Sorry I haven't been around much lately. I really don't know what I've been doing except work and uh...I don't know, lol. Seriously. Oh I've done some cleaning, laundry, etc. Mostly just being lazy. Today I did get up and get a shower earlier than I normally do. Then Caleb had some errands for me "Mom, remember you promised me to go to McDonald's today? And I want to go to Toys R Us too because they have Pokemon toys. Can we, please Mom?" Oh how could I refuse, after all, every little boy needs some Pokemon toys. Don't they? We also ended up buying "Open Season" so we could watch when we went to bed tonight. I didn't see much of it because Caleb got started without me, but what I saw was cute.Tell me your opinion on this one. My 20year old niece is getting married this December (despite me telling her she is too young, ha ha). Rachel wants to earn some extra money. I could use a live-in nanny. So I proposed for her to come out for the summer. Now Rachel can only come out for about 7 or 8 weeks, but every little bit would help. I proposed to pay for her round trip airfare, room and board, and whatever family entertainment (movies, dinner out) we do. I then proposed to pay her $450 (for 40 hours, which equals $11.25 an hour). That would be a huge savings for me because I pay Lindsi $15 per hour, so in one week I could end up paying her $675, plus $75 paid to the agency ($750 a week). Do you think that is fair, more than fair, or I should offer more? I don't want to offend family, and I want it to be financially beneficial to both of us. I think it would be fair because Lindsi doesn't live with us and Rachel would be. Tell me what you think.
This week at work has been interesting. It seems that the CNO (Chief Nursing Officer) has decided that we are not busy enough at night to warrant 5 nurses and a tech after 3am. So we have really been pushed to the limit (taking 4 patients all night plus whatever else ends up in the hallway which could mean 5 patients). Although the JACHO (Joint Commission on Accreditation of Healthcare Organization) has determined that a safe emergency department nursing ratio is 1:4 (nurse:patient), anything over that ratio increases mortality and morbidity ratios by 7% per patient. So here we are lately having 1:4 all night, and at times 1:5 ratio. That is really, really scary. And the fact that at times we do not have not even had a tech is stretching us even further.Of course, you have to look further than a standard 1:4 emergency department ratio, because JACHO also advises a 1:2 ratio for critical care patients, and a 1:1 ratio for every trauma patient. There are plenty of times when 1 or 2 of your 4 is a critical patient, and sometimes (if you have the "code" room) a trauma patient. What then occurs, what happens to your remaining "non-critical" patients? They are put by the wayside and hopefully will not end up with a bad outcome.
According to the ENA (Emergency Nurses Association), inadequate nurse staffing has already resulted in more overcrowding of hospital emergency rooms, diversion of emergency patients to other facilities and fewer staffed hospital beds to move the patients admitted through the ER out to their rooms to be taken care of by other nurses. If you don't have enough nurses you can't effectively and safely take care of the patients, nor can you move whatever comes in by ambulance or the front door due to beds being taken up by admit holds.
The problem with all this is that we (nurses) are responsible for maintaining patient safety no matter how overcrowded or under staffed we are. So basically what this boils down to is that if the work environment is not safe for the nurses, then the nurses cannot safely care for the patient. It can make for a very stressful night trying to balance everything out.
So why do I do what I do? It really is simple. I truly love what I do. I only hope that I don't become so burned out by working short that I end up quitting, like so many nurses today.Okay...was that more than you wanted to know about my job?
De ;)PS: I just have to put in a plug for one of my favorite sites. Pop on over to Patrick's Place for a daily dose of interesting tidbits, current events, and day to day thought provoking topics. Patrick also has a couple of weekly memes that you can find over on his other site, Patrick's Weekender.
5 comments:
that is a fair price plus room and board:) have a good sunday
Deb
I see it all the time at work. Money is the bottom dollar. Now part of me can understand. Medicare pays maybe a penny for every dollar spent and most of our patients are elderly on medicare and medicaid. But they cut us so short if makes safety a real issue and then our boss has the gall to say patient satisfaction is down because the call lights aren't getting answered promptly. Sigh. Is your hospital accredited? Ours is a designated trauma center, level 2, and we could lose our accreditation if we don't staff like they recommend. And our hospital will do anything not to lose their trauma level standing. Personally I think they could cut quite a bit from administration without hurting any patient care or the way the hospital runs. If they don't show up the hospital still runs smooth as silk. If us nurses and staff don't show up, well you know what would happen.
Julie
I think your offer to Rachel is very generous. She would be able to save a good amount of money, even in the few weeks that she`ll be able to stay with you.
That is scary about the nurse to patient ratio. Cutting costs like everywhere else. I just hate how there is the bare min. number of employees anywhere any more!
hugs
penny
I think you are offering plenty!!! Many of the live ins around here only get $350 or so because they are getting food and board.
Being an RN is stressful always!
be well,
Dawn
I wanted to offer a belated thank you for the plug and for the kind words about my blog. :)
Patrick
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