NursingStudentTutor Phlebotomy Guide

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Minnesota Nurses Strike Determination Continues

Minnesota Nurses Association is in confrontation with the Twin Cities Hospital Managements. The main issue is negotiation of the contract, which failed resulting in to one day strike.

The negotiations were started by both the Minnesota Hospitals and nurses union, but the hospital insisting for “No strike till 31st July” was considered by the nurses union as tactics of hospital gaining time to make interim arrangement. The proposed strike is now imminent.

The scene is very hot and full of hectic activities at the hospitals as well as in the camps of striking nurses.

In the mean time thousands of replacements are lining up at the scene ready to join. The impending strike can be harmful to both the warring factions i.e. the Hospital Managements and striking nurses. The winner can be who is able to hit hard and cause maximum loss to the other side. If the accord on contract agreement is not reached 12000 twin city nurses shall proceed for strike on July 6.

Arranging Replacement Nurses:

The availability of replacement nurses through nursing agencies is the strength on which the hospitals are banking upon for the time being. During the last strike on June 10, 2010 the hospitals mobilized 2800 nurses to keep the activities of the hospital going.

According to Maureen Cloutier ‘one of the nurse ready for reaching Minnesota to join as a replacement nurse’ who is based at Florida, stated she is ready waiting for a call and she has packed every thing and ready to fly to Minnesota. About 4000 nurses are holding temporary work permits as per information available from Minnesota Board of Nursing.

The activity of issue of temporary work permits is taking place since May, 1, 2010 and majority of the work permits are issued to persons not belonging to Minnesota. A little more than 50 % work permits are issued to inhabitants of southern states. There is a warning to the replacement nurses by the striking nurses that the things at Minnesota are going to turn worst and there are no charms one can expect. Warning remarks are posted on facebook accounts of the replacement nurses ready to move in to benefit from the strike imbroglio. 

Statement of a Replacement Nurse:

Cloutier one of the replacement nurse has been signed with Health Source Global Staffing, one of the nurse agencies, which has come forward to supply replacement nurse to 14 Minnesota Hospitals affected by the nurse’s strike. According to Health sources information spread to it’s replacement nurses that they can make $5300 in a week with free air and hotel rooms to stay. The plans are to fly the Nurses on July, 3, 2010 to the twin cities.

Cloutier has spent 32 years in nursing and is presently working as a fill in nurse at the Florida based hospital, where there are no unions. She was unaware of the situation of inadequate staffing at Minnesota. She has the impression that Minnesota nurses feel that they are working very hard.

She felt that Minnesota Nurses are not trying to view the other aspect like hit by the economy, every one loses something. The nurse Union are rumoring that the Hospitals are paying much more to the Nurse agencies as compared to the amount paid to replacement nurses is just a fraction of what a nurse agency gets out of the deal.

Reaction of Nurses & Observers:

Nellie Munn a nurses Union leader representing negotiations a replacement nurse just costs double the amount because persons coming are required to give labor coverage and there is lot of difficulty in recruiting them.

 Although by spending lot of money strike breaking is tried, the objective is not likely to succeed, because the replacement nurses are lacking in experience and can not be replacement for long experienced nurses.

 According to University of Minnesota labor specialist that the Hospitals require around replacement 6500 nurses for taking over the functions of the hospitals, in case they perform more tan 60 hours duty per week.

The available nurses although less experienced are not at all fit to handle the situations, for which they are being recruited.

On the other hand the affected Hospitals maintain that they shall be in a position to manage the show with the replacement nurses and shall look after safety of the patients more carefully.

The Hospitals are not divulging the information about the cost of these replacement nurses to the hospitals. Occasional remarks one can get saying fighting the strike in any case is less expensive than meeting the nurse’s union contract demands.

The cost of the strike is much less than one agrees to add expenses in millions without improvement in the quality caring.

According to market experts with the strike taking place, there shall be reduction in the number of patients affecting revenues generation. 1 % increase in the nursing cost shall affect the hospital by around 25 % in the face of falls in revenues generation.

