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Now, I am filling in boxes in an Excel spreadsheet that has preset descriptions and multiple selections that require me to scroll up and down for each box to find the right assessment descriptor. For each patient, I have to fill out fifty or more of these rows in one flowchart and they have also added additional flowcharts. If I want to add a comment to the flow sheet description, I am limited to five to seven words and I would have to write a note in another section of the chart, which would require someone to search through multiple notes to find the issue I was addressing.
This additional time has not been accounted for in our workday, and when we have asked to have additional time for charting, management has accused us of inflating the numbers.
Regarding the cardiac monitor system, it is written in the manual that the monitor is not even a first-line response system. The system sends alarms to the nurse as she is passing medications, speaking with families, ambulating a patient, on the phone with the physician, charting, or responding to a call light. Basically, the pager system goes off constantly while the nurse is trying to care for immediate needs. Most of the alarms are yellow, which means "not clinically dangerous," and there is little you can do to prevent some of these alarms from going off because the system is already pre-set. The problem with this is that the system just causes alarm fatigue.
On chronic under-staffing, we have reached a point where we have not trained new staff for years and we are expected do more with less. Open positions, when nurses retire or transfer, are often not filled. They choose to use travel nurses who are from out of state and give them twelve-week contracts that get extended multiple times. Many of them do not pay taxes in our state or own homes so they do not invest in our communities. Yet even with them, we still do not have enough staff to take care of our patients.
So then management emails and texts staffers to come in for extra shifts, which many of them do because they want their colleagues and patients to have enough help. These nurses get tired and sick after being stretched so thin for so long.
I always thought when people paid for insurance they were paying for the "what if." What if I get sick? I personally want to know my hospital is ready to take care of me and has the power to do so — especially when the company is so profitable.
The cost-effectiveness argument for why we don't have the ability to provide staffing is not being backed up by a decrease in administration or decrease in patients' premiums. Many hospital floors now employ three to five assistant nurse managers who do no patient care. I have witnessed situations where we have two managers on site for one floor while two bedside nurses are taking care of ten patients while the other nurse is on a break! How is it cost-effective to have two people combing through charts to tell someone they forgot to document a pain re-assessment while they are moving nonstop just to provide the care needed to their patients?
Kimber Wooten, San Rafael
"Zoo Gone Wild," News Feature, 9/3
The Sierra Club Is Wrong
As I approach my ninetieth birthday and reflect on all of the changes I've seen in California over my lifetime, I can see how some would argue the Bay Area has grown beyond capacity, yet I still believe we live in one of the best places on earth! I first joined the Sierra Club as a child because, even then, I supported the organization's mission to, among other things, "explore, enjoy, and protect the wild places of the earth." Imagine my disappointment to watch as the organization — as well as others, like the California Native Plants Society (where I also held membership) — fell so far from its objective over the past nine decades, as evidenced by its strident opposition of the Oakland Zoo's proposal for the California Trail Exhibit.
I have been honored to serve as a docent at the Oakland Zoo for 38 years, teaching schoolchildren and other visitors about our animals and educating them about our conservation efforts. During this time I have learned there is no organization more concerned with conservation and habitat protection than our zoo.
Both state and federal agencies that have oversight of our state's natural resources have permitted the California Trail Exhibit, including requiring the City of Oakland to set aside a portion of Knowland Park for permanent conservation. Oakland Zoo's California Trail Exhibit will integrate, enrich, and protect the park's native habitat, while providing new educational opportunities for all ages. I am disheartened that groups like Sierra Club and CNPS would misuse their environmental credibility by suggesting, inaccurately, that the zoo would do anything not in the best interest of both the environment and our community.
The California Trail Exhibit was approved in 1998 and again unanimously in 2011. The proposed conservation easement is a last step in a very long public process and will ensure Knowland Park habitat monitoring and management in perpetuity. It is time for conservation organizations to get back to their mission and focus on ending true environmental injustices. What the Oakland Zoo is proposing will only enhance and protect our wild places, educate our young people about their role in nature, and provide opportunities for the next generation of docents like myself.