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  1. #61
    Quote Originally Posted by Najnaj View Post
    From someone who grew up with a nurse, FU lady.

    If the Republicans get to be any more of a cartoonish villain party they will need scary organ music when ever they enter a room.
    While I don't have anything to do with 'muricans or their politics, I have to wonder: who in their sane mind WOULDN'T want scary organ music whenever they enter the room?

    You have to be pretty badass to have ominous music play whenever you show up.

  2. #62
    Quote Originally Posted by Celista View Post
    Yeah I don't think it would be as difficult as you state, although there would be a lot of whining from the mommy nurses who chose the profession so they could work long shifts and have more family time.

    I agree about other factors influencing health care professionals' QOL though.

    - - - Updated - - -
    @gaymer77 I've read the studies, long shifts by health care staff increases burnout and has other negative effects on care. This isn't limited to nursing btw. Clearly there are other things contributing but I have seen the effects of long hours on my boyfriend and friends who work as RNs/MDs.
    As an example of the logistics... The hospital I work for has a nurse labor union. According to the contract (which is a huuuge deal. the hospital can try to make decisions that, if they violate the contract, can be overturned by the union, otherwise risk severe legal action) if a nurse wanted to switch from 12 hours shifts to a different hours the hospital would have to open an entirely new position (they could keep it to an internal-only position and not have to worry about external applicants). Again, according to the contract, that new position would be entirely affected by seniority of the nurse at the organization assuming the basic requirements are met (Bachelor's degree, ACLS/BLS certifcation, etc.) If the original nurse had 10 years of experience and some other nurse had 11 years of experience (in a completely different department) and both applied, the nurse with 11 years experience would get the job, no questions asked, no appeal, no other option.

    Now, even if you were to be hired as a variable start time, it can only vary by approximately 4 hours. Each start time would have to be covered and follow the same restrictions on seniority and opening new positions. Most floors work on a 0700-1930 and 1900-0730 rotation. Switching everything from 12's to 8's would likely have to transition to 0700-1530, 1500-2330, 2300-0730 shifts. The day starts would likely be less of an issue but the other 2 shifts are now going to be staffed by nurses who have become accustomed, according to the families, schooling, etc.. to specific start times, and expand that from 3 days a week to 5. The hospital I work at employees approximately 1200 nurses. So now, if this law passes, you'd have to rearrange over 1000 nursing positions, according to seniority, and it would have to be done as the nurses want (a good number would likely cross state borders to avoid this kind of a fiasco) and you'd have to do it all according to a brand new nursing contract. Contracts at my specific hospital have sometimes taken an entire year of negotiating. Now do it for every hospital-which likely all have their own unions with their own bargaining teams and their own individual contracts. I think you're grossly underestimating the logistical nightmare doing this for literally 10s of thousands of nursing positions and nurses across the entire state. And this would just be for hospitals.
    Last edited by medievalman1; 2019-04-20 at 03:59 PM.

  3. #63
    Quote Originally Posted by Seranthor View Post
    So I'm confused... is this a support the nurses thread, or bash the Rs thread?
    in this case its one in the same, and deservedly so.
    I could stand in the middle of 5th Avenue and shoot somebody and I wouldn’t lose voters.
    -Donald J Trump.

  4. #64
    Quote Originally Posted by medievalman1 View Post
    As an example of the logistics... The hospital I work for has a nurse labor union. According to the contract (which is a huuuge deal. the hospital can try to make decisions that, if they violate the contract, can be overturned by the union, otherwise risk severe legal action) if a nurse wanted to switch from 12 hours shifts to a different hours the hospital would have to open an entirely new position (they could keep it to an internal-only position and not have to worry about external applicants). Again, according to the contract, that new position would be entirely affected by seniority of the nurse at the organization assuming the basic requirements are met (Bachelor's degree, ACLS/BLS certifcation, etc.) If the original nurse had 10 years of experience and some other nurse had 11 years of experience (in a completely different department) and both applied, the nurse with 11 years experience would get the job, no questions asked, no appeal, no other option.

