Thursday, January 24, 2013

Top Issues For Staff Nurses: What The New Generation of Nurses Can do About It


Below is an excerpt that I found on the American Nurses Association (ANA) website discussing the top three issues in hospital-based nursing.  After each section, I will discuss why I think this is an issue, an example, and suggestions about how we, the next generation of nurses, can improve the current nursing issues.  (My responses will be color coded similar to the above text)

Safe Staffing Levels:

 For the practicing RN, staffing is an issue of both professional and personal concern. Inappropriate staffing levels can not only threaten patient health and safety, and lead to greater complexity of care, but also impact on RNs’ health and safety by increasing nurse pressure, fatigue, injury rate, and ability to provide safe care.

ANA has worked continuously to ensure that safe staffing levels are recognized and implemented through surveys, research, data collection, and legislative means, and other activities.

Nursing shortage is a problem everywhere, and is only expected to become worse as many of the boomer nurses pursue retirement.  Hospitals are constantly fighting in the battle of budget versus adequate staffing.  With changes in insurance reimbursement, this battle will undoubtedly continue.  There is also an inadequate number of nurse educators, therefore schools can only accept small groups of nursing students into each class. 

I have two jobs; both in health care.  One job is at a clinic and one at a hospital.  At both jobs, I see the nursing shortage, firsthand.  At the clinic, the nurses are constantly multi-tasking and are forced work long hours in order to complete their work.  At the hospital, nurses are asked on a daily basis if they can stay to work a double because they are short. 

Improving the nursing education in a way that would allow more students to graduate and get in the work force would benefit the nursing shortage immensely.  Hospitals could hire more casual/per diem workers to cover shifts when they are short-staffed.  Putting a scheduling cap on nurses hours would force the hospital to hire more nurses.  The hospital would not have to pay time and a half for all of the overtime that is disbursed, and could use that money to pay new nurses to cover the need.   

Mandatory Overtime:

Staff nurses across the nation are reporting a dramatic increase in the use of mandatory overtime as a staffing tool. This dangerous staffing practice, in part due to a nursing shortage, is having a negative impact on patient care, fostering medical errors, and driving nurses away from the bedside.

ANA really understands the root cause of this issue; the nursing shortage.  There is no other reason that overtime would be mandatory, especially being that it negatively contributes to patient safety and medical errors.   

At the clinic I work for, there is no policy that mandates overtime; however, when clinic runs late the nurse really is forced to stay past her scheduled time.  The hospital that I work for does not practice mandatory overtime. 

My solution is to educate more nurses, get them into the work force, and hire them to fill the nursing needs.  Legislature should also get involved in solving this issue.  The risk of medical errors and unsafe care is worth fighting for. 

Safety on the Job:

Staff nurses work hard on the job, but they shouldn’t have to risk their health to do so. ANA is always working on ways to keep you and your workplace safe.

·         Safe Patient Handling - Back injuries are always a danger, so ANA mounted a profession-wide effort to reduce them. This campaign includes greater education and training, workplace information on increased use of assistive equipment, and efforts to reshape government ergonomics policies to protect nurses.

·         Safe Needles -  Safer needle devices and procedures will keep you safer, and ANA has information on this important program through our Safe Needles Save Lives campaign.

·         Preventing Workplace Violence - No staff nurse should have to deal with violence in the workplace, whether from staff, patients or visitors. See our information on ways to help your employer prevent this. Replacing Hazardous Products - Hazardous chemicals, toxins, and dangerous waste products may be a part of the workplace, but there are ways to reduce and replace them. ANA's environmental health campaign has collected information and procedures to protect your environment.

·         Preventing Influenza - Influenza no doubt impacts your workplace, but there are ways to learn about it and prevent it. ANA's Influenza Initiative gives you the information you and your patients need.

There is always a risk that a nurse may be exposed to something unintentionally at the workplace; however, we take many actions to prevent such things from occurring.  By using proper PPE and precaution, we are not only keeping ourselves safe, but we are also doing it to keep our other patients safe. 

The hospital I work for utilizes bright signs to caution staff of patients’ precaution status and uses reminders to wash hands and cover coughs.  On the oncology unit, we take special precaution by using special gowns and gloves while disposing of patients bodily fluids when they are receiving chemotherapy, also while handling hazardous drugs. 

Proper training and continuous education is key to solving this problem.  It may be beneficial to have annual skill fairs to test nurses’ knowledge and capability to use safety equipment. 

American Nurses Association. (2013). Top issues for staff nurses. Retrieved from http://www.nursingworld.org/EspeciallyForYou/Staff-Nurses/staffnurses

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