Fear of Violence: A Poor Rationale for Better Mental Health Care

Insulin shock therapy is given in Lapinlahti Hospital, Helsinki in 1950s (Wikimedia) Insulin shock therapy is given in Lapinlahti Hospital, Helsinki in 1950s (Wikimedia)

By Doug Olsen, PhD, RN, associate professor, Michigan State University College of Nursing, and AJN contributing editor. Olsen regularly addresses topics related to nursing ethics.

There are many good reasons to provide better mental health care in the United States; however, the prevention of mass murder is not one of them.

Mental disorders involve great suffering, and many people who could find some relief through treatment either don’t receive it in a timely fashion or never receive it at all. After the large psychiatric hospitals of the mid-20th century discharged their patients in waves of deinstitutionalization starting in the 1970s, many of the resources that were promised to support these people in the community never materialized. In recent decades, many persons with mental disorder have ended up in the prison system, often for minor offenses, where treatment, if received at all, can be harsh and inadequate. (See: Early, P. (2006). Crazy: A Father’s Search Through America’s Mental Health Madness). A

Adequate resources to support all persons with serious and persistent mental illness in the community would prevent and alleviate a tremendous amount of suffering. We know these patients exist; we know that community […]

2016-11-21T13:08:34+00:00 January 11th, 2013|Ethics, Nursing, Patients, safe staffing|1 Comment

With Inadequate Staffing, ‘Nonessential’ Care Goes First–Then Patient Safety

A coworker of mine made a medication error a few weeks ago. It was a multifactorial error—the medication had been ordered wrong, labeled wrong, and administered wrong—and was investigated accordingly. That particular nurse was also “tripled,” with two ICU trauma patients and one critically ill medical resident patient. The nurse’s workload wasn’t factored into the documentation or investigation of the error, though, since the nurse manager didn’t consider it relevant. I heard her say, “An extra patient shouldn’t make any difference in the standard procedure for passing medications.”

‘Go Home, Stay, Good Nurse’: Hospital Staffing Practices Suck the Life Out of Nurses

By Shawn Kennedy, AJN interim editor-in-chief

After I last wrote to you from the NTI (the American Association of Critical-Care Nurses’ annual National Teaching Institute and Critical Care Exposition), I headed back to the exhibit hall to check out the helicopter and the Army’s mobile operating tent. But I didn’t get to either one, because I met a young critical care nurse from a regional hospital in Missouri. We chatted about her workplace, and it was obvious that she was very proud of the work she and her colleagues did. When I asked her, “What’s your biggest issue?”, she said that it was probably staffing. I expected her to cite the shortage and the difficulty of finding qualified critical care nurses. But that wasn’t what she meant—rather she was talking about  bare-bones staffing because of tight budgets. Her hospital routinely switches between two tactics: it sends nurses home when the patient census is low (when this happens, the nurses are paid only $2 an hour to be on call, but must still use a vacation day to retain full-time benefits, a tactic that rapidly depletes their vacation time); or, when the patient census is higher, the hospital imposes mandatory overtime, creating havoc in nurses’ schedules, finances, and personal lives. And people wonder why there’s a nursing shortage! […]

What’s It Gonna Take to Improve Nurse Staffing?

From otisarchives4, via Flickr

It’s easy to forget that nurses are the ones who will continue to provide most of the care in whatever health care system we end up with in the coming years. Unfortunately, two recent announcements about how nurses rated staffing and workloads gave me a nasty sense of déjà vu.

On July 6, the American Nurses Association (ANA) announced the results of an online survey it conducted for several months last year: 70% of the 10,000 plus respondents say staffing is insufficient; 52% said they are considering leaving their job (of these, 42% say it’s because of inadequate staffing). Slightly more than 35% say they “rarely or never” are able to take full meal breaks. Over half say the quality of care has declined and almost half (49.5%) are unsure if they’d want someone they care about treated in the facility in which they work. […]