    Now, even if you were to be hired as a variable start time, it can only vary by approximately 4 hours. Each start time would have to be covered and follow the same restrictions on seniority and opening new positions. Most floors work on a 0700-1930 and 1900-0730 rotation. Switching everything from 12's to 8's would likely have to transition to 0700-1530, 1500-2330, 2300-0730 shifts. The day starts would likely be less of an issue but the other 2 shifts are now going to be staffed by nurses who have become accustomed, according to the families, schooling, etc.. to specific start times, and expand that from 3 days a week to 5. The hospital I work at employees approximately 1200 nurses. So now, if this law passes, you'd have to rearrange over 1000 nursing positions, according to seniority, and it would have to be done as the nurses want (a good number would likely cross state borders to avoid this kind of a fiasco) and you'd have to do it all according to a brand new nursing contract. Contracts at my specific hospital have sometimes taken an entire year of negotiating. Now do it for every hospital-which likely all have their own unions with their own bargaining teams and their own individual contracts. I think you're grossly underestimating the logistical nightmare doing this for literally 10s of thousands of nursing positions and nurses across the entire state. And this would just be for hospitals.
    Perhaps but it sounds like most of the challenge would be with union issues and state/federal law supersedes established employment contracts, which negates a lot of your post. The point is that there is no good reason to have such long nursing shifts when all of the evidence (that I have read) regarding longer shifts for nurses points towards increased burnout/fatigue, more nursing errors, and more on the job injuries, and that long hours have shown to have an adverse impact on nurses' health. Those studies adjust for all other factors that confuscate data outcomes, like number of patients under a nurse's care.

    We don't need to prop up bad practices because it's convenient and people like four day weekends. I would really love it if the data showed otherwise, I think everyone likes the idea of longer hours at work and longer weekends and I include myself in that statement. But in places like health care that practice can be dangerous.

    Again...1000% aware that the problem in nursing/health care isn't just long workdays.

  5. #65
    Quote Originally Posted by Celista View Post
    Perhaps but it sounds like most of the challenge would be with union issues and state/federal law supersedes established employment contracts, which negates a lot of your post. The point is that there is no good reason to have such long nursing shifts when all of the evidence (that I have read) regarding longer shifts for nurses points towards increased burnout/fatigue, more nursing errors, and more on the job injuries, and that long hours have shown to have an adverse impact on nurses' health. Those studies adjust for all other factors that confuscate data outcomes, like number of patients under a nurse's care.

    We don't need to prop up bad practices because it's convenient and people like four day weekends. I would really love it if the data showed otherwise, I think everyone likes the idea of longer hours at work and longer weekends and I include myself in that statement. But in places like health care that practice can be dangerous.

    Again...1000% aware that the problem in nursing/health care isn't just long workdays.
    The only thing that a legal change like this would change with regards to a union/contract would be the change in shift hours. Nothing to do with the way that the positions would be filled. So again, and in short, a logistical nightmare.

  6. #66
    Quote Originally Posted by medievalman1 View Post
    The only thing that a legal change like this would change with regards to a union/contract would be the change in shift hours. Nothing to do with the way that the positions would be filled. So again, and in short, a logistical nightmare.
    Again--don't prop up bad practices because it's easier to maintain the status quo.

    At least you'd only have to do all that work once.

    P.S.: I think a significant amount of the issue here is that we have had a nursing shortage for so long, and nurses were able to negotiate from a position of real power. Not necessarily a bad thing, but when nurses themselves want to prop up bad practices because they don't want to give up their 4-day weekends, that really makes me wonder about their motivations for practicing nursing. Because it's not in the patient's best interest and their desire for long weekends even causes harm to themselves.

  7. #67
    Scarab Lord gaymer77's Avatar
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    Quote Originally Posted by Celista View Post
    Perhaps but it sounds like most of the challenge would be with union issues and state/federal law supersedes established employment contracts, which negates a lot of your post. The point is that there is no good reason to have such long nursing shifts when all of the evidence (that I have read) regarding longer shifts for nurses points towards increased burnout/fatigue, more nursing errors, and more on the job injuries, and that long hours have shown to have an adverse impact on nurses' health. Those studies adjust for all other factors that confuscate data outcomes, like number of patients under a nurse's care.

    We don't need to prop up bad practices because it's convenient and people like four day weekends. I would really love it if the data showed otherwise, I think everyone likes the idea of longer hours at work and longer weekends and I include myself in that statement. But in places like health care that practice can be dangerous.

    Again...1000% aware that the problem in nursing/health care isn't just long workdays.
    This is where I have to correct some things you touched on. The burnout/fatigue you're referring to has nothing to do with the number of hours a nurse works. It has to do with the amount of patients the nurse has to care for during his/her shift without being able to take a break because they are understaffed (Rogers & Hughes report from 2008). Nursing errors typically happen because that nurse is having to deal with numerous patients in a very short amount of times because their load is huge. In a home-health setting, it is normal for a nurse or nurse's aid to work a 12 hour shift and errors are extremely low because the patient to nurse/aid ratio is 1 to 1. Same goes for ICU and the OR which also typically have a 1 to 1 ratio (again as I mentioned in other posts to you, California is the ONLY state in the USA to mandate ratios and has since 1999).

