An Understanding.

so everyone is entitled to their opinion, here's mine.

Days short of my one year anniversary as a RN, I find myself watching from the sidelines the passion my fellow co-workers have for their jobs and their patients...

As most of you have heard, as of 7am yesterday, 3rd day of Jun 2009, the unionized nurses of EHMC were locked out. As a result, informational picketing commenced. At first, I didn't quite understand what was going on. All I knew was that, from then on, I was unemployed.

  

Staffing issues were the deal breaker for negotiations. Safe staffing. Numerous times, I've witnessed the floor file for unsafe staffing because of the "ridiculous" nurse to patient ratio. Now, what is the ideal patient ratio? Well, it depends on the acuity, the level of care a patient needs. Nowadays, people are becoming more sick with multiple diagnoses and treatments. We use a program called "OptiLink" that helps us organize staffing as well as project census with the ratio. According to the site it's a "Patient Classification System" designed to:

• display real patient demand, enabling you to balance assignments: meet cost, quality, and staff satisfaction goals on each shift
• measure real-time acuity adjusted actual census: deploy and manage required staff precisely and efficiently

We are able to assign Low, Medium, High, and Extreme to a patient depending on the classifications the staff have developed. High is assigned if the patient falls into one of the factors, the most common are: total dependent care with ADLs, high risk for falls or injuries, procedure or treatment requiring more than one hour. Don't be surprised if a lot of these patients are complete care. They can't wash, feed, or even turn themselves. Some of them sundown to the point where they become violent, where we have to call security. Even then, there's not enough staff in security to cover the rest of the hospital. Imagine RNs spending a lot of time trying to de-escalate the situation, risking their lives to help the patient who has no control and while protecting the rest of the floor and staff. The time spent away from the rest of the patients accumulates, and by that time, the nurse has missed their break, and is now trying to catch up with the rest of their duties before the shift is over. Rushing. An increase in staffing would allow the nurses to distribute the patients more evenly. It's safer. So basically, what I'm saying, is that why are we using this system, a lot of the patients are actually HIGH, and staffing doesn't provide more RNs? Not only RNs, but the PCAs and probably sitters also. It's hard.

The claims of average nursing salary over $100k ?!?! What is that? I don't see it. If they do, it's like 14% of them. Those RNs have earned it. Their 30+ years experience. The lives they've saved and helped. The new RNs they've trained and retained. The MAGNET recognition 2 years in a row!!! 

Now about overtime. Overtime happens because of the acuity. So many things have to be done in such a short amount of time. More people to available to work, would mean less overtime. Safer staffing.

Extra 30 minutes without pay? Sure. 15minutes before and 15minutes after. How is that going to work with families and their schedule? Kids have to go to school, someone has to pick them up, babysitting?

How come more $$$ was spent to hire temp RNs? They have room, board, transportation. As I saw them enter and leave via coach bus. I saw the ones leaving looking so tired and overwhelmed. They're called "scabs." I don't know why; I'm assuming a metaphor. They are nurses, too, doing their job. I quite don't agree with the term. It's so harsh. Perhaps, it was the experience from 3yrs ago where the temp RNs hired cursed, gave the finger, and were mean to them. I do hope they understand how stressful the job is. Patient population has dramatically changed from 20 years ago. 

As for the media, the proposed contract that was offered to the union... unacceptable. The use of vague words leaves management to use loop holes. What is the difference between "no changes" and "no significant changes"? It's like handing over a blank check.. too dangerous.. would you sign something without reading the fine print?

i'm done for now...