Skip Navigation LinksHome > March 2014 - Volume 114 - Issue 3 > Best Practice Vs. Reality
AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000444474.57607.c5
Letters

Best Practice Vs. Reality

Hayes, Shannon RN

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Shannon Hayes, RN

Brooklyn, NY

I've worked on a medical–surgical floor at an extremely busy urban hospital for a little more than a year. I became a nurse because I love people, and I feel honored to be so intimately involved in patients’ lives while they are in my care. I am highly committed to providing care for my patients that I would want my own family members to receive.

However, staffing levels at our hospital mean that I usually have eight patients, and the certified nursing assistants on our floor generally have 15 patients each. Many of our patients have dementia or psychiatric issues in addition to the complicated comorbidities all nurses working today are familiar with. Often we discharge two to four patients in a couple of hours and are immediately hit with as many new admissions.

When one or more patients require a rapid response or experience another type of emergency—which is not infrequent—it's impossible to do more for my other patients than make sure they're still alive and say, “Sorry! An emergency came up!” Not to mention the quantities of documentation we are required to complete every day. I often don't have the time to ensure that a patient recovering from a stroke is fed and has his or her teeth brushed, even though this was on my priority list at the beginning of the day.

Even though I try to care for everyone as though they are my own parents, I know that I am failing, through no fault of my own. I work hard to keep my heart and eyes open, but I am not surprised that so many nurses shut down, doing just the bare minimum to get through the day. And, after working three 12-hour shifts, who has the energy to advocate for changes such as safe staffing that would improve these conditions?

Shannon Hayes, RN

Brooklyn, NY

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