Three of us met at Orientation for our new jobs. We were told once Orientation was over, we would not be mandated for the first week. Did you hear that? First week! New Nurse to a hospital. Unsure of policies and practices. Unsure where things are. Unsure of the procedures at the new employment site.
Well, the new nurse is coming off Orientation on Monday. She's already been asked if she'll work a double shift on Day 1. Yup, Day 1! She was told that she didn't have to, but if she wanted to they certainly could use her. Now this is a single mother of 3 children and she needs the money, so she said, "Yes". She was also told if she didn't want to do it they would mandate another person.
In this case, it worked out semi OK, but Day 1. Come on guys. Have a heart!
Sunday, October 14, 2007
Sunday, October 7, 2007
Definition of Mandatory
The definition of "Mandatory" (see dictionary hyperlink) includes the following:
Verb - to assign, order, direct, and require
Noun - authoritative, command, formal order
The word mandatory doesn't give a person a lot of leeway to say no. In fact, it appears it doesn't give you any leeway!
Verb - to assign, order, direct, and require
Noun - authoritative, command, formal order
The word mandatory doesn't give a person a lot of leeway to say no. In fact, it appears it doesn't give you any leeway!
MANDATORY OVERTIME FOR NURSES
Mandatory overtime for nurses. That phrase makes me shiver each time I hear it.
Hospitals admit patients without making sure they have enough staff and back-up staff (if needed) to take care of them. What should be a hospital problem, by making sure they have the staff to cover all that patients needs, now becomes a nursing problem and, ultimately, a patient problem.
If the hospital has admitted more patients than the current staff can handle, they just tell a nurse that may have worked an 8 or 12 hour shift that they are mandated to stay longer without taking into consideration that the nurse may not be feeling well, may be exhausted from a heavy load during their initial shift, may have children at home waiting for Mom or Dad to relieve their babysitter, the list goes on.
I specifically remember one day when I went to work on a 7:30 am to 4:30 pm shift. Once there, I started having a conversation with a nurse who had worked the day-shift the day before, then was mandated for the evening -shift, and had to come in early on his regularly scheduled so as to split the shift with the night nurse who had come from another floor after having been mandated to work an additional 4 hours.
His schedule looked like this: Scheduled Work - 7:30 am - 4:00 pm
Mandated 4:00 pm - 12 midnight
Mandated 4:00 am - 8:00 am
Scheduled 8:00 am - 4:00 pm
Assuming his drive home was 15 minutes each way and it took 1/2 hour total to get to sleep and wake up and get dressed to go back to work, this nurse got 3 hours sleep between working through 2 twelve hour work periods.
While in conversation with this nurse, I noticed that he stopped talking and had a strange look on his face. He, then, shook his head and said, "I'm sorry, but I can't seem to keep my thoughts straight. What was I saying?" This made me realize that we, the nurses and the public, have a critical problem on not only our hands, but everybody's hands and my thoughts were, "And this is the person who will be taking care of patients for the next 8 hours?", "He has glucoscans with coverage of Insulin twice during his shift and 2 other med pours and if he can't keep his thoughts straight at 7:30 how is he going to keep his thoughts straight sorting and dispensing meds?" What should have been the hospital's problem, now became the nurse's problem and the unsuspecting patient's problem. I know this person and I know he's a good nurse, but I certainly wouldn't want him to be my nurse after having been forced to work all those hours.
I spoke with a nursing supervisor and discussed the problem that nurses were having with working double shifts without sleeping or resting in between; the supervisor laughed and said, "that's what happens when you're working at a 75% staffing rate". This means the hospital only has 3/4 of the staff needed to care for the patients already admitted and are still admitting new patients without enough staff to care for the existing ones. It doesn't have to do with the nursing shortage, it has to do with common sense, IF YOU DON'T HAVE ENOUGH STAFF TO CARE FOR YOUR PATIENTS, STOP ADMITTING! How simple was that. You don't need to be a rocket scientist to figure that one out, but since nurses, like most other working people, need to bring home a paycheck, they're at the mercy of the facility they work for. If a nurse says no to mandatory overtime, they're abandoning their patients. If a nurse says, "I don't feel safe without having some sleep between shifts, they have to work the additional shift anyway.
I, also, remember working with a nurse who worked 17 days straight. These days weren't neccessarily mandated, but the hospital let the nurse sleep in a room near the operating suites between shifts and used her services for 17 days straight. I don't believe anyone can do a good job for 17 straight days without taking a day here and there to rest and step away from the job to regroup.
I have owned a couple of businesses (not in healthcare) prior to being a nurse. I wouldn't have allowed my Secretary to answer my business telephones without having received a full nights sleep, yet nurses are forced to make life and death decisions while working under sleepless conditions and it's their license that's on the line since the hospital is not going to take the blame for a mistake the nurse makes, even though they've mandated the nurse.
