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I am an experienced ICU nurse with 33 years of bedside practice. I have always been very  enthusiastic about my profession and have strongly encouraged many to follow me.  I have faced all the problems that all bedside nurses face and have found solving some of these problems a real challenge. Fortunately for me I am in a professional union environment with NYSNA. When our nurse patient ratio reached 1:14 and Mandatory Overtime reached a daily critical mass our facility of 500 nurses went on strike and eliminated that problem over 6 years ago.   

I agree there has to be a better way to solve this problem with collective action by all nurses at the state and federal levels, demanding our law makers pass legislation that addresses Staffing Ratios and the elimination of  Mandatory Overtime.                                                                         

  The ANA and many states have made "SAFE STAFFING" their top priority we need nurses to get behind them and push hard to get them passed. The real question is how long can we ask our bedside nurses to tolerate the intolerable. This week one of my you young protégés, from Maryland  wrote me the following email.

"I have some nursing questions for you. About 5 months ago I left homecare and started working at  ?? Hospital in the Stroke Center and we also have telemetry. Needless to say the acuity of our pt's are pretty high.  Our management do not take into consideration pt acuity when assigning pt's.  I don't know my rights as far as nurse/pt ratio.   I believe that it is different for every state but can a certain hospital dictate that you have to take 8 patients on a tele/stroke floor.  Now this does not happen everyday but it happens quite frequently when we are short staffed.  There are typically 6 pt's in a group which can be too many when their acuity is so high.   If I were to refuse can I be charged with abandonement?  I am contemplating requesting a move to the ICU, do you think that I am still too young of a nurse to make that move.  I feel very unsure of my knowledge to be able to move to such an intense setting but am so tired of trying to give care to eight pt's at a time and as you know that is impossible.  I might assess them and pass some meds but I am unable to give them the care and attention they deserve.  Sometimes I will have a pt go into resp distress that if I had more time to monitor I would have caught it much sooner.  Let me know your honest opinion.  I like working in the hospital again but it can certainly be unsafe."
 
Thanks, love ya.
 
BA

It is very disheartening to be repeatedly  battling the same issues in every facility across this country. We need to get behind the staffing legislation, both state and national, and put an end to this morale breaking and dangerous practice of endangering patients and chasing our nurses from patient care settings.

Someone tell me how they would answer this young womans plea for help and advice. I come from a union environment with several approaches to this problem. I use labor management meetings and I now have nurse patient ratios  in my contract, and NO Mandatory Overtime language. None of which will help this young nurse solve her immediate problem.

I would appreciate knowing how others have dealt with or are dealing with this ongoing issue in an nonunion environment.

Barbara Crane RN  NYSNA