nurse staffing Archives - Page 4 of 6

When There’s a Disconnect Between Good Nursing Practice and Reality

Recently I spoke with other nurses about our personal experiences with hospitalization and those of family members, and the conversation turned to disappointment with nursing practice and nursing care. In fact, whenever I’ve asked, every colleague has disclosed a similar experience. Some say that they’d never leave a family member alone in a hospital.

We need to acknowledge that there is a disconnect between what we know to be good practice and what is often the reality—even in facilities with Magnet accreditation. There are far too many instances in which nursing practice is substandard.

This is a heads-up about Shawn Kennedy’s editorial in this month’s issue of AJN, excerpted above. You should read it. The article, “Straight Talk About Nursing,” is free. There are no easy answers to the issues it raises. That’s all the more reason to discuss them openly.

In AJN, we often focus on examples of best practices and insightful, compassionate, engaged care. And we get that there are many institutional obstacles that undermine nurses in their attempts to provide quality care to patients. But even so, we’d be remiss to pretend we don’t hear about, and sometimes personally experience, care that simply falls short. This is scary, at least to me. Patients depend on nurses in so many ways. So have a look at the article and let us know your thoughts, as a nurse or as a patient.—Jacob Molyneux, senior editor

Jacob Molyneux, senior editor/blog editor2016-11-21T13:05:54-05:00December 6th, 2013|career, nursing perspective, patient engagement|15 Comments

Guess Who’s Wearing Housekeeping Garb Now? Surprise! It’s Your Nurse

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Catch-all: noun [usu. as modifier]

a term or category that includes a variety of different possibilities: ex. the stigmatizing catch-all term “schizophrenia”

American Hospital/by J. Paradisi

The first thought that came to mind after I heard that Vanderbilt University Medical Center had laid off its housekeeping staff and assigned cleaning patient rooms to nursing was this: Has anyone from the hospital’s administration ever looked inside the nursing staff’s refrigerators, microwaves, or sinks?

Universally, nurses’ staff lounge kitchens nearly rank biohazard status. In every unit a single nurse, but often it’s the unit secretary, martyrs herself (or himself) by emptying these refrigerators of forgotten food. She washes the moldy containers and places them on a nearby countertop, with this message scrawled in Sharpie:

CONTAINERS NOT TAKEN HOME BY WEDNESDAY WILL BE THROWN OUT! (Caps intended)

Another sign commonly posted above the staff lounge sink or microwave by this same nurse or unit secretary reads:

CLEAN UP AFTER YOURSELF! YOUR MOTHER DOESN’T LIVE HERE!

Fact: Nurses know a lot about infection control, but this does not automatically make us good housekeepers. Besides, nurses already have a job: keeping hospitalized patients safe while assessing their needs and administering their care.

While Vanderbilt’s decision to lay off its housekeeping staff and assign […]

Julianna Paradisi, RN, OCN2018-03-28T10:28:19-04:00October 28th, 2013|career, nursing perspective|15 Comments

Telling Patients About Staffing Levels: Transparency or Self-Interest?

It’s a very busy Monday. Because of chronic difficulty in recruiting staff, the unit has only three-fourths of its RN positions filled. In addition, Mary Evans, an experienced nurse who always helps less experienced staff with their patients while carrying a full caseload herself, has called in sick.

Linda Smith is 68 years old and two days post-op from hip replacement surgery. As you enter her room, 45 minutes after she first requested pain medication, you can sense her irritation—but worse than that, you can see from the grimace on her face and her guarded movements that she’s in pain. After several days of good nursing care, you’ve let her down, and you consider telling her about the staff shortage. But you wonder: Is it right to disclose today’s short staffing to Ms. Smith?

The situation above is an ethical conundrum because values are in conflict. On one hand, transparency is good and patients have a right to know about administrative factors affecting their care. On the other hand, care should stay focused on a patient’s problems, not the nurse’s.

As the article excerpt above suggests, nurse staffing is a contentious issue having to do with both patient safety and job satisfaction for nurses. We’ve covered this issue many times in the past, most recently in a blog post that got quite a few comments back in January.

But should a nurse ever tell a patient about inadequate staffing? This is […]

Jacob Molyneux, senior editor/blog editor2018-03-13T10:49:19-04:00May 9th, 2013|Ethics, Nursing, safe staffing|7 Comments

What’s So Hard to Understand: Patient Safety, Quality Care Linked to Nurse Staffing

The evidence linking nurse staffing and patient safety is strong.

The data linking nurse staffing as well as shift length with patient outcomes and satisfaction with care continue to roll in. The latest report on nurse staffing, published in the January 13 issue of Medical Care by McHugh and MA, links higher nurse–patient ratios and good work environments to reduced 30-day readmission rates. Read the abstract here.

Most nurses seem to support better nurse–patient ratios, but there’s continuing ambivalence about reducing shift length, as seen in the comments we received on a recent blog post asking whether it’s time to retire the 12-hour nursing shift.

In August, researchers reported a link between nurse staffing and hospital-acquired infections. Publishing in the American Journal of Infection Control, the authors noted a “significant association” between nurse–patient staffing ratios and both urinary tract infections and surgical site infections. Further, they noted that reducing nurse burnout was associated with fewer infections. (Read our news report on the study here.)

Health Affairs published a report in November called “The Longer the Shifts for Hospital Nurses, The Higher the Levels of Burnout and Patient Dissatisfaction.” The findings were there, loud and clear—researchers Stimpfel, Sloane, and Aiken found that “extended shifts undermine nurses’ well-being, may result in expensive turnover and can negatively affect patient care.”

And […]