As we head into Halloween weekend, you might be nervous about rowdy teenagers toilet papering your lawn or worried about running out of candy by 7pm. With the television schedule full of slasher movies and retrospectives on classic horror flicks, you might be scared of things that go bump in the night.
But, INQRI researchers at Midwestern University have uncovered what you should really be nervous about this weekend - the idea of needing to check in to the hospital.
In their INQRI study, Patti Hamilton, Gretchen Gemeinhardt and their team examined the impact of receiving care during "off-peak" times - on nights and weekends. Sixty-four percent of nursing occurs "off-peak" and consumers are (rightfully) concerned about being admitted during those times.
To learn more about their study, please visit the website, Nursing: Open 24/7.
(As for the rest of your weekend, keep that porch light on, make one more run for extra candy and don't watch anything that stars a mad man in a mask.)
Happy Halloween from everyone at INQRI!
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Our hats are off to all the nurses who will be working this Halloween. They will likely be working with fewer staff, reduced ancillary services, inadequate supplies, less supervision and decision support and sicker patients than if they were working during the day Monday through Friday.
ReplyDeleteINQRI and Robert Wood Johnson want to assure that patients receive high quality, safe care regardless of day of the week or time of day.
We would love to hear your suggestions for improving off-peak nursing work environments.
I know that with my experience working the weekends on the floor, it was difficult to get a hold of different disciplines, some procedures had to wait until Monday, and sometimes getting certain on call areas to come in was like pulling teeth. One suggestion or thought is increasing the accessibility and availability of on call disciplines or services over the weekend. Also, patients are still sick on the weekends and it seems that the same amount of staff that is maintained Monday-Friday should also be maintained throughout the weekend in most areas of health care.
ReplyDeleteLucky me... I will be working this Halloween night shift. It has been my experience that there is less staff and ancillary departments available for specialty services. I have also noticed that nurses are reluctant to call physicians for problems. We have several new graduate nurses on our night shifts. I think the recent development of the "Early Interventions Teams" have saved many lives, especially on the night shift.
ReplyDeleteDr. Hamilton,
ReplyDeleteWish I had a solution for lack of ancillary and staff on weekends. I work the weekend agreement for my hospital in the ED 7a-7p for the last 5 years and it is an ongoing issue. I enjoyed the article regarding the increase in mortality on nights and weekends. Its a shame but unfortunately true. Now that the winter months are upon us, we will be double busy trying to care for the influx of pneumonia and flu patients and we have already started holding/boarding admit patients in the ED because of the lack of floor staff and empty beds. We are currently trying to work on an on-call program for our ED during high volume. I will also be working on Halloween. Makes for a crazy day in the ED...
Tamara
I will not be working this Halloween, but have worked the night shift many times in the ER or as house supervisor on holidays. It gets busy and can get crazy with not enough extra hands to help. It is usually short staffed, on at least one floor. Holidays and weekends are always that way. I will be on call all of the Christmas holiday, but not this one.
ReplyDeleteI will not be working this Halloween shift! Unfortunately in the past we received visitors that had no business being at a hospital. Working at a forensic hospital for the criminally insane years ago there was "chatter" about visiting the patients!! Well not such a great idea...better heads prevailed and they were quickly redirected! Luckily, we have to staff accordingly to State and Medicare guidelines and we are even more aware of our surroundings both inside and outside as well. Have a safe Halloween!
ReplyDeleteI had the opportunity to work this weekend, I turned it down. I have missed many holidays and celebrations because I was working. Most of the working culture is a Monday through Friday; for the hospital it is 24-7. How unfortunate, for the nursing/medical culture, that we have families and lives outside. We, as nurses and hospital employees must give up our Halloweens, Christmas’s, Thanksgivings, birthdays’ and other celebrations with our loved ones, which the rest of the world may take for granted. It is a fact, those “off-peak” times in the hospital is also “off-peak” for other profession working cultures: but that is also what is so wonderful about nursing. A nurse is able to work on the weekend, night or holiday, to schedule around ones’ family needs. The nurse can schedule the working hours when there is someone else to care for the children or the elderly loved one. I truly love nursing and having to sometimes work on the holidays can be rewarding and frustrating.
