By Juli Uzlik, RN
It’s amazing how just the smallest change can have the biggest effects on registered nurses and their patients. At my hospital, Fairview Southdale in Edina, a temporary nursing consultant came in and decreased the staffing in the Heart Center by one nurse per shift. The hospital has taken away one charge nurse where there have been two since the inception of the unit.
Not a big deal, right? Still have a charge nurse. Not really. The Heart Center is laid out in two separate sections with literally a wall and a hallway between the two sections. One charge nurse can’t see both sides at the same time. One section is the CSC (Cardiac Special Care) with less acute patients and the other is CCU (Cardiac Care Unit) with more acute patients. In addition, the 35 cardiac monitors are now being “watched” by the health unit coordinators (HUCs) who have no medical training. We were told that there was no money in the budget for cardiac monitor techs. Most of the experienced charge nurses have refused to be in charge of such an unsafe situation and many have stepped down from the role. As a result, the hospital is now choosing to break our contract and employ “traveling nurses” as charge nurses. These nurses were given a one-day orientation to the unit, and were apprised of general topics like common side effects of Cymbalta, heart disease, etc, and a one-day orientation to the charge nurse role.
This is an unsafe situation and one of the hospital’s own making. Many of our experienced cardiac nurses have left the Heart Center due to the lack of management’s response to detailed reports of unsafe situations. These are also the nurses who respond to “Code Blues” or cardiac/respiratory arrests throughout the hospital.
The nurses who are still working in the Heart Center are making the maximum effort to ensure that patients and their families don’t notice the staffing shortages. That’s what we do, but how long can we go on?
The sad part is that the patient care we give is changing due to the decrease in registered nurses. The decrease of just one nurse is all it takes to create an unsafe situation in a unit where all patients are on cardiac monitors. Due to the lack of a qualified RN watching these monitors, a subtle changed may not be noticed until the situation becomes much more urgent.
If you or a loved one has been in the hospital recently, you know it is the nurses who are on duty 24/7 and it is the nurses who are expected to pick up subtle changes in their patients and notify the MD. Nurses save patients lives!