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California hospitals raise limits on nursing workload as COVID surges: Shot »TechnoCodex
Nerissa Black works as a telemetry nurse at Henry Mayo Newhall Hospital in Valencia, California. Since early December, she has been tasked with caring for six critically ill patients per shift instead of four.
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Nerissa Black works as a telemetry nurse at Henry Mayo Newhall Hospital in Valencia, California. Since early December, she has been tasked with caring for six critically ill patients per shift instead of four.
Nerissa black
Telemetry nurses in California, who specialize in electronic monitoring of critically ill patients, typically care for four patients at a time. However, Nerissa Black had to track six since the state eased California’s mandatory nurse-patient ratio in mid-December.
And these six patients are really ill: they all need constant electronic heart monitoring, many of which are being treated simultaneously for stroke and COVID-19, or heart attack and COVID. Black says he is worried that he may miss something or make a mistake because more patients need more complex care than usual.
“We are given 50% more patients and are expected to do 50% more at the same time,” he said. Henry Mayo New Hall Hospital For the past 7 years in Valencia, California. “When I get home, I feel like I’ve done more. I don’t feel like I’m taking care of my patients as humans do.”
As COVID patients continue to flood the California emergency room, hospitals are increasingly desperate to find enough staff to take care of them all. The state requires nurses to treat more patients at the same time than usual, undermining what many nurses and their unions consider to be the protection of the most sacred work. ..
Governor Gavin Newsom said on December 11th, after quietly allowing the hospital to adjust the ratio of nurses to patients, “temporarily, very shortly, temporarily, regarding staffing needs. It needs to look a little different. ” Normally, California law requires hospitals to first obtain state approval before tinkering with these ratios. Newsom’s move presumably approved hospitals to work immediately outside the ratio rules.
Since then, 170 hospitals, primarily in Southern California, have been operating under the new pandemic rate. ICU nurses may be required to care for 3 patients instead of 2. Emergency room and telemetry nurses are now required to take care of 6 patients instead of 4. Medical Surgical Nursing cares for 7 patients instead of 5.
The nurses protested and went out to the streets, demonstrating socially distantly throughout the state, screaming and carrying a poster with the words “Ratios Save Lives.” Union, California Nurses AssociationSays that staff shortage is the result of Bad hospital managementTake a follow-up approach rather than a proactive approach. Dismiss nurses during the summer and do not hire or train enough in the winter.
“What we see in these hospitals is just-in-time response to pandemics they never prepared. Just-in-time staffing, just-in-time resources, shift nurses, not staffing. Just-in-time — to increase profits. ” Stephanie Roberson, Director of Government Relations, California Nurses Association. “And we are seeing how nurses are stretched even thinner.”
Coalition Nurses in California held a rally on August 5 as part of National Action Day to raise awareness of how hospital nurse staffing can affect patient safety. They say.
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Coalition Nurses in California held a rally on August 5 as part of National Action Day to raise awareness of how hospital nurse staffing can affect patient safety. They say.
Nerissa black
But hospitals say this is an unprecedented crisis that swirls beyond their control. In the current surge, four times as many Californians test positive for the coronavirus as compared to the summer peak. According to the report, as many as 7,000 new patients could soon come to a hospital in California. Calmera coil, Leads the California Hospital Association.
“This is devastating and we can’t dodge this math,” she says. “We are simply outside the nurses, doctors and respiratory therapists.”
The state asked the federal government for staff, including 200 Pentagon health care workers, and attempted to revitalize the California Health Corps, an initiative to bring retired health workers back to work. As a result, few people were there. Have the necessary qualifications to care for inpatient COVID patients.
Hiring contract nurses from staffing agencies and other states is currently nearly impossible, Coil said.
“California surged in early summer, and then in other parts of the United States,” she says. “These travel nurses are taken...“”
The next step in the hospital is to try “team nursing”. For example, we attract nurses from other departments, such as the operating room, and work with experienced emergency nurses to help care for COVID-19 patients.
Joan Spets A professor of economics studying healthcare professional issues at the University of California, San Francisco. She says hospitals should have started training nurses for team care in the summer in anticipation of a surge in winter, but for cost reasons they didn’t. The hospital lost a lot of income from the canceled selective surgery that could pay for its training. — Or because of excessive optimism.
“”California was doing very well, “she says. “For all of us, it was easy to believe that it was controlled to some extent. We believed that we could maintain it.”
The California Nurses Association has good reason to be defensive when it comes to the integrity of the patient ratio method, Spets said. It took 10 years of lobbying and activity before the bill passed the state legislature in 1999. It then took several more years to overcome the challenges of multiple courts, including those from then-Governor Arnold Schwarzenegger.
“I’m always kicking their ass, that’s why they don’t like me,” Schwarzenegger said famously about nurses, drawing widespread anger from the nurses’ union and its allies. I did.
The nurse won the court of public opinion and the law. A rule that puts a legal limit on the number of patients per nurse finally came into effect in 2004. However, long battles have led nurses to violently protect their victory. They have even accused hospitals of using pandemics to permanently roll back ratios.
“this is Disaster capitalism In the best place [hospital administrators] We are fully maximizing the opportunity to take advantage of this crisis, “says Roberson.
The hospital has denied that it wants to permanently change the ratio method, and Spetz says it is unlikely to succeed if it tries.
The public can see the nurses burned out by overwork due to the pandemic, so she added that there would be little support to reduce the protection of their work once it was done.
“Insulting,’Oh, when we let them abandon, you obviously worked so well without proportions, so let’s get rid of them altogether,’ I think, just to moral injury. It will add insults, “Spets says.
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