important means of improving patient outcome when you're involving nurses.

Given the research that shows that 'multitasking' is actually a bad idea, the more a nurse is able to focus on a few patients at a time, the better the care each will get - a frazzled nurse with too many patients will spend all day typing on the $%^$% computer chart, with no time to actually be helping patients.

While it certainly doesn't replace adequate staffing, what it does is allow for "intensity" points-- if you have one patient at 10 points, you are going to be very busy with this patient, so we try to give a lighter patient load (We get 3 patients, generally, it's a busy transplant med/surg unit in a teaching hospital with high acuity)

And that's the just patients. It doesn't include frightened or angry family members, obstreperous residents, general emergencies, work place injuries---on and on and on

And our computer program? It's a huge program, you find that the information is replicated in several places, say, ins and out, pain scale, fall risk, would care, by the end of the day in my note I try to chart only what is relevant. The rest is already charted, but the temptation and the habit to pull it all together in note isn't anything I'll be breaking soon.

It's ridiculous.

in my more recent clinicals has been shifting towards charting by exception. Many are using EPIC, which makes it all too easy to simply copy previous columns forward, allowing errors to creep in. I frequently noted in my last clinical that my observations did not match the prior columns, and I didn't see how specific shifts could take place so quickly, and I'd walk backwards and see entries that looked like they'd simply been copied forward since before the patient was admitted, things that were noted when they hit the ER.

My sister and niece are nurses in Massachusetts.

They are understaffed.

As ACA kicks in and more people get health insurance - hospitals are going to become even busier. Think about it - these newer patients will probably be poorer, sicker and less educated. All health professionals in hospitals will be busier and more prone to errors and lapses in infection prevention. Hospital Administrators are going to have to hire more people if they want to avoid costly readmissions, medication errors and lapses in infection prevention that would extend the stay of a patient.

If there is any area that is subject to rapid job expansion - health care will be it.

I hadn't heard these numbers, but I can tell you from experience that staffing DOES make a difference.

Reminds me that my ONA and ANA dues will probably be coming due again soon.

I've been to nursing homes where one nurse has to deal with a whole hallway/ward and deal with medications which are on different schedules for each person along with all the other unexpected problems that can arise which is way too much for one person.

On the other hand, I have been in ERs where I have been terrified for my loved one's immediate need for care where I have seen 6-7 staffers drinking sodas and chit-chatting around there cubicles and no one seems to care about my loved one or any repercussions for their lack of caring. Questions just get a shrug.

We all know increased productivity from individual workers is a bunch of crap that just makes people work harder for less money but I am not going to defend what I have seen several times in ER departments. For what they charge and what their mandate is they should be more responsive.

Maybe if nurses didn't have so few available physicians to call upon there would be less deaths? Every time I hear there is a shortage of doctors, I think to myself there a ton of poor people that would love to learn medicine and would gladly practice it for a measly $100,000 a year if the AMA would not limit the number of people admitted to medical school.

They just do. And it's not acceptable.

But with the affordable care act rolling in along with Medicare bundling, hospitals are going to be held to greater accountability. That, or they flat out won't get paid. It is, unfortunately, a great motivator.

My hospital we got doctors everywhere, but it is a teaching hospital.

Having gone into the ER many times with my own father, the most frustrating thing is having to wait for nurses to be able to do much of anything until after a doctor has been dragged in to see him. No pain meds, not even water until you can finally get a doc in. ERs need more docs, while other units need more nurses.

so people have been going to nursing schools in increasing numbers. There are a tons of nursing school grads. Yet I personally know quite a few who are having a hard time finding jobs as nurses. There's some sort of disconnect there. There's lots of work to be done. And plenty of people who want to do this work and have the qualifications. Maybe there aren't enough internship/residency type slots for new nurses to get experience?

I was under the impression there was a shortage of nurses. Maybe that isn't the case. I had heard a few years ago that a large number of nurses were going to be retiring who are in the baby boomer generation and that will cause problems. Maybe the hospitals just aren't hiring enough nurses.

On a sidenote, my niece is going to school here in Korea to be a nurse and I have encouraged her to think about going to the US to work for a year because speaks English well. Of course she said no until it turned out her boyfriend is going to school in Texas. I abruptly decided to do an about face and support her mom as being against that idea. Ha, kids these days

but for the nursing schools, it would be good to find one that is connected to a hospital and has some way to get experience. I've heard most nursing positions want a new nurse to have at least a year or 2 of real world hospital experience first, and that can be hard to get.

She was living in Texas for the first month and her fiance had to move to the east coast because of work. I think that might have been a bit of a relief not having to stay there.

Held off on retiring out of fear of inadequate retirement nest when their 403b's took a nosedive, leaving new grads without those slots to fill. We can thank greedy Wall Street banisters for that.

I got the ADN, got my RN, and couldn't get a job. Went back, got the BSN, and it's been 13 months since I graduated with that, several hundred job apps, and I still haven't found a job. Hell, I'd work my first year at minimum wage if I could find a hospital job like that, just to get the experience that everybody simply passes m over for not having.

I was working for a charity that took American nursing students to burn hospitals in China to assist with burn surgeries as an unpaid internship. That sort of thing might be good to look into. They would put postings up in nursing schools.

I'm job hunting myself in a completely different field, and I know it just sucks. But there are opportunities out there somewhere.


http://scrubsmag.com/top-5-places-to-look-for-jobs/

http://www.wikihow.com/Gain-Experience-in-Nursing


Good luck!

I also help take care of my two elderly parents, one of whom is rather medically unstable in various ways (hence his many trips to the ER.) I live next door to them, and can maybe travel 50 minutes or so in any direction, but can't travel any further and feel too safe.

... financial pressures, so corners get cut and patients are the ones at risk when this happens. The stress on nurses is very high.

Also, hospital nurses are overworked and underpaid, with 24 X 7 X 365 staffing requirements eating away at family life and job satisfaction. As a result, many of our best nurses are leaving the hospital environment to work in physician's offices and other 8 X 5 jobs that have less stress and fewer demands.

My hope is that the Republican Party starts a War on Nurses and further undermines their own position.


Nurses Remain Nation's Most Trusted Professionals

http://www.medscape.com/viewarticle/775758

My father was in this week for a blood clot issue. We regularly heard the nurses talking about the way things happen when a new administration takes over the hospital, which happens every few years through regular turnover. Each time a new one comes in, they look at ways to cut costs. Staffing is always one of those ways. They just don't get it.