Albany school of Public Health is of the opinion that getting new trained nurses is not any problem, but the experienced nurses are difficult to find.

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Urgent Need of Computerization in Nursing Care

There have been tremendous changes affected in the working of the hospitals with computerization taking the place of manual recording. But as far as nursing protocol and patient history is concerned, it is still following the same old path, it is a common practice for the nurse going off duty, when the new shift begins the outgoing nurse briefs the incoming nurse about the health status of the patients in the previous shift.

There is possibility of devising nurse care plans with the aid of vast changes in the technology influenced by advancement and conveniences with which new technology can be adopted by the nurses. Having made nurse care plan for a patient on the computer and with the advantage of networked computers any of the health care professional can have access to specific nurse care plan and implement the same. The advantage is the nurse can update any changes considered necessary and the concerned nurse after change of duty can view the nurse care plans and implement.       

Now there is no necessity of looking at the notes left by the previous nurse, every thing one can find updated on the computer. The important messages can be communicated through computer boards.

Welcoming Revolutionary Changes:

Modernization of facilities at Nurse Care Plans is welcomed by all, rather it is being awaited eagerly. The nurse station should have the looks of as flight board at air ports, where all current information is displayed so that the nurse learns, which patient is coming and which one is likely to go so that necessary preparations can be made of receiving the patient or sending the patient with completed discharge records. With all the data available on the board one can update the details of what happened during the shift and act in administering of medicines viewing the prescription of the doctor.

Instead of passing the information to one nurse, who communicates with subsequent nurses orally, there are chances of communication gaps and resulting into lapses of grave consequences for the patient under treatment.

The change is taking place slowly, but one day the above is going to happen, the earliest the better. Medical community is used to computerization. The medical documents are already on the computers leaving the paper bound documents far behind and all this happened in few years only. The hospital administrators shall also realize this and shall go ahead with the plans. Every one shall be working independently saved from the dependence on others for petty things.

Drawbacks of Paper Documentation:

Patient’s history requires lot of paper work and difficult to store and search manually, whereas after computerization patients histories can be searched online from any where within the hospital complex from a computer terminal by the doctors, the registered nurses and administrators.

This shall bring speed, efficiency and accuracy besides there shall be no need of manually searching, storing. Taking the heavy to the right person after lapse of crucial time and bringing it back to be stored can be avoided. There shall be lot of saving of man hours of orderlies, which can be saved for other tasks.

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Considering Nurse Agency Solution for Nurse Shortage

The present situation of recruiting nurses, therapists, pharmacists etc. is very tough. Reputed Nurse Agencies are better placed to provide nursing staff of all categories to the hospitals and nursing homes.

The statistics suggest that presently 84 % of US hospitals are understaffed and their service is affected due to nursing staff shortages experienced by them. With the present nursing shortage the situation is going to be worse in the following years as expressed by the American Hospital Association.   

Registered Nurses Availability v/s Requirement:

The requirement of nurses is much higher than the requirement and in a short time it is not possible to get these nurses so quickly even in spite new training programs launched. The shortage of nursing staff is so severe that besides the suffering at the hospital set ups, there is no availability of nurses for community welfare programs. About half a century before there was never any shortage in the nursing staff felt. Considering the long term need of nurses, the present shortage is going to exceed in it’s dimensions beyond imagination.

Even with the arrival of offshore nurses, the shortage is bound to remain since the shortage. The shortage experienced is in certain specific high skilful areas of specialization like kidney dialysis, surgery and intensive care departments. 

Wrong way of Managing Nurse Shortage:

It is a sad situation that the hospitals are resorting to deployment of traveling nurses can be compared to a situation selecting a less effective solution, when the need is of a solution many times potent. Use of travel nurse in place of low salary staff has capability producing an imbalance in already staff in short supply. Some nurses may leave to become a travel nurse because of capability of earning more. This situation is required to be reversed to prevent further damage of understaffing of nurses.