    Same can be said about injuries on-the-job for nurses and aids. These happen more because of time cutting measures the nurse or aid uses so they can get done with the patient they are caring for and get on to the next one in a timely manner. The studies you are referring to that show longer shifts impacting a nurse's health are referring to the work load a nurse goes through during his/her shift not the amount of hours per say. Higher the work load/patient load then the higher the fatigue. In fact, in a study examining the relationship between health care errors and work breaks, researchers found a 10% decrease in the likelihood of error when nurses were given an additional 10 minutes for their meal and break periods per work shift (report from Rogers, Hwang, and Scott in 2004). It isn't the time a nurse is working that is an issue but the amount of time a nurse is working without being able to take a break and the amount of patients the nurse has to care for during his/her shift that is the factor for errors, injuries, and fatigue. A study published in The New England Journal of Medicine found that the risk of death increased two percent each time a patient was exposed to shifts with below target RN staffing (report by Needleman in 2011).

    Quote Originally Posted by Celista View Post
    Again--don't prop up bad practices because it's easier to maintain the status quo.

    At least you'd only have to do all that work once.

    P.S.: I think a significant amount of the issue here is that we have had a nursing shortage for so long, and nurses were able to negotiate from a position of real power. Not necessarily a bad thing, but when nurses themselves want to prop up bad practices because they don't want to give up their 4-day weekends, that really makes me wonder about their motivations for practicing nursing. Because it's not in the patient's best interest and their desire for long weekends even causes harm to themselves.
    Another thing I must correct you on is this. It isn't an issue of nurses wanting to give up their 4 day weekend (most don't get 4 days off in a row anyway because it is typically 3 or 4 days on and then 2-3 days off or they schedule it 7 days on 6-7 days off because of back to back work weeks). The issue for nurses is that we know a patient is getting better care when they only have to deal with 2 nurses per day than 3 nurses per day. Only changing who is responsible for the patient twice per day means that less information about the patient is lost during change of shift report and this leads to better care for the patient. One nurse looking after a patient for 12 hours can notice and measure better changes in condition than a nurse who is looking after the same patient for only 8 hours in the day. Yes it sounds like it shouldn't matter but small changes in a condition are easier noticed over a longer period of time even with those extra 4 hours by the one nurse.

    The problem with the number of nurses out there who can take care of a patient is that hospitals are a for-profit company. Since there is only 1 state that mandates a minimum number of nurses on charge per day (again California is the ONLY state that has mandates) that means that the non-nursing staff determines what is "cost effective" in terms of how many nurses will be on shift that day. If a hospital decides that the ER only needs 8 RNs for peak hours and suddenly they get a rush of patients come in, the hospital doesn't suddenly call in nurses to pick up the slack. The 8 RNs who are there simply have to take on more patients which translates into higher work load which translates into more than likely no breaks for that nurse which translates into increase of nursing errors. I've seen it first hand even here in California where we have mandated minimum ratios where at the start of a shift the census is low so they send home a nurse or two only to get bombarded with patients a couple hours after the nurses leave. Happens daily here.

    - - - Updated - - -

    Quote Originally Posted by Celista View Post
    snip
    In fact, if you care to read the article by Philip Tucker where he discusses the research about nursing fatigue over the course of their shift while increasing the number/length of breaks you can read about it HERE

  8. #68
    I am Murloc!
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    Quote Originally Posted by Vash The Stampede View Post
    So we are for or against nurses working 12 hour shifts? That seems excessive to me. I get that they should hire more nurses so they aren't doing the job of three nurses but do you guys want to work 12 hours?
    Three days on and four days off is a great schedule. And that leaves four hours for extra time if you're busy on a shift. And that's not mentioning anything about being called in, because nurses are per diem regardless of scheduled time.

