BigPurpleSkiSuit@Mingg
https://www.newschoolers.com/videos/watch/1029123/Hospital-Greed-Is-Destroying-Our-Nurses--Here---s-Why----NYT-Opinion
Yup. This. 100%. Hospitals are trying to find the maximum workload they could put on workers without them quitting to maximize their profits. It’s how they save money. But unfortunately saving money doesn’t save lives.
We just signed a contract to have 4 patients per nurse on day shift, 5 per nurse on nights. I’ve never had less than 5 on days. Usually 6-8 patients and nights routinely has 8-12.
Just for perspective. It takes me anywhere from 3-10 minutes to assess a patient depending on their acuity and if I can do more of a focused assessment or if I have to do a full. I need to assess every patient before 8am, per policy. But I usually can’t start seeing patients until 7:10-7:15 because I have to get handoff report when I get to work at 6:45.
When I have 7-8 patients or even 6 higher acuity patients, I can’t do that without shortening my assessment. If they are here for respiratory reasons, maybe I just have time listen to their heart and lungs. I skip listening to their belly. I don’t ask them the last time they pooped. Turns out being bed bound caused them to have a bowel obstruction. I don’t catch that until theyre complaining of severe abdominal pain. Now they need a NG tube and emergency surgery. Had this issue been caught early, it can literally be treated with bowel rest and in fluids. Now the patient is in the hospital 5 extra days and has to recover from major surgery. This sounds extreme but it happens.
Anyways back to my original point. It’s physically impossible to do my assessments fully without cutting corners. You just learn which corners have to be cut. We call it prioritization.
The majority of patients meds are due at 9. Some at 8 or 10 but we literally don’t have time to go into the room on 3 different occasions so we have to give all the morning meds together. They call this “clustering care.” It can take me anywhere from 5-20 minutes per patient passing meds. I have to go to the Pyxis which dispenses meds and pull all of them. Cardiac and blood pressure meds require vitals to be taken before giving. Pain meds need a pain assessment. I have to get blood sugars before giving insulin. If someone needs all of this it easily takes 20 minutes. Not to mention really sick patients might need their meds crushed or dissolved in a special solution. Maybe even given through a feeding tube. That can take even longer.
If I have to assess 8 patients and give meds the proper way at the proper times… I would need 30-45 minutes per patient each morning alone. But we have rounds at 10am. We need to have this all done by 10. I need to get all of this done. I only have 20-25 minutes per patient.
We have another round of blood sugars and insulin to give before lunch. And another to give around dinner. There are usually meds to give every hour. Patients asking for pain meds, nausea meds, etc. PLUS charting takes 10-15 minutes per patient throughout the whole shift.
I don’t even want to keep going with this, I think my point has been made. With 4 patients I have 3 hours with each patient per shift. With 8 patients I have 1.5 and it is not enough time. I can get the bare minimum done in that time but patients fucking need more.
The end.