Thinking of travel nurses, temporary staffing agencies become expensive short term solutions affecting profitability, staff moral and retention aspects resulting into shortfall in the level of patient care.

By resorting to overtime payment to get, additional services from low level staff, results in poor performance of the nurses besides inflated budgeted expenditure.

Based on the analysis carried out by AONE, the expenditure per Registered nurse is $50,000 partly accounted for with balance unaccounted in a year.

The actual total costs of turnover are $42,000 per medical/ surgical RN and $64,000 per specialty nurse.

The Benefits of Availing Nurse Agency:

It is possible to get benefit from long term solution and correct the staff crisis with prescreened nurses with total guarantee regarding candidates procured through reputed nurse agencies. One also benefits in cutting cost in selection process of the nurses by self involvement. One saves on time spent in selection process. Some of the benefits can be viewed as below:

  • More retention Time for the Nurses, by signing a 36 months contract with the nurses secured through reputed nursing agency.
  • Ready availability of adequately trained nurses and therapists.
  • Meeting the affordability criteria, there is likely hood of saving around 40 %.
  • Increase in the profitability or the healthcare facility.
  • Better performance because newly hired nurses are highly motivated in comparison to other nurses in contrast to traveling nurses.
  • Nursing agency takes care of al the matters related to immigration support and searching the creditworthiness of the nurse before considered for appointment.
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Seasonal Dependence of Hospitals on Nurse Agency

The definition of Nursing Agency as appearing in Florida Statutes 400.462 states “A person who gets, makes the offering, does the promise for getting healthcare contracts for healthcare professionals like registered nurses, Licensed practical nurses, certified nursing assistants, home health aides, companions or home makers, who are compensated by fees as independent contractors including, but not limited to, contracts for provision of services, to patients and contracts to provide private duty or staffing services to health care facilities licensed under chapter 395, this chapter or chapter 429 or other business entities”.

A nursing agency is a business entity providing nurses and normally healthcare assistants also referred as certified nursing assistants to person, who are requiring the services of health care assistants. The nurses get temporary employment through the nursing agency at the hospitals, care homes, and other health care providers to assist them during overload of work period or in situations of their staff on long leave to fill the necessity of the health care providers. Some of the nurses are sent to the homes of the patients, who require nursing care at their homes.

In US the Nursing Agency is also called nursing registry, being nursing staff providers on per day basis or for longer duration to the hospitals, medical offices and individual persons. The nursing agencies are small establishments managed by individuals.

Operating a Nurse Agency:

To operate the Nursing Agency one requires lot f funds, because the nurse agencies pay to the nurses as and when they work in a hospital, whereas the nursing agency gets the payment after 3 to 4 months. The nursing agency operates on a margin of 4 % to as high as 70 % depending upon the quality of the nurses engaged by the agency.

The nursing agency operates to meet the seasonal needs of the hospital. The hospitals prefer paying overtime to their staff during holidays instead of availing the services of a nursing agency for hiring nurses through them. In the summer months, when the hospital staff goes on vacations of long duration, there is good business for the nursing agency.

Nurse Agency requires lot of responsibility on the part of the operator in respect of the nurses being provided to the hospital involving undertaking of the liability claims on behalf of the nurse provided in the event any negligence or in-appropriate action takes place at the place of work in a patient handled by the nurse. There can be law suits pertaining to any injury to the patient occurred while the patient was under the care of such a nurse. The nurse agency must insure itself against malpractice conduct of the nurses provided to be on safe side for provision of damages in a law suit.

Existence of Online Nurse Agency Services:

In view of the present draw backs in carrying out the profession of the nurse agency and the technology advances offered by the internet the nurse agency now put up job boards on their website, whereby the employer’s need of the certified nursing assistant or any other required nursing professional can be compared with the data of Registered Nurses of the nurse agency. Thus a direct contact of the candidates with the employers can be arranged eliminating any liabilities on the part of online nurse agency.

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