Protecting Patients and Their Caregivers

For Robin Henderson, the best part of being a nurse is interacting with patients. But her time with them is all about quality, not quantity. “I have to make an impact in about five minutes,” she said, “because after that, they’re asleep.”

Henderson has been an operating room nurse for 17 years. In the five — sometimes 10, maybe 15 tops— minutes she has with a patient before a procedure, she’ll explain what will happen before, during, and afterwards. You might wake up with a head the size of a pumpkin, for example. But no worries, the swelling will go down within an hour, she reassures. 

After the patient is asleep and can no longer monitor what’s happening, Henderson is the representative and advocate.

The worst part of the job, Henderson says, is not “having what you need when you need it.” What she and other nurses need, above all else, is other people. 

The Minnesota Nurses Association (MNA) represents 20,000 Registered Nurses and other healthcare professionals in Minnesota, Wisconsin, and Iowa. Henderson sits on the association’s Board of Directors. 

Short staffing is a major focus of the MNA, which compiles an annual safe staffing report. According to the 2016 report, “Short staffing occurs when there are not enough nursing staff scheduled or available to care for patients on a specific hospital unit at one time.” In 2016, MNA documented 3,000 incidents of short staffing — a 45 percent jump since 2014. The report uses Concern for Safe Staffing (CFSS) forms, on which nurses track patient care breakdowns in 17 categories, including:

• Delays in treatments, medications, and care, and incomplete assessment and admissions.
• Unanswered patient call lights.
• Incomplete discharge instructions. 
• Overtime that results in nurses working longer than 16 consecutive hours (double shift), or multiple nurses working consecutive double shifts.

To address the problem, MNA wants a state law setting standards for, and limits on, the number of patients a nurse can be assigned to care for at one time. Legislators from both parties have authored nurse staffing bills in the 2017-18 session, but as of this writing, they have not moved out of committee.

Although it doesn’t necessarily result in harm, Henderson says, patient care suffers when nurses don’t have time to simply sit with patients and get to know them. “You have to keep moving. Your focus is always on the next task [when there are not enough nurses available],” she says. “That’s what causes your staff to burn out.”

The operating room has to be cleaned between procedures. If those who do that work are stretched too thin, the half hour a patient sits in pre-op could become 45 minutes or an hour. That’s extra time for a patient to get nervous.

A hospital runs on teamwork, with everyone “working to give the patient the best possible outcome,” says Henderson. The ability to help others on a daily basis, and make a real difference in someone’s life, is what drew her to working at a hospital more than 30 years ago, when she was 17 years old.

Henderson worked in medical records, later becoming an administrative assistant, handling payroll and scheduling shifts for nurