Letters: August 2014

Who Advocates for Nurses?

Re: Page 28 in May AACN Bold Voices

I commend Ray Carter’s letter, because it reveals the elephant in the room. Since 1969, I have seen the critical care environment change as I progressed from nurse’s aide, unit secretary and LPN to RN.

I have been a lead preceptor and assistant clinical manager and am currently a staff nurse two years from retirement. We all have to deal with budgets, and I understand that they change because of how healthcare is delivered today.

But is laying off nurses then laying off those who help us, such as unit secretaries and patient care aides, the solution?

Working in a 20-bed MICU with a staffing matrix of 10 nurses means we are always short staffed. It means one nurse’s assignment may be to care for a patient with therapeutic hypothermia after cardiac arrest, a newly admitted patient with sepsis who has multiple medication infusions and requires CCVHD plus a third patient.

I have lowered my standards for what is acceptable, but I cannot lower them anymore, because it means poor care and no support for families. So I join Ray Carter in asking who advocates for nurses.

We have been admired for many years, but that has not been enough. Will AACN advocate for us to confront these issues with more than just words?

Barbara DeRyckere

As a critical care nurse for 15 years, I can relate to Ray Carter’s letter. Healthcare has become dollar driven, while bedside nurses carry high patient loads in environments that are more complex.

At the same time, hospitals expect to have great patient outcomes and face financial penalties for readmissions, while many patients do not receive optimal holistic care. So everyone loses.

Overworked nurses burn out and cut back to working part-time or leave the profession. Either way causes costly high turnover, which further impacts readmission rates and patient outcomes.

Most of us recognize the importance of customer service and patient satisfaction scores. But when a nurse does not have time to establish any type of relationship with a patient or family, the scores drop and so does the nurse’s job satisfaction.

Studies show 68 percent of nurses are thinking of leaving their current job within the next year because of poor job satisfaction. If nurses are to utilize evidence-based practices to improve patient care, they need the time and resources to implement them.

The nursing profession seems to be concentrating on gaining professional respect by increasing the minimal educational level to a bachelor’s degree and performing more research. Yet the concerns of hands-on nurses at the bedside are getting lost in the sauce.

Scott Colombo
Wilmington, NC

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