ratios are not good for the patients when there are already not enough nurses....
...unless, of course, you're one of the first 4 to arrive.

18 comments:

girlvet said...

You thnk the nursing profession created a shortage?!! Nurses quit nursing because of the stress. Whadda ya say we switch roles and see how you do?

ERMurse said...

Nursing ratios have both good and bad aspects, the bad ones were pointed out in this post but lets hear some of the benifits. As a ER Nurse in California with 20 years experience I finally am able to do my job and feel good about it with ratios. Many of my co-worksers are staying in the profession because of the ratios. In California we get experienced Travel Nurses from all over the country because we have ratio's. Ask them some of the horror stories about the states without ratios when you have a chance. Yes, ratios have driven up wages to a range they should be and I dont feel bad about that. As far as not being able to give tylenol that is more likely your institutions rule, blame them, not the nurses. With all the crap that joint commission and others have put on us lately taking care of 4 patients is still very hard work. I would say, get used to it. The ratios are here to stay and now part of a nation wide movement.

Ucalcal said...

I am always shocked to see one group of individuals get upset and make things personal when another point of view is expressed.

First let me say that I do not work in medicine. I am an average joe in america. But I wonder how can anyone think that being an ER doctor is not stressful. I am sure being a nurse is stressful but I am also sure that there are alot of jobs in medicine that are also stressful.

Dont be so full of yourself and think that only your job classification is the most "stressful" job in the world.

In addition, Nurses need to remember that at the end of the day, people come to the hospital to see a "doctor" and not a nurse. At some point if the ratio issue is over done, there will be a backlash and people will quickly remind nurses that while they are an important part of the healthcare team, they should not overestimate their position and not put themselves in a position of nurses versus everyone else in healthcare.

If patient care is truly the issue, then nurses should be fighting for a "healthcare team" ratio. You know doctors, RN, LVN, radiology techs, etc. What good is it for a patient to have a 4 to 1 ratio for a nurse but have a 100 to 1 ratio for other essential service providers?

Where are the nurses on ensuring enough paramedics are available to provide a quick response to 911 calls so sick individuals get to the hospital in time to be saved?

The nurses are coming very close to becoming the source of the "ME" in medicine.

angry male nurse said...

I may be a bit late for this post but... I can't believe how incredibly fucked up you are. I can smell your arrogance from here.
You are so painfully misguided- you misconstrue reality to satisfy your idiotic arguments.

HOW MANY ER DOCS DO YOU SEE JONESING TO GIVE FIBRILE PATIENTS TYLENOL? IS THAT WHAT YOU WENT TO MED SCHOOL FOR?
As if all docs are just dying to do 'nursing tasks', C'mon. "for fear of reprisal". That's fucking hilarious.

You are so full of crap.

And oh yeah, that's a good one: there's a nursing conspiracy to fuck patients over, make as much money as doctors, and keep the field full of open positions.
HAVE YOU EVER BEEN A RN ON A BUSY FLOOR?
While basic care may seem mundane to your brilliant self, these menial tasks (wound cleaning, activities of daily living, med distribution, documentation) are what heals the patient and get them back to life.
Why is it so hard for docs to believe that they are not the only group of medical professionals who perform crucial, critical care.
Perhaps it is the sad reality that you are not as utterly brilliant and usefull as the docs portrayed on ER, House, Gray's Anatomy.
Herbalists are in the same league as nurses, eh? Yep, its not like it takes a decade to train a nurse. It's takes 2 years of training and a licensing exam to get on the floor and about 3 more years to know as much as your chump ass who spent a decade getting your head filled with as much ego as it could possibly stand. But in the end I win because my fellow nurses aren't so full of themselves to realize that helping to make healthcare better, safer, takes a team effort.
And even though you worked hard in your education, and truly most nurses respect the education you went through- not the snotty self righteous attitude that comes with it- you just can't believe that nursing school is academically demanding and that all someone has to do is just show up at nursing school and they get pushed through. Med school has a higher attrition rate than nursing school. For every crappy nurse I'll show you 3 MD's who are so busy admiring their own superb intelligence that they don't even bother to listen to the patient, fucking ever.
Face it prima donna: Without us you are nothing. Without dumb, greedy RN's cleaning up your constant barrage of ridiculous mistakes you would be out on your ear without a license.
Yeah nursing school only takes 2 years. That's about how long it takes to learn how to cover for your illegible, tantrum throwing, socially awkward ass.
Fuck off...

ER doctor said...

You're a...what??...nursing student??

Yeah...let's have this discussion after you...actually know something about ER doctoring, ER nursing, and can speak from experience and not hearsay from others.

Anonymous said...

