The Biden Administration announced that it is awarding more than $100,000,000.00 to train more nurses in growing the nursing workforce.
However, will adding more nurses solve the problems in nursing where nurses are leaving in droves?
I don’t think so. The problem is the context of nursing is practice and how nurses don’t feel valued and appreciated by administrations. Context means environment.
$8,700,000.00 is going to help LPNs become RNs; $34,800,000.00 will go towards advancing The Nursing Education Workforce Program; and $30,000,000.00 will go towards advancing nursing education – nurse practitioner residency fellowship programs and $26,500,000.00 will go to nurse faculty loan programs to provide low interest loans and loan cancellation to incentivize careers as nursing faculty.
While I am glad that this bill is addressing nursing faculty, I truly believe that nursing is in our DNA. You cannot pay enough to have people to do the things that nurses are required to do. Therefore, putting money into adding more nurses to the profession is, in my opinion, not going to help.
The system is broken and must be fixed or is going to continue to be a revolving door with people coming and going.
I would love to see more money being put toward nurses’ salaries but putting in more money is not going to solve the problem. Until healthcare facilities show how valuable and appreciated nurses are, listen to them and implement their feedback, things will not change.
At this time, nurses are treated like disposable workers, “we can always get another one!” Unfortunately, it is more difficult these days to get another nurse to replace those who leave.
Also, it takes a lot of money to orient a nurse to a new facility.
What are your thoughts about adding more money to nursing education? Will it solve or decrease the problems in nursing.
It has been said that in business, you have to kiss a lot of frogs to get to a potential buyer. The more frogs that say no, the closer you are to “yes”.
Unfortunately, we as nurses are programmed that if someone says “no” to us, we tend to take it personally. But “no” just means “not now”. “No” is nothing personal. How many times do you say no and it’s nothing personal?
Let’s look at it this way. If you are a store owner with people coming to your store and they browse and don’t buy, do you get mad at that person?
Of course not. Because the store owner knows that the next person who comes in or the person after that will be a “yes”.
So, does “no” really mean “no”?
If you’re talking to a potential client, is he really saying “no, I am never going to be interested”, or is he just saying, “not now”? There is an important distinction because if they say, “not now”, ask if you can check back with them later. This is a great follow-up.
Most of the sales are made anywhere after the 5th through the 8th contact. Therefore, if you are not following up with the “no’s” to turn them into “yeses”, you’re wasting a golden opportunity.
I suggest you get permission to check back with the person to see if their circumstances or their desires have changed, and do they really need help with the problem that you can solve for them?
In Augusta, Maine, that state has promulgated legislation called the Maine Quality Care Act which sets enforceable nurse to patient ratios in many hospitals. The bill unfortunately does not include long-term care facilities where it seems many of the problems occur.
However, it will cover acute care and psych hospitals as well as freestanding emergency departments and ambulatory surgical facilities. This should provide some relief for many nurses.
The legislation, which passed the state’s Labor and Housing Committee, focused to not only protect patients and nurses, but to bring nurses back to the bedside. Should the legislature enact this measure, Maine would be only the second state in the country with this safe staffing legislation following California which was the first in 1999.
Studies have shown that mandated RN to patient ratios improved patient care and decreased patient mortality as well as decreased complications and medical errors. Safe staffing also helps recruit and retain nurses.
However, the legislation is attracting fierce criticism from the Maine Hospital Association (“MHA”). The first point in their press release states is that the initiative will “Cost well over $100 million dollars”. Clearly the hospitals are concerned about increasing their costs rather than improving the quality of care.
The MHA claims also that there will be limited access to hospital care if hospitals cannot meet the minimum staffing ratios and will strip nurses of autonomy and flexibility by stating that the units are based on the condition of patients and the skill and experience of the nurses.
This legislation will not change that. It’s just requiring mandatory minimum staffing, but staffing can flex up as needed. The MHA also claims that the legislation won’t create a nurse. While that is true, nurses are attracted to places with safe staffing so I believe more nurses will move to Maine to have a better working environment.
The MHA’s main concern is that it will not improve healthcare quality. But that is not true according to research. Quality is improved when staffing is improved.
Additionally, they claim it won’t help recruitment and retention, to which I also disagree. I think many nurses are interested in traveling to California because of the safe staffing ratios and I believe the same would be true of Maine.
What do you think about mandatory minimum staffing ratios. Please let me know in the comments.
Did you know that nurses’ honor guards pay tribute to nurses at the time of their deaths? They give the nurse a Nightingale Tribute at the funeral or memorial service.
The nurses who participate in the Nurses Honor Guard dress in the traditional white uniform complete with cap and cape. The ceremony is brief, usually taking only a few brief minutes.
The Nightingale Tribute is a recitation of the late nurse’s name three times after which a triangle is struck to ring out after each call.
As nurses, our identity is tied with our career. For a nurse to be honored in this fashion is so beautiful.
The Nightingale Tribute was copyrighted by Dwayne Jaeger RN, MSN and says, “[e.g., Nurse Smith] was there when a calling, quiet presence was all that was needed, Nurse Smith was there in the excitement and miracle of birth, or in the mystery and loss of life, Nurse Smith was there.
When a silent glance could uplift a patient, a family member, or friend, Nurse Smith was there.
At those times when the unexplainable needed to be explained, Nurse Smith was there.
When the situation demanded a swift foot and a sharp mind, Nurse Smith was there.
When a gentle touch, a firm push or an approaching word was needed, Nurse Smith was there.
In choosing the best one from a family’s ‘thank you’ box of chocolates, Nurse Smith was there.
To witness humanity — its beauty in good times and bad, without judgment, Nurse Smith was there.
To embrace the woes of the world willingly and offer hope, Nurse Smith was there and now that it is time to be at the greater one’s side, Nurse Smith was there.”
Many nurses are starting their own Nurse Honor Guard. If you would like to honor nurses in your area, this sounds like an amazing opportunity to make a difference and honor them.
If you are interested in starting a Nurses Honor Guard, contact Julie Murphy at jmury581@gmail.com. I first heard about the Nurses Honor Guard while on a cruise sponsored by Show Me Your Stethoscope, the largest online group for nurses.
Along with learning about the Nightingale Tribute, I had an amazing time on that cruise and met some amazing and truly brilliant nurses. I learned so much in the process.
So, what are your thoughts about a Nurses Honor Guard? Please feel free to post your reactions in the comments below.
Interestingly, Beckers Hospital Review just published its 2023 rankings on an educational resource site called Nursing Process. The survey determined the 15 happiest and unhappiest jobs for nurses.
I was surprised to see that nursing’s number 1 unhappiest job is the school nurse. This is so interesting because as a school nurse, being surrounded by youngsters all day would seem to be enjoyable. However, I once worked for an agency that assigned me to different places all the time. And, personally I did not like being a school nurse.
Guess what was number 5 on the list? Legal nurse consultant!
When I looked over the unhappiest jobs, they tended to correlate with the Nursing Board complaints. Although I have had very few school nurse cases, number 2 on the list was hospital staff nurse followed by emergency room nurse as number 3. Also, at number 10 on the list was nursing home RN and at number 14 hospice nurse.
I thought, most nurses I speak to who do hospice care love it! But, then again, hospital staff nurse, emergency room nurse and home health nurse seemed to have the highest number of Board matters.
Nursing home nurses are also on the unhappy list and again many of them seem to have accusations against their licenses.
I also looked at this list to see how it might correlate with malpractice claims. I know nursing home litigation is very big these days, primarily due to lack of staff. Another big area of malpractice claims is in obstetrics, but I do not see obstetric nurses on the list of 15 happiest or unhappiest jobs.
What do you think? What area do you work in and, are you happy or unhappy with your job?
Last summer, an 81-year-old man admitted to a Lexington, Kentucky hospital and died within 48 hours later. He had a GI bleed in which he was ordered GoLytely which is a bowel prep for colonoscopy but instead, the nurse gave Naturalyte, a dialysis liquid not intended for human consumption.
According to the Kentucky Board of Nursing, no charges were filed against the nurse for this medication error. In addition, I do not believe criminal charges were filed either. The Board, believing many process failures and system issues were involved, did not feel that charges against license of the nurse were warranted.
After treating another patient several days earlier, the dialysis team left the liquid behind on the ICU floor.
Nurses scan barcodes on patients’ wrist bands and then scan the medication they are about to administer. Unfortunately, the container of Naturalyte would not scan and when the nurse called the pharmacy, rather than sending the proper medication or coming up to see the liquid in question, the pharmacy just sent a label to the ICU floor through the hospital’s pneumatic tube system.
The nurse administered eight ounces of Naturalyte which she believed to be GoLytely before her shift ended. The patient was unable to tolerate the liquid and after the nurse left for the evening, a second nurse gave the patient the remainder of the bottle’s liquid through a feeding tube. The medication mix up was caught at about midnight, but the patient died the next morning.
This is so sad. That night, while the patient was being transferred to their hospital, 3 ICU nurses were pulled to work on another unit that night. The nurse who took care of this patient took him on as her third patient.
It is unfortunate that this terrible mistake was made and that the Barcode system wasn’t working which contributed to the nurse failing to scan the liquid to be alerted to the use of the wrong medication. The nurse should have done her Five Rights and known it was the wrong medication.
It’s interesting how one state north of Tennessee views things completely differently as in the Radonda Vaught case. The nurses involved in this Kentucky death did not face criminal charges or have trouble with the Nursing board. It would be nice if there was some consistency with neighboring states, if not the entire country.
So, I’m somewhat relieved that the nurses in the Kentucky medical error matter did not get charged criminally or face a challenge to their nursing licensing. That does not negate the loss.
When I began legal nurse consulting, I was surprised just how easy it was. I was simply using my existing nursing knowledge and sharing it with attorneys to help them with their cases.
I used to say to myself, “I can’t believe that they actually pay me for this.” Now I understand how important it is to get paid for your valuable work and not to give it away for free.
Now, in the beginning I felt like an impostor saying to myself, “Who am I to get paid for doing this?” But I came to realize that when I was a baby, I didn’t feel like an impostor, I didn’t feel like a fraud. But as we age, we do begin to feel like frauds or impostors.
We say to ourselves things like. “Who am I to have this business? Who am I to charge this kind of money?” But I say, “Who are you not to?” Playing small does not serve anyone. You have important knowledge to share, and you deserve to be paid for that knowledge.
Many of us are at the top of our game in nursing. However, we did not start that way. When we hit the floor for the first time, we were new, green, and terrified. It took us a while to get our nursing legs. However, we were safe and we did practice competently. We just didn’t yet know everything that we know now, and we still don’t know everything.
When we start a business, we must repeat that phase again and we will probably begin to question ourselves, “Can we really do this?” Well, of course you can. You wouldn’t have the desire to have a business if you couldn’t.
I have no desire to be an astronaut, president or a marathon runner because I can’t do any of these. But I do have a desire to be a business owner, and I absolutely love it. If you have the same desire, you too can own a business and have your dream come true. It just takes consistency, persistence, and a belief in yourself because you absolutely can do it!
You are NOT an impostor. You are NOT a fraud. You are perfectly on the path you need to be to have the business of your dreams.
As a nurse, I have dedicated my life to caring for others and advocating for their well-being. I entered this noble profession with a heart full of compassion and a burning desire to make a difference in the lives of those who need it most. However, over the years, I have witnessed firsthand the toll that inadequate staffing ratios can take on nurses and, ultimately, on the quality of care we are able to provide. In this deeply personal blog, I want to share my heartfelt plea for safe staffing ratios, not just for our sake as nurses, but for the sake of the patients we serve.
The Emotional Weight of Caring
Every day, we walked into the hospital with a mix of anticipation and dread. Anticipation for the chance to make a positive impact on my patients’ lives, and dread for the overwhelming workload that awaits. When staffing ratios are unsafe, we find ourselves running from one patient to another, barely having a moment to catch our breath. The emotional weight of knowing that we might not be able to give each patient the attention and care they deserve weighs heavily on our hearts.
The Fear of Missing Something
Nursing is not just a job; it’s a responsibility that we carry with us every second of every shift. When the nurse-to-patient ratio is skewed, it becomes nearly impossible to give each patient the level of attention required. We fear that in the rush to care for everyone, we might miss a subtle change in a patient’s condition, overlook an important medication detail, or fail to provide the emotional support they need during a vulnerable moment. The fear of making a mistake or missing something crucial is a constant companion, and it takes a toll on our emotional well-being.
