By Lewis Mitchell
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I f you’re a patient at St. Charles Medical Center, can you be sure your nurse is properly trained to care for someone with your diagnosis?
Imagine you went to St. Charles for open heart surgery. On the day you showed up for surgery, you’re told that the cardiothoracic surgeon (the doctor specially trained in open heart surgery) isn’t available, but an obstetrician (the doctor that delivers babies) will be filling in.
It’s OK, though; they’re both doctors, right? In fact, you know it’s not OK — not safe — because the practice of medicine is highly specialized.
In the same way, nursing care is highly specialized. Nurses on the Ortho/Neuro unit are trained to take care of a different patient population than nurses in the ER, which is different than the patient population in the ICU, or the Family Birthing Center, etc.
In fact, the practice of nursing is so specialized that many nurses at St. Charles are board certified in their specialized areas. Nurses hold board certifications in critical care nursing, emergency nursing, neuroscience nursing and pediatric nursing, among many others.
I, for instance, am board certified in critical care nursing — I am an expert in caring for the critically ill patient in the ICU, and am not ashamed to say that I am not an expert in taking care of a patient who just had a hip replaced; there are other nurses who are experts in that area and would be just as lost in the ICU as I am on the Ortho/Neuro floor, for example.
The management of St. Charles, however, would like to treat nurses as a fungible asset — that is, a nurse is a nurse is a nurse. St. Charles wants to require nurses to work, or “float” outside of their area of expertise. Sure, there are some basic nursing tasks that are common across all areas of the hospital, but a highly specialized patient population requires nurses trained in caring for that patient population.
And a nurse floated outside of their area of expertise would only be able to provide that basic nursing care; which is not only unsafe, but don’t the patients of Central Oregon deserve the best care, not just basic care? The nurses of St. Charles believe they do.
In the current round of negotiations between the nursing union and St. Charles Medical Center, the union has proposed language that would stop the forced floating of nurses outside of their specialized area, unless a particular nurse volunteers to float.
And nurses who volunteer to float outside of their specialized area would be required to undergo continued training and orientation to the area in which they are volunteering to float.
The management of St. Charles, though, seems uninterested in agreeing to this language. Rather than hiring and adequately staffing all of the nursing units, they would rather require nurses from adequately staffed units to fill gaps in the units without enough staff. There is evidence that this practice leads to worse patient outcomes and greater risk for things like patient falls and bloodstream infections. I believe this practice is not only unsafe, but ignores the varied experience and expertise that the nurses bring to St. Charles.
I encourage everyone who is concerned with patient safety to contact St. Charles and demand safe nurse staffing, which means keeping nurses staffed in their area of expertise, not moved around the hospital as management sees fit.
— Lewis Mitchell lives in Bend.