Enloe’s nursing ills

Enloe’s registered nurses are facing sicker patients, long shifts and larger workloads, and it doesn’t look like that is going to change anytime soon.

The good news is that Gov. Arnold Schwarzenegger’s issuance, on Nov. 4, of an emergency regulation postponing implementation of minimum nurse-patient levels due to begin in January will have little negative impact at Enloe.

While the California Nurses Association charges that postponing the increase to 2008 will put patients at risk and exacerbate the nursing shortage crisis, Enloe spokeswoman Ann Prater notes that the hospital has been operating with the new ratios since last summer.

Prater said the hospital currently has 87 more full-time nurses than at this time last year and plans to maintain the higher ratios.

“Enloe supports minimum staffing levels because we know that the more caregivers at the bedside, the better care our patients are going to receive,” she explained. Nevertheless, she added that the relaxation of the regulations is good news generally because it allows for a more reasonable and flexible way to manage nurses.

Sharon Roberts and Kasey Merrill, longtime registered nurses at Enloe, say that they and their colleagues are experiencing larger work loads even with the voluntary ratios in place. The problem, Roberts said, is that RNs are dealing with patients who have on average a 30-percent higher acuity than patients did 10 years ago, which means they’re sicker, they need more monitoring and more nurse hours and the patient care is more complicated. “Staffing should be upgraded according to how sick the patients are,” Roberts argued.

Merrill said that one of the biggest problems is “the use of LVNs at a level of practice that is beyond their license and pressuring the RNs to ‘share’ their licenses.” This creates larger work loads and can cause problems for the RNs, who are required to ensure that patients are getting correct care.

Further adding to their stresses are the 12-hour shifts, two or three days a week, plus alternate weekends, that are locked into six-week schedules. Merrill says that nurses would like to have a more flexible scheduling system that allows for the changes that happen in life. The current system, she says, promotes burnout among nurses and feelings of being treated as commodities rather than humans.

Roberts noted that these problems aren’t specific to Enloe but exist throughout the nation and the healthcare system. That doesn’t make them any less important to Enloe nurses, she said, because "this is where we live and work, and we want to make it the best we can."