Building Genuine Connections
One of the most rewarding aspects of nursing is building genuine connections with our patients. It’s the heart-to-heart conversations, the understanding glances, and the moments of shared laughter that make us human. Yet, with unsafe staffing ratios, time becomes a precious commodity, and these invaluable connections are often sacrificed. Patients become mere tasks on a checklist, and we miss out on the chance to truly understand their fears, hopes, and dreams.
The Impact on Patient Outcomes
Safe staffing ratios are not just about easing the burden on nurses; they directly impact patient outcomes. When we are stretched thin, the risk of medical errors increases, and patient safety is compromised. It breaks my heart to think that a nurses’ inability to be fully present might hinder a patient’s recovery or lead to preventable complications.
The Toll on Our Well-Being
Nursing is physically and emotionally demanding, even under the best circumstances. But when we face chronic understaffing, it pushes us to our limits and beyond. The exhaustion sets in, and burnout becomes a real threat. Our passion for nursing dims, and we start questioning whether we are truly making a difference.
The need for safe staffing ratios in nursing is not just a matter of convenience; it is an essential element in providing compassionate, high-quality care to our patients. When we are supported with adequate staffing, we can pour our hearts into our work, giving our patients the care they need and deserve. As a nurse, I plead with healthcare administrators and policymakers to recognize the importance of safe staffing ratios, not just for the sake of nurses but for the well-being of the patients we hold close to our hearts. Please reach out to the legislators in Maine to give them your support as safe staffing ratios are pending. Together, let’s create a healthcare system where nurses can thrive, patients can heal, and compassionate care can reign supreme once again.
Erslia Pompilio, a friend of mine, of roguenursemedia.com and podcast host of the nurses and hypochondriacs recommended I listen to the podcast called The Retrievals. The Retrievals is about Donna Monticone, a nurse at Yale Fertility Center who was stealing fentanyl over a period of several months.
Meanwhile, over 200 patients were taken for egg retrievals for their in vitro fertilization procedures without anesthesia or with a substantially reduced amount of fentanyl since Ms. Monticone was stealing the fentanyl and replacing it with saline.
As an advocate for nurses, I don’t necessarily see the impact on others. This podcast was from the standpoint of the patients who underwent this egg retrieval procedure without anesthesia and were writhing in pain. The podcast was a wakeup call to consider the impact of the nurses’ actions.
I certainly can personally relate as I had undergone in vitro fertilization to achieve pregnancy for both of my sons. I specifically remember in one of my retrievals that I was showing signs of discomfort, so they gave me more Versed.
The procedure was extremely uncomfortable, and I cannot imagine going through it without any anesthesia. What concerns me is that with numerous patients complaining that they remember their entire procedure and were writhing in pain that Yale did not investigate and figure out why all these patients suddenly were having pain.
This is another system issue. There is no reason for such a delay in realizing that patients were not actually getting the fentanyl. I understand that Ms. Monticone would take the vials home and replace the fentanyl with saline. It wasn’t until a cap came off easily that anyone questioned something being wrong. What kind of system would allow any narcotics to be taken from the facility?
There was malpractice on the part of Yale for not investigating the earlier patient complaints and by giving patients saline rather than fentanyl.
My heart truly goes out to these patients who were harmed by the criminal act of this nurse. I do believe such acts are part of a disease. While I do believe substance abuse is a disease, it is the nurses responsibility to get help.
Ms. Monticone did acknowledge her actions and pled guilty in the criminal matter to which she was sentenced.
Interestingly, she herself went through in vitro fertilization and was successful having children of her own. Donna’s attorney argues that her children would not be safe with her ex-husband as they had ongoing custody issues. The women who did not received adequate sedation for their egg retrieval only wanted to have children.
The sentencing judge did take this information into account and sentenced Ms. Monticone to imprisonment only on weekends. All I can say is that she must have had a great attorney to get that kind of sentence. But I also can imagine how the victims in the hospital felt when they learned of Ms. Monticone’s surprising sentence.
The Department of Justice also fined Yale $308,000 to resolve allegations of violations of the Controlled Substances Act.
Along with that sentence. I also found it interesting that the Nursing Board placed her license on suspension for 6 months after which she is eligible to get her license back on a probation after that time period. Therefore, this nurse will be able to work again despite causing physical harm to over 200 people by having them undergo fertility and egg retrieval services without anesthesia!
Yes, I have mixed feelings about this because I am such an advocate for nurses and believe nurses deserve second chances because, after all, they do make mistakes. It is what they do about those mistakes that makes the difference.
Yet, when over 200 people are injured, that does cause me some concern. Would love to hear your thoughts on this matter. Tell me your thoughts below.
In the demanding world of nursing, where compassion and dedication know no bounds, it’s all too easy to fall into the trap of neglecting oneself. Nurses are the unsung heroes, tirelessly tending to the needs of others, often at the expense of their own well-being. However, it’s crucial to recognize that self-care is not only vital but also a powerful tool in combating nurse burnout—a pervasive issue that affects the very essence of our profession. Let’s talk about why self-care is not selfish but rather a lifeline for nurses.
Nurse burnout is a silent epidemic that silently creeps into the lives of even the most passionate and resilient caregivers. The long hours, demanding schedules, emotional intensity, and constant exposure to suffering can gradually drain even the most dedicated among us. Burnout can manifest in various forms—physical exhaustion, emotional depletion, decreased empathy, and an overall sense of disillusionment. It not only compromises our own well-being but also threatens the quality of care we provide to our patients.
Self-care becomes an urgent necessity for nurses, acting as a lifeline amidst the storm of burnout. It is a means of refueling our physical, emotional, and spiritual reserves so that we can continue to offer the highest standard of care to those who rely on us. Not just our patients but also our families. By engaging in self-care practices, we replenish our energy, restore our resilience, and prevent the insidious erosion of our passion for nursing.
Contrary to popular belief, self-care for nurses is not synonymous with selfishness. In fact, it is an act of self-preservation and self-love that enables us to sustainably care for others. Just as the safety instructions on an airplane remind us to secure our own oxygen mask before assisting others, we must prioritize our well-being to be effective caregivers. When we neglect self-care, we risk reaching a point of no return—a state where our ability to provide compassionate care becomes compromised.
Practicing self-care as a nurse involves honoring our physical needs. It means embracing healthy habits, such as nourishing ourselves with nutritious meals, staying hydrated, and engaging in regular exercise. Taking breaks during shifts, ensuring adequate rest, and seeking support for physical ailments are also essential aspects of self-care. By prioritizing our physical well-being, we build a foundation of strength and endurance necessary to navigate the challenges of our profession.
Equally important is addressing our emotional and mental well-being. Nurses are exposed to intense and often traumatic situations, which can accumulate and weigh heavily on our hearts and minds. Engaging in activities that promote emotional resilience, such as journaling, meditation, therapy, or joining support groups, can provide a safe outlet for processing our emotions and building coping mechanisms. Self-compassion, kindness, and forgiveness toward ourselves are vital ingredients for sustaining our emotional well-being.
Spiritual self-care, regardless of religious beliefs, nourishes the soul of a nurse. Connecting with our inner selves, finding solace in nature, practicing mindfulness or meditation, or engaging in creative pursuits can rejuvenate our spirits. These practices provide moments of respite from the demands of our profession and remind us of our deeper purpose—to bring healing and comfort to those in need.
When nurses prioritize self-care, it sends a powerful message to the healthcare community. It challenges the notion that burnout is an inevitable part of our profession and encourages a shift towards a culture of well-being. By practicing self-care, we become advocates for ourselves and our colleagues, fostering an environment where our mental and emotional health are recognized as essential components of providing quality care.
In conclusion, self-care is not selfish; it is a vital investment in the well-being of nurses and the patients we serve. By embracing self-care practices, we can combat burnout sustain our passion for nursing, and ensure that we continue to provide compassionate care. Let us reclaim our well-being, not as an act of selfishness, but as an act of profound dedication to our noble profession. Remember, we cannot pour from an empty cup, but with self-care, our cups will overflow with compassion, resilience, and unwavering care.
