 2001 AJN Table of Contents
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Workplace Rights
American Journal of Nursing -
May, 2001 - Volume 101, Issue 5
Policy vs. Reality
Established policy at our facility states that RNs can be floated only to certain units from
certain units. A severe staffing problem has led to floating and working overtime just to cover minimum staffing needs. What rights do we have to make certain our established policy is once again enforced?
The floating policy established in your hospital is a great one! Nurses across the country are working actively to establish “no floating” policies, as well as minimum staffing requirements, better staffing systems, and abolishment of mandatory overtime. These priorities should be basic part of a safe and satisfying work environment where patient care is not compromised. You have every right to hold the policymakers accountable. But, as you have discovered, certain circumstances such as staffing shortages can render virtually useless any rights established through policies, contracts and laws.
While the number of readily available and experienced registered nurses does vary across
the country, the 2000 National Sample Survey of Registered Nurses, conducted by the
Health Resources Service Administration’s Division of Nursing shows that, currently at least, there are enough RNs to deliver care. The problem, many experts believe, is that the current work environment is so difficult—particularly in hospitals—that it has become virtually impossible to recruit and retain a sufficient supply of RNs. Employers should be held accountable for working conditions that discourage recruitment and retention, and nurses should take steps to see that policies meant to protect
patients and providers are put into practice.
Most problems now plaguing nursing are not new rather; they are longstanding, unresolved issues, ameliorated from time to time. What nurses really need and want are rights basic to all professionals. A 1999 study conducted by the American Association of Nurse Executives (AONE), the American Hospital Association (AHA), and the American Society for Healthcare Human Resources Administration (ASHHRA) to better define the pending shortage and to identify more successful recruitment strategies outlined major stressors for nurses. Included among them were:
Research has shown that certain characteristics must be present in the work environment if the facility expects to attract and retain sufficient nursing staff. During the nursing shortage in the late 1980s, it was noted that despite the supply problems, certain hospitals never lacked for nursing staff. Facilities successful in creating environments without recruitment and retention problems became known as magnet facilities. Research done by Linda Aiken in the early 1990s discovered that patient
outcomes were better in magnet facilities.1 Current research by Aiken shows that those original findings still stand, and also finds that nurses working in magnet facilities have had a lower incidence of needlestick injuries.2 Characteristics common to magnet facilities include the following:
Nurses face responsibilities that seem to grow in inverse proportion to the resources, support, and acknowledgment afforded them. An important lesson from the research is that a satisfying and supportive practice environment should be a fundamental right for any professional. It would benefit everyone: the institution, the patients, and the nurses.
For more information from the American Nurses Credentialing Center (ANCC) Magnet Nursing Services Recognition Program, contact Kammie Monarch, Director of ANCC Accreditation and Magnet Programs, at
(202) 651-7253.
1. Aiken LH, et al. Lower Medicare mortality among a set of hospitals known for good nursing care. Med Care 1994;32(8):771-87.
2. Aiken LH, et al. The Magnet Nursing Services Recognition Program. Am J Nurs 2000;100(3):26-36.
What do you do when your rights are limited by the realities of the workplace?
References
Katherine Kany is senior policy fellow, Department of Practice and Policy, at the ANA
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