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In which the writer asks for support from the medical community.
We are all shocked and appalled by this situation, and yet some of us are probably still afraid of what will happen if we stand up for this nurse. I am not afraid. I know that it could be me next time. This is the time to do something about LTC facilities who think it is acceptable to put one of us in a completely dangerous situation, and then fire us and/or blackball us when we advocate for our frail patients.
I need assurances that you are ready to #DoSomethingChangeSomething
I will also need to know how many people I have within driving distance of Des Moines, or willing to travel to the Des Moines area on a weekday.
The bottom line here is, we are going to have someone in our lives impacted by dangerous and poorly thought-out staffing plans in long term care. It could be a nurse, but it also could be a frail elderly family member.
Your grandmother? Your best friend? You?
We have absolutely no power by ourselves. We must be united in this. Nurses have been told to do dangerous things for the benefit of healthcare organizations for literally decades. Where does it end?
It can end with you. Here and now. Let this situation be the beginning of the end of the abuse of your coworkers.
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A Nurse we will call “Tom” has reported to me that he was fired from a midwestern LTC facility because he stood up for his Residents.
No, you will not like this story.
Tom is a very experienced nurse who was working nights in a LTC facility. The building has about forty Residents, nine or ten of which are safeguarded in the locked CCDI unit. At night, they were staffed with a barely manageable four people total. One nurse, and three CNA’s.
One person has to remain in the locked unit at all times. It can never be left unattended.
At some point, the administration stopped scheduling a third CNA. Naturally, Tom filled the holes in the schedule so he would have the appropriate amount of staffing. He called people and offered them shifts, and filled the holes. Like charge nurses do.
A few weeks into this, Tom was told by the management team that they were no longer staffing a third CNA on nights. Tom said it was rough, but they were getting through it. And then……. A new Resident, we will call her “Jane” was admitted to the facility. Let’s just say Jane’s conditions make her more than a handful to care for. In fact, her plan of care called for her to be a three person assist. So, here we have Tom, one CNA, and…..
Oh wait, the other CNA cannot leave the locked unit. Tom asks what happens if they have to move this Resident? She is in excruciating pain because of her ailments. How can she be safely moved with only two people? For that matter, what if a FIRE starts in her room or if she falls to the floor? The care plan clearly says she is to be a three person assist.
Tom naturally spoke to his supervisor immediately about this, and explained that because he was unable to do what the patient’s care plan called for, he could not take responsibility for the shift.
Tom was forced to take his objection to the next level. The Administrator, we will call him “Jack” was adamant in explaining to Tom that the facility was fully staffed (with a total of three), and professed he and his management team had discussed Jane’s needs amongst the other nurses – and aides – and determined it “shouldn’t be a problem” to run with just three staff (two actually, the third is on the unit). Tom couldn’t believe he was being asked to run with one less person than was – required – according to the plan of care for Jane!
Tom put his foot down and said he was standing up for safe staffing then politely refused to accept the shift. Sometime later Jack stated he could come in that night – to be the fourth person – and added that by doing so Tom’s issue was solved. (Mind you Tom was already late for work because of this).
Tom had worked with Jack once before, as the nurse, when Jack came in to cover an open CNA position on the locked unit during Christmas. So Tom, always willing to compromise, agreed to come and work his scheduled shift. However, Tom was still annoyed by the whole situation because he had made it clear earlier that day, upon finishing his shift from the night before around 0700, that the schedule for that night was short (actually short two CNA positions), and Tom had arranged for both slots to be filled. Tom had called the facility around 1900 to confirm the two empty slots were filled.
It was then that the DON, let’s call her “Sue” told Tom they weren’t filling the fourth position which is when Tom first objected. So here was Tom, an hour and a half later, still in a standoff between Jack, Sue, and himself, which could have been resolved well before Tom would have been late when Jack finally agreed to be the fourth.
Tom arrived to work at 2330 and Jack arrived shortly after. Within about an hour Jack told Tom, “Call me if you need me”, as he walked off to the back of the building to crash, Tom didn’t see Jack again until 0550. No accidents happened; however, that isn’t really the point, is it? Jane was not safe. She could not be immediately rescued from danger in her room, she could not be lifted, and they needed three people to turn her to provide care because of her conditions.
What LTC facility leaves two people responsible for 30 residents, several of whom are total lifts, with at least one like Jane who needs three people to help her? She is in pain, for heaven’s sake.
This LTC facility.
Tom was off the next day, the following day Tom was told by Sue that she had revised the schedule. Going forward Tom was to report for 2nd shift instead of 3rd. Sue had removed Tom from the night shift and put a nurse who ‘didn’t mind the staffing plan’ on nights.
So, a nurse who didn’t know better? A nurse who would not advocate for himself or his Residents? Instead of Tom, who cares deeply about his Resident’s safety, and understood that Jane was not safe on nights in that facility. Their decision was to force Tom out – instead of providing the required amount of staffing!
Here was Tom’s response, “I decided that the action of changing my schedule was clearly an attempt to avoid scheduling enough staff to safely care for the Residents – according to the plan of care – and as such it was my duty as a Mandatory Reporter to report same under elder abuse/neglect. I called the state DIA and told them everything. Then I told Jack and Sue that I had reported it, reminding them I had tried to work it out internally first.”
Twelve hours later Jack called Tom. Tom was no longer needed.
So, he was fired for advocating for his residents.
This is a true story, as you have probably guessed by now.
My question for you is, are you ready to go to bat for this nurse?
Will you protest, write letters, call state agencies, talk to the news, and bring this problem to the public eye?
Or are you going to keep sitting there?
Let me know.
Link to Press Release #NursesTakeDc .http://conta.cc/1WdiI2M
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Remember what I said about trips to DC, local safe staffing rallies at your State Capital and such things?
They are important. For real. This is what you need to be doing. You complain a LOT about your working conditions. I read the message boards. And for that matter, I have never once in my life met a nurse, CNA, MA, ETC who did not complain about their staffing. Never.
So, essentially if you sit there and scowl….and do nothing… You are a whiner.
If you become involved and make a difference, you are an advocate.
Advocate is a harder title to achieve than whiner, but it looks better on a resume. I am just saying.
So, tell me what it is going to take to get you involved. Are you willing to travel to your State Capital? Are you going to DC on May 12? Are you tweeting for safe staffing on February 27? <-click
OR are you going to sit there and complain, while healthcare organizations use and abuse you? Do you not realize that you hold ALL of the cards here? We are numerous, intelligent, responsible, trusted and DRIVEN. So drive yourself to the location you need to attend on May 12.
If you live anywhere near DC, that is where I want you. I will be there, and I will fight for you. You have to show up to fight for me. We do not operate in a vacuum. Everything we do impacts the rest of our profession. Bring your nurse coworkers, CNA’s, MA’s, NURSING STUDENTS, and all interested parties with you. We need change, nurses. Advocate for your patients by advocating for yourselves. Bring your enthusiasm, your brain, your organization, your passion….
And Your Stethoscope.
We are here because at the bottom of it all, nurses stand up for other nurses. We fight like siblings, have awfully strong personalities, and opinions as large as all outdoors. But we know we only have each other, don’t we? We will never change our working conditions and the dangerous staffing situation our patients are living with every single day unless we stand together.
So, come out on May 12, 2016. Show the world your Stethoscope.
Show ME Your Stethoscope.
I think you may be surprised how important your voice is. You matter so much.