    And yes the nurses prefer that, so why bother changing something that they are fine with

    - - - Updated - - -

    Quote Originally Posted by gaymer77 View Post
    This is where I have to correct some things you touched on. The burnout/fatigue you're referring to has nothing to do with the number of hours a nurse works. It has to do with the amount of patients the nurse has to care for during his/her shift without being able to take a break because they are understaffed (Rogers & Hughes report from 2008). Nursing errors typically happen because that nurse is having to deal with numerous patients in a very short amount of times because their load is huge. In a home-health setting, it is normal for a nurse or nurse's aid to work a 12 hour shift and errors are extremely low because the patient to nurse/aid ratio is 1 to 1. Same goes for ICU and the OR which also typically have a 1 to 1 ratio (again as I mentioned in other posts to you, California is the ONLY state in the USA to mandate ratios and has since 1999).

    Same can be said about injuries on-the-job for nurses and aids. These happen more because of time cutting measures the nurse or aid uses so they can get done with the patient they are caring for and get on to the next one in a timely manner. The studies you are referring to that show longer shifts impacting a nurse's health are referring to the work load a nurse goes through during his/her shift not the amount of hours per say. Higher the work load/patient load then the higher the fatigue. In fact, in a study examining the relationship between health care errors and work breaks, researchers found a 10% decrease in the likelihood of error when nurses were given an additional 10 minutes for their meal and break periods per work shift (report from Rogers, Hwang, and Scott in 2004). It isn't the time a nurse is working that is an issue but the amount of time a nurse is working without being able to take a break and the amount of patients the nurse has to care for during his/her shift that is the factor for errors, injuries, and fatigue. A study published in The New England Journal of Medicine found that the risk of death increased two percent each time a patient was exposed to shifts with below target RN staffing (report by Needleman in 2011).



    Another thing I must correct you on is this. It isn't an issue of nurses wanting to give up their 4 day weekend (most don't get 4 days off in a row anyway because it is typically 3 or 4 days on and then 2-3 days off or they schedule it 7 days on 6-7 days off because of back to back work weeks). The issue for nurses is that we know a patient is getting better care when they only have to deal with 2 nurses per day than 3 nurses per day. Only changing who is responsible for the patient twice per day means that less information about the patient is lost during change of shift report and this leads to better care for the patient. One nurse looking after a patient for 12 hours can notice and measure better changes in condition than a nurse who is looking after the same patient for only 8 hours in the day. Yes it sounds like it shouldn't matter but small changes in a condition are easier noticed over a longer period of time even with those extra 4 hours by the one nurse.

    The problem with the number of nurses out there who can take care of a patient is that hospitals are a for-profit company. Since there is only 1 state that mandates a minimum number of nurses on charge per day (again California is the ONLY state that has mandates) that means that the non-nursing staff determines what is "cost effective" in terms of how many nurses will be on shift that day. If a hospital decides that the ER only needs 8 RNs for peak hours and suddenly they get a rush of patients come in, the hospital doesn't suddenly call in nurses to pick up the slack. The 8 RNs who are there simply have to take on more patients which translates into higher work load which translates into more than likely no breaks for that nurse which translates into increase of nursing errors. I've seen it first hand even here in California where we have mandated minimum ratios where at the start of a shift the census is low so they send home a nurse or two only to get bombarded with patients a couple hours after the nurses leave. Happens daily here.

    - - - Updated - - -



    In fact, if you care to read the article by Philip Tucker where he discusses the research about nursing fatigue over the course of their shift while increasing the number/length of breaks you can read about it HERE
    That's true for any type of work. I'd much rather work through my shift without a break and leave early or get the extra pay.

  9. #69
    Quote Originally Posted by Vash The Stampede View Post
    So we are for or against nurses working 12 hour shifts? That seems excessive to me. I get that they should hire more nurses so they aren't doing the job of three nurses but do you guys want to work 12 hours?
    As an RT (think of a nurse, but a specialty that deals with heart and lungs only) I like 12 hour shifts. I work 3 days a week and have 4 days off. In all actuality, 12 hour shifts aren't that bad. You hit a lull period around the 8 hour mark, but as soon as you start moving again, it's a breeze making it to the 12 hour mark.

    I like having more days off to recuperate after working my 3 days, and can even pick up a fourth day if I want to and still have more days off than most people.

    Nurses (and the like) aren't tired because we work 4 more hours per shift than everyone else. We're tired cause we deal with bullcrap on a constant basis. And comments like this senator made are a prime example.

    We need breaks, and yes we know patient care comes first and foremost (no one was arguing that). But can I at least eat a sandwich and use the restroom before fetching someone ice? As if that is an emergency that can't wait 30 minutes?

  10. #70
    Why do I feel like in reality these politicians "play cards" for considerable amounts of their day...

  11. #71
    The Insane Belize's Avatar
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    I have a friend who's a nurse and was screaming some incredibly colorful things at her phone when she saw this.