ReplyDeleteHappy and Safe Halloween to everyone.
Sharon Wiles
When a holiday falls on a weekend, it seems even more short-staffed. I can remember my first weekend shift and some nurses enjoyed it because it was "more laid back." When I looked around I saw one doctor for the usual four on a weekday, and at least 1/3 fewer nurses. It can be more laid back, but when it gets busy it is instantly more hectic. It is a difficult balance because most people would love to be with their families on the weekends and holidays so leadership often agrees to staff at the lowest possible level.
ReplyDeleteKimberly HRowell Said
ReplyDeleteMy experience of working nights, weekends, and holidays were not great. From calling the doctors who would be mad to having emergencies with little staff to help. I believe there should be the same amount of staff during these times as there are other times. If they can't be actually working, they should at least be accessible in the hospital or with a quick phone call. There should be more then one person to contact and strict consequences if their phones are not answered. My hats go off to everyone that is working under these conditions. Kimberly HRowell
Fortunately, I will not be working the Halloween weekend. I enjoyed reading about this topic and my eyes were opened widely after reading it. I had always been acutely aware of how the decrease in staff affected my job as a nurse during off-peak hours, but had not thought about it having adverse effects on my patients. I work in a large ER, we see approximately 72,000 patients annually. So we have a standard staffing matrix and physicians on site at all times. I have worked in rural emergency departments where I was the only staff on duty. All other personnel had to be called in, including the physician. That can be quite scary when a critical patient shows up in your ER and you are waiting sometimes up to 30 minutes for on-call personnel to arrive.
ReplyDeleteHope everyone has a safe and happy Halloween.
Thanks,
Duron
Fortunately, I will not be working this Halloween weekend. I enjoyed reading about this subject and must say it opened my eyes to a whole different view of the situation. I have always been acutely aware of how decreased staffing and resources has affected my job as a nurse during off-peak hours, but did not realize it had such an impact on my patients' morbidity and mortality. Currently I work in large ER that has a standard staffing matrix and physicians on site at all times. I have worked in rural EDs where I was the only person on duty. That can be quite scary when you have a critical patient arrive and you are having to call everyone from the physician to on-call personnel from all departments in.
ReplyDeleteHopefully everyone will have a safe and happy Halloween!!
Thanks,
Duron Cranford, MSU Graduate Student
Brandie said.........
ReplyDeleteFortunately, I was not working on Halloween tonight and was out with my little ones trick or treating. I am fortunate though to work for an organization who strives to provide the same level of care at 3a or 3p. We do have less ancillary staff, but do have staff on call who have requirements on response times. We have a great administration team who supports quality care to each and every patient no matter what time of day or day of week. We have many teams that respond to emergent situations to provide timely response and interventions. We also have a FAST team that responds to changes in patient conditions that providds a resource to the staff and a higher level of expertise to the patient. I have worked for an organization in which there may be just you and a few other nurses available and you provide housekeeping and dietary, as well as nursing in the organization. It is a very true situation in many organizations and it is very sad to see the mortality that does result.
I agree that the level of care decreases during the off peak hours for patients. I worked in the ICU setting for 10 years and a lot of times our ancillary staff would drop off after 5pm and on the weekends. This increased the demand on nursing without decreasing the expectancy from patients and their families. In regards to the halloween holiday, I am sure nurses are already skeptical of working this holiday nurses are of course supersticious by nature. I don't know how many times I have heard them say after a code, "Things always happen in three's," or "It's a full moon we are sure to have some crazy patients come in," and all of us are aware of not saying the "Q" word, quiet!
ReplyDeleteI took the day off from my ICU unit to take my scary monsters out trick or treating. However, with it being a Sunday night hopefully the party goers will keep their actions to a minimal. I am curious to see if there was any admission Saturday as that seems the day when most of the parties took place.
ReplyDeleteVicki Jackson