Hospitals used to be run by nurses and doctors. Policies were made and carried out by them. Eventually this changed to some extent and nurses pretty much did all of this. They collaborated with the doctors, but finally the doctors became guests of the hospital and were given privileges to practice there. The doctors still provided a lot of input and usually the hospital had a board that consisted of doctors and nurses as well as other people. However, the nurses still played a huge role in how the hospital functioned.
I remember when I first took over a unit as an administrative head nurse, I had to go to a session with the head of human resources. I remember one thing that he said. The meeting was for all of the new leadership people in the hospital. He said remember this—Housekeeping runs housekeeping, Dietary runs dietary, Nurses run the hospital.He was saying that all of the various departments run their own department, but nurses are responsible to coordinate all of the departments in the hospital when patient care is directly concerned.
This is so true. Nurses have to coordinate everything that goes on in the hospital to meet the needs of the patient.She needs to make sure that the floors are clean and taken care of daily; she needs to make sure that the patient is receiving the right diet for the patient; she needs to make sure that the lab work gets done and that what is ordered in done. She is responsible to see that everything that is related to patient care is done and done correctly.
Of course she has to follow the orders of the doctor and at least question them if she feels they are not right for the patient. If something goes wrong in the care of a patient, whe is responsible and can and will be sued. Yes others such as the pharmacy if it is a med error, but so will the nurse because she has to know that the dose, for example, is wrong and do something about it and not just give it to the patient.
I had a grand nephew that was born very prematurely, weighing only 2.2 pound when he was born. During his extensive stay in the hospital he was given a medication that was many times the amount that any baby, let alone a premature baby should have been given. He survived and fortunately had no ill effects from it. He could have gone blind from this error. The hospital was very lucky that the family did not sue, but several, including the nurse, were liable for this huge error.
I do not like law suites and I think people are often sue happy, but I have to say that I encouraged the parents to sue. The pharmacy was ultimately responsible because they sent this to the floor to be given to the baby and it was the wrong dose. However, the nurse was, also, responsible as she should have never given such a dose. She should have questioned the pharmacy and the doctor and investigated more to find out what was going on and refused to give the dose. The same is true if a patient gets the wrong diet and something happens or if a patient falls or is injured because of a wet floor with no signs in the room.
I think I have gotten off track a little. I am trying to point out that nurses have a huge responsibilty in a hospital and still do, which brings me to the point of this article.
Hospitals have changed their model today. Many and most hospitals and especially the large one have adopted a business model today in order to survive. Of course hospitals have to make money and only those that do so continue to exist.
The problem with this concept is that now you have business men running the hospital. The problem here is that business men usually know nothing or very little about hospitals and patient care. They no doubt bring the money in, but some of the things that they have to do to save money and make the hospital profitable is harmful and destructive in conjunction with patient care.
I worked in an administrative position at a hospital a long time ago. I was touring the ER at the time and one of the huge things I noticed was the phisycal set up in the ER. One of the major things was a sink that was not strategically placed and the area for a utility room was not in the best place. When I asked about this, I was told that when they remodeled the ER no one asked nursing what they needed and where they needed it, so they designed it according to what they thought. I have often found this to be true. Had they asked nursing it would have been designed better or nursing to function.
Business and politicians have no idea what is needed in hospitals. They have no medical education so of course they have no idea what is needed or even what might be unsafe in a hospital. Even the architects don’t know all of the ins and outs that would make a nurses’s life easier.
I was reading a couple of things today that prove just this. In one of the articles the state decided that they would make a policy about nurse/patient ratios. This is always an issue for the policy makers. If they are business oriented or politically oriented, they want to save money and cutting down on staff will do this. However, many times it is dangerous to the nurse and to the patient. The acuity level changes all of the time and at times you can safely manage with the lower staffing levels, but at other times it is not. These people making the policy have no idea about this. If the policy is made in an office at the State House or even in the business person’s office, it becomes written in stone and does not safely work.
The other article that I read was sort of the same, indicating that a politician has no idea as to what a nurse does all day. The article was talking about a Senator that made a statement about a nurse playing cards all day. She based her statement on what she saw on some of the shows on TV. She apologigized and admitted that these shows really do not depict what a nurse does during her shift. These shows are not real. She was invited to follow a nurse around for a shift and she found out that a lot of what a nurse does are not seen by the average person. This is true for everybody. No one knows what really goes on in a nurses 8 or 12 hour shift, and have the same concept that the politician had. The difference is, is that the politician is making policies that effect the patient and the staff.
So what can be done about this? Hospitals have to survive. They have to make a profit to do this? Ideally, of course, consult a nurse. Ask a nurse. Most hospitals don’t or can’t do this. There are a few places that have been able to see that their input is invaluable, but change takes a long time. Hopefully more and more input will be asked for, but in the mean time what happens? There needs to be a balance.
Nurses continue to be stressed until that time and she needs to survive, too. How does she do this? Quitting nursing altogether is not the answer. We all need nurses. If all of the nurses quit, what then? Maybe in the not to distant future places will ask nurses for their input. However, until then, she has to find a way to cope with the stress that the policy makers make.
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If you have any questions please ask me and I will get back to you.