ER Doc reacts to Nursing Ratio’s and Unionization

Posted at Backstage Pass ER Doctor blogs on the down side, as she sees it, of California’s Nursing Ratios effect on Emergency Departments and patient care. A lot of this is venting but worthy of ED Nurses review and consideration. I have seen this opinion expressed widely among my EM Physician Colleagues. Organized initiatives such as diminishing the RN’s role in Triage and other corner cutting measures are a reflection of it. So the question, Is there a backlash forming against Nursing's success in healthcare and patient advocacy and job protections? I'm feeling it!!

5.12.2007
Nursing ratios
4:1 nursing ratio...sounds like a good idea on the surface.But I tell you what - if you're in the ED waiting room, dying of a brain bleed; or if you're sitting in triage with an open fracture in excruciating pain, you'd appreciate one tenth of a nurse if it meant basic treatment......

...."Basically, nursing ratios are not good for the patients when there are already not enough nurses.......unless, of course, you're one of the first 4 to arrive".
Posted by ER doctor at 11:05 AM

I have been on both sides of this issue, formally against ratios while in ED Nursing Management, and now very much for them working at the Staff Level. I am convinced I am on the right side now, more evidence here. I made comments on ED Doctor's post regarding my support of ratios and got an interesting comment that followed. Worth a read.

ER Doctor in this post and another on Nursing Unionization express anger that Physicians and their organizations did not take an earlier stance on this issue and others and are not organized like the Nurses which advocates the balance of power to Nursing. Hey, thanks for the complement or at least acknowledgement that were kicking your butts. Were used it. We have to every day just to keep things flowing and our patients safe. Hopefully, after you vent you will realize that our advocacy is to your benefit and patients benefit. Yes, some Nurses do take advantage of the ratio's but the overall effect is good for patients. I do sense your anger and see some of your points. Others are just plain wrong like a RN can be cooked up from scratch in 2 years.

In another post ED Doctor writes

5.23.2007
Letter to my peers on unionizing
(I will kindly *not* include myself in this)Doctors are stupid, because they have allowed this to happen.Still living in an era of the rich, private practice mentality...not accepting the fact that most physicians today are employees in one way or another. And instead of turning up their noses to unionizing, perhaps they should realize that they are now more like the average worker. They've allowed the nursing union to be the be the sole legislative voice on healthcare policy, to their detriment, and to the detriment of their patients.As the nursing union shouts "patient advocacy," they are trying to implement healthcare policy that actually hurts the poorest, sickest, neediest members of our society (I'll elaborate as needed). The whole while, the AMA/CMA (made up of mostly people who are completely out of touch with young physicians) asks for money, but does nothing to help their cause. Time after time, taking "no position" on matters that make a huge difference with regard to modern physician's issues. Case in point - the Governor's proposed tax on doctors and hospitals. The doctor's are getting fucked, and there is no unified voice advocating on their behalf. Therefore, patients are getting fucked, and healthcare is a complete mess. And where are the doctors? Where is their voice. What solutions are *they* offering?Doctors need to change their thinking, hold the medical societies accountable, (or refuse to join), participate in the legislative process, and drop the arrogance against unionizing. Or we can all prepare for complete chaos as healthcare continues to fall apart, without a legitimate beacon of leadership. As the doctors bury their heads in their arrogant asses, allow everyone else to take control, and then wonder why they are (directly) paying for a shitty healthcare system, run by nurses/chiropractors/optometrists/herbalists/and the 'people at the healthfood store.'Get a clue.

Posted by ER doctor at 1:50 PM 4 comments
Labels: Issues

Nurses need to be aware that a Physician backlash is taking place and be prepared to defend our practice and ability to perform patient advocacy.