    It's amazing how people this stupid keep getting elected.

  12. #72
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    My wife is a nurse. Started off on the ER where it was no breaks, extra hours, and low pay. Granted eventually she got on with individual doctors and it became easier. But when I say easier it isn't playing spades 6 hours a day. Its like you work 8 to 5 and get actually get off at 5 99% of the time. Pay is better. But cards.. lol.. no..

  13. #73
    Quote Originally Posted by Belize View Post
    I have a friend who's a nurse and was screaming some incredibly colorful things at her phone when she saw this.

    It's amazing how people this stupid keep getting elected.
    people tend to vote on the "would I enjoy drink'n with them at the bar" standard
    me, I wouldnt want ANY of the people I knew that met only that standard having power over anything

  14. #74
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    Quote Originally Posted by D Luniz View Post
    people tend to vote on the "would I enjoy drink'n with them at the bar" standard
    me, I wouldnt want ANY of the people I knew that met only that standard having power over anything
    Maybe I'm a "Liberal Elite", but a condescending overweight elderly prick is the last person I'd want to go to the bar with. That's just me though, maybe my standards are too high.

  15. #75
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    Pure pandering to whoever's is filling her pockets, nurses are one of the most overworked professions in the world and everyone knows that. This dumbass is crazy to think anyone would agree with her.

  16. #76
    Over 9000! Vash The Stampede's Avatar
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    I've learned something here, and that is a lot of people who post here are nurses. What I'd like to know is what benefit do hospitals get from reducing working hours for nurses?

  17. #77
    Quote Originally Posted by Benedictu View Post
    I'm more than willing to take heat on this for being ignorant, but why are nurses, of all professions, working 12-hour shifts. I understand a lot of people would like to work in big chunks for 3 days and get the rest of the week off. I understand it's nice for patients to see the same faces all day and that it's easier for the hospital to schedule longer shifts.

    However, what about fatigue and burn-out on a life-saving job? Is it humane to expect people to work 12 hours (or more) in a row? Is it safe to the nurse and to patients? I don't have the answers, just the questions.
    As an RT (fairly similar to RN) the amount of hours per shift is not really taxing as many people think. In all honesty, it would probably lead to more burn out if we worked 5 days a week and only had 2 days to recover than what we have currently.

    The issue with fatigue and/or general tiredness is not due to shifts being what they are, it's the demands that are forced upon us during the shift. Mainly having to deal with unrealistic expectations (answer all call lights within a certain time frame) or dealing with unruly patients and/or their family members.

  18. #78
    Quote Originally Posted by Celista View Post
    <snip>
    Ya know, I was thinking about your statements about the research that ruled out all variables aside from shift length... I'd like to have links. Not because I want to dissect and pick it apart piece by piece. More because I wanna know where to submit my application to a hospital that has been able to adequate solve the issues that actually cause burnout for nurses-inadequate staffing of primary care and support staff, adequate resources involved with direct care such as streamlined and quick access to medications/equipment necessary to care for patients efficiently, ensuring adequate break coverage (2 nurses covering each other for lunch when they have 6 patients a piece isn't adequate...), a sense of security and safety in their own workplace coupled with the knowledge that legal action will be taken against those that victimize healthcare workers, etc... Show me hospitals that do that and I'll move across the country.

    And to the matter at hand, show me research that has actually ruled all of these and so many other issues that cause burnout (which increases medical errors) to effectively suggest causation instead of mere correlation with shift length.

  19. #79
    I'm more surprised that someone helping run the country still thinks people play cards. I think that's evidence that we shouldn't be electing politicians over the age of 40...
    Quote Originally Posted by blobbydan View Post
    We're all doomed. Let these retards shuffle the chairs on the titanic. They can die in a safe space if they want to... Whatever. What a miserable joke this life is. I can't wait until it's all finally over and I can return to the sweet oblivion of the void.

  20. #80
    Scarab Lord gaymer77's Avatar
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    Quote Originally Posted by Vash The Stampede View Post
    I've learned something here, and that is a lot of people who post here are nurses. What I'd like to know is what benefit do hospitals get from reducing working hours for nurses?
    That's the thing. Hospitals don't get shit by reducing the number of hours nurses work. In fact, they stand to lose if nurses are cut back to 8 hour shifts. They would have to hire more nurses because they would have to have more nurses in 1 day than they currently have. As it is now, many nurses come in for OT on their off days if/when they are called by the hospital because so & so called in sick.

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