15.03.2016 // 00:05 Studying In Bed Is Not The Best Option But It's Okay To Do It Sometimes Working On

15.03.2016 // 00:05 Studying in bed is not the best option but it's okay to do it sometimes 😁😁 Working on my Oncology notes ☺️

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In most parts of the world doctors are usually required to have bare (fore)arms when in 'uniform'. So if you have to get one, get it one your back. I wouldn't recommend you getting one at all, since I think (and many with me) that it's highly unprofessional.

Ouch. 

I don’t see them as unprofessional, necessarily. The way I see it, if someone went to the great length of permanently inking themselves, their ink probably has deep meaning to them and is an important part of them. Just my thoughts tho. 

I’m Rampaging

I’ve been on my own as an ICU nurse only three months, but it hasn’t taken long at all to realize how dangerous nurse understaffing is.  

Many days there aren’t even enough staff scheduled and all it takes is one call in to necessitate three patient assignments. Any ICU nurse can tell you that with critically ill patients, that is not a safe ratio.

I’ve spoken up about it before to management only to receive the “smile-and-nod.”  I’ve been wondering what the party line is, the official reason (read:  excuse) the hospital will give for not dealing with it.  Because money is the real reason, and everyone knows it.

I found out yesterday.  I was speaking to one of the hospital Directors and was told “Well, there’s unsafety and then there’s the perception of unsafety.  And we need to sort out which is which.”

Ah, I see.  We are only PERCEIVING that the situation is unsafe.  You question someone’s perception and you can pretty much take the strength out of their argument, especially if you are the one with the power to change anything.

Interesting considering that our nursing assessment, our perceptions about the patient’s condition, is such an essential part of our responsibilities and is so important to getting patients out of the hospital safely and effectively. 

I would argue the hospital lives and dies on nurse’s perceptions.  And yet our perception concerning basic patient safety has no influence.

What happens when the nurse is too busy to notice that the patient diureses 3L in one hour after Lasix and all of the sudden is having more PVCs, and never calls the resident to see if we should check a potassium level?  What happens when we are stuck in one patient’s room and don’t notice the shortened sentences, the slightly increased rate and work of breathing, that can signify impending respiratory failure in our newly extubated patient next door?

Let’s be real here…when you’re understaffed, a lot of work goes by the wayside.  A lot of reassessments don’t get done or are done hastily, a lot of Q2H turns are late or skipped or done poorly.  Nurses don’t want to work that way.  Most of us chose this job because we want to go the extra mile for our patients, yet we too often don’t even have what we need to take care of them minimially.

You want to prevent complications and reduce readmissions? You want to decrease Length of Stay?  You want to retain nursing staff and keep them happy?  You want to make patients happy because they are well cared for?

Staff us appropriately. 

And yet it seems like the answer to every problem that comes up is met with more work or charting for nurses to do, in less time, without enough staff.

It honestly seems like the hospital is willing to do/fund/support anything besides appropriate nurse-to-patient ratios.

The research supports us, too. 

I’m going to compile a list, but I know for a fact we have research to support each of the following statements:

-Increased nurse satisfaction increases patient satisfaction

-High nurse workload leads to medication errors, poorer patient outcomes, and increases length of stay.

-Nurse burnout correlates directly with understaffing and increased workload.

We don’t want more money.  We want a safe environment in which to practice our craft and care for the people put in our charge.

We are reaching our breaking point and they are not listening to the reasons why.  I’m afraid they aren’t going to listen until someone gest hurt.  And who will the blame be on then?  Whose license will be on the line then?

I think we need to start speaking up more about staffing ratios. 

We need to advocate for our patients and ourselves.