Question: Comment 1

My executive summary will be on change of shift admissions and effects on patient care. Change of shift is a vulnerable time for both patients and nurses. During change of shift, critical informatin regarding patients is communicated to the on-coming nurse and ancillary staff. Interuptions during hand-off, including admissions and transfers may hinder the integrity of communication between nurses and delay the completion of critical patient-centered tasks. I would like to create a policy to decrease the flow of traffic during critical shift change times between the hours of 7:15am-8:15am and 7:15pm-8:15pm.

Comment 2

I would like to describe differing approaches of nursing leaders and managers to issues in practice when discussing nurse-staffing ratios. This is a big issue in the country because aside from California, legally mandated nurse-staffing ratios do not exist. When it is discussed in the hospital now, nursing supervisors discourage it by telling nurses that it is not all it's cracked up to be. Some hospitals can go under due to the need to staff appropriately. When talking to a nurse who has worked under both situations, she has said that the cost of healthcare ends up declining in a good way because nurses are making less overworked mistakes and patient-satisfaction is up. This can be the big difference between managers and leaders in the big picture of things. Managers will listen to nursing complaints of being overworked beyond safe circumstances and the manager will simply say, "this is what you signed up for when you became a nurse," like we're soldiers complaining about being shot at when we chose to be a soldier. We signed up for nursing to care for patients and participate in the optimization of their help. Leaders will listen to nursing complaints and ask themselves what can they do to help. At the end of the day, if more people were leaders, nursing shortages may not exist. Nurses would be happier and stay in their positions longer.