What may take a Dr. 3 minutes to write (Ng, IV, nitro drip, place on cardiac monitor, POX, 02, ASA, get labs, etc., etc.) can take me 20-30 minutes to do! This is IF I'm not interupted umpteen times by other crap. Multiply this x 4 pts., and I am running my butt off 12 hours straight. More shifts than not, I get no dinner break. There is no one to cover for me, and no, I am not in Calif. Nursing ratio's are in place so that patients get better, SAFE care. Not so that we can sit on our butts just because some quota has been filled.

Anonymous said...

........oh yeah, does that head bleed that gets "one tenth" of my "basic nursing care" survive? When their family sues because this patient died, do I loose "one tenth" of my license? Just wondering.

Anonymous said...

to ucalcal:

If all nurses were to go on strike, refuse to work only one day.......health care in this country wound come to a grinding HALT. This is because we ARE important. We are the BACKBONE of the hospital; and you, it seems, are an ass.

Ucalcal said...

"does that head bleed that gets "one tenth" of my "basic nursing care" survive?"
-------------------------
Seems you've missed the point: The sick patients may get all of your time...but the other 20 patiets in the waiting room would have no nurse that's the issue here. It's not about the patient's that have the care, it's about all the rest who don't. Reread the post if you're still confused.
----------------------------

----------------------------
If all nurses were to go on strike, refuse to work only one day.......health care in this country wound come to a grinding HALT. This is because we ARE important. We are the BACKBONE of the hospital; and you, it seems, are an ass
-------------------------
Can you say "powertrip!!?" I guess it's not PC to tell people they aren't number one on the "who's MOST important list." Nurses aren't number one, that's the point.

If all nurses were to go on strike, doctors could still see patients, and honestly after a brief 'orientation' could do the nursing tasks too. True, you'd need more docs, but it can be done. Meds can be given by pharmacists, and all the rest can be done by LVNs, MAs, and CNAs. This has actually happened in hosptials before...and things are more difficult, but patient's can be treated. And long term solutions can be implemented if needed to increase effiency. It's a mistake to think you're not dispensable when you in fact are.

Get this...
...if all the DOCTORS went on strike....healthcare would INDEED come to a halt.

Who has the bigger balls??

ED Scribbler RN said...

Well, the way I see it, we need each other. As an RN, I can't prescribe meds, I can only provide them. (although an NP can) The old saying "docs prescribe, nurses provide" lends evidence to the fact that we all need to work as a team. The docs in the ER where I work are VERY hard workers, often sitting down for 5 minutes to scarf down whatever they happened to snag from the patient food fridge, usually with one or two charts in hand, before being interrupted umpteen times by a variety of folks. Sadly, the same thing happens to nurses.

As for the pay, well, I work hard for my paycheck, but wouldn't mind seeing more, especially since the govt seems to take a huge portion.

Nurses didn't create the shortage, nor do we encourage it's continued decline. As it is, there are no shortage of hours available for anyone that wants to work them.

And things are only going to get worse.

Interesting blog, however, if not a bit one sided. Then again, it is just your opinion.

Aimee said...

I stumbled upon this website. I am an RN who has done it all for 30 years...ER, ICU, pain management, cardiology....

We nurses are not doctors and the patients do come to see the doctor, but guess what? If there were no nurses nothing the doctor ordered would ever be carried out. And how many times have I caught an inappropriate order and saved the doctor's behind? TNTC.

For those of you who have not been there or done that, butt out. It's a hell of a tough way to make a living, but we all do it because we love helping people get better. And they wouldn't get better without us. Trust me on that one.

Anonymous said...

Wow, lots of opinions. I am an ICU/ER RN, been one for a long time.
My opinion on the original post, it is rather one sided. My opinon on the ranting male nurse....Easy Tiger, we work as an entire team, the RN's, the doctors, the secretaries, the housekeeping. Who do you think empties our sharps, cleans my trauma room up after a bloody episode and who calls radiology when we need them? What about the CT techs, specialty docs (ortho, trauma, cardiology and so on) that come to the ER to see patients? And I could not live another day in ER without our awesome social services staff, they save me a lot of grief when death occurs, make all the phone calls for car accidents and help us get WEAVE when we have a rape case.

I just see it as one huge environment where a team works, together to help the people that come night and day, and they come because they know we are all there waiting for them.

And Doc, there is a shortage, it will not go away soon and I'm all good with the ratios because it has saved my license, my ass and my patients more than once. I can just barely keep up with four because I do not just have four patients, I have the entire area I am in, because I help my fellow RNs as well. I watch everyone and make sure they all have the help they need.
For the freaks....calm down, take a time out for f's sakes.

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