I remember seeing medical shows on TV when the medical resident had to stay up for 36 hours to care for patients and thought, "Please don't ever let anyone take care of me who's working like that". I came to realize that these residents had a room to sleep in between working on patients during those 36 hours and, at least, had a place to rest and gather their thoughts. As terrible as I think that is, Nurses don't even have that luxury (if you can call it that). Nurses don't get the chance to close their eyes for an hour or two or relax for a bit with a cup of coffee and a newspaper. Many times these nurses are also working without breaks and/or meal breaks due to "hospital needs". This shouldn't be called "burnout", it should be called torture. I see it as, "let's work them to death, take everything they have to give, then bring in the next one to do the same thing to them". It's a sad situation and the patient, the poor patient who has to be taken care of by a nurse that can barely think, no less think rationally, that patient isn't receiving appropriate care or what they're being billed for. The nurse suffers and the patient suffers all because of decisions the hospital makes and is allowed to get away with.
Hospitals admit patients without making sure they have enough staff and back-up staff (if needed) to take care of them. What should be a hospital problem, by making sure they have the staff to cover all that patients needs, now becomes a nursing problem and, ultimately, a patient problem.
If the hospital has admitted more patients than the current staff can handle, they just tell a nurse that may have worked an 8 or 12 hour shift that they are mandated to stay longer without taking into consideration that the nurse may not be feeling well, may be exhausted from a heavy load during their initial shift, may have children at home waiting for Mom or Dad to relieve their babysitter, the list goes on.
I specifically remember one day when I went to work on a 7:30 am to 4:30 pm shift. Once there, I started having a conversation with a nurse who had worked the day-shift the day before, then was mandated for the evening -shift, and had to come in early on his regularly scheduled so as to split the shift with the night nurse who had come from another floor after having been mandated to work an additional 4 hours.
His schedule looked like this: Scheduled Work - 7:30 am - 4:00 pm
Mandated 4:00 pm - 12 midnight
Mandated 4:00 am - 8:00 am
Scheduled 8:00 am - 4:00 pm
Assuming his drive home was 15 minutes each way and it took 1/2 hour total to get to sleep and wake up and get dressed to go back to work, this nurse got 3 hours sleep between working through 2 twelve hour work periods.
While in conversation with this nurse, I noticed that he stopped talking and had a strange look on his face. He, then, shook his head and said, "I'm sorry, but I can't seem to keep my thoughts straight. What was I saying?" This made me realize that we, the nurses and the public, have a critical problem on not only our hands, but everybody's hands and my thoughts were, "And this is the person who will be taking care of patients for the next 8 hours?", "He has glucoscans with coverage of Insulin twice during his shift and 2 other med pours and if he can't keep his thoughts straight at 7:30 how is he going to keep his thoughts straight sorting and dispensing meds?" What should have been the hospital's problem, now became the nurse's problem and the unsuspecting patient's problem. I know this person and I know he's a good nurse, but I certainly wouldn't want him to be my nurse after having been forced to work all those hours.
I spoke with a nursing supervisor and discussed the problem that nurses were having with working double shifts without sleeping or resting in between; the supervisor laughed and said, "that's what happens when you're working at a 75% staffing rate". This means the hospital only has 3/4 of the staff needed to care for the patients already admitted and are still admitting new patients without enough staff to care for the existing ones. It doesn't have to do with the nursing shortage, it has to do with common sense, IF YOU DON'T HAVE ENOUGH STAFF TO CARE FOR YOUR PATIENTS, STOP ADMITTING! How simple was that. You don't need to be a rocket scientist to figure that one out, but since nurses, like most other working people, need to bring home a paycheck, they're at the mercy of the facility they work for. If a nurse says no to mandatory overtime, they're abandoning their patients. If a nurse says, "I don't feel safe without having some sleep between shifts, they have to work the additional shift anyway.
I, also, remember working with a nurse who worked 17 days straight. These days weren't neccessarily mandated, but the hospital let the nurse sleep in a room near the operating suites between shifts and used her services for 17 days straight. I don't believe anyone can do a good job for 17 straight days without taking a day here and there to rest and step away from the job to regroup.
I have owned a couple of businesses (not in healthcare) prior to being a nurse. I wouldn't have allowed my Secretary to answer my business telephones without having received a full nights sleep, yet nurses are forced to make life and death decisions while working under sleepless conditions and it's their license that's on the line since the hospital is not going to take the blame for a mistake the nurse makes, even though they've mandated the nurse.
I remember seeing medical shows on TV when the medical resident had to stay up for 36 hours to care for patients and thought, "Please don't ever let anyone take care of me who's working like that". I came to realize that these residents had a room to sleep in between working on patients during those 36 hours and, at least, had a place to rest and gather their thoughts. As terrible as I think that is, Nurses don't even have that luxury (if you can call it that). Nurses don't get the chance to close their eyes for an hour or two or relax for a bit with a cup of coffee and a newspaper. Many times these nurses are also working without breaks and/or meal breaks due to "hospital needs". This shouldn't be called "burnout", it should be called torture. I see it as, "let's work them to death, take everything they have to give, then bring in the next one to do the same thing to them". It's a sad situation and the patient, the poor patient who has to be taken care of by a nurse that can barely think, no less think rationally, that patient isn't receiving appropriate care or what they're being billed for. The nurse suffers and the patient suffers all because of decisions the hospital makes and is allowed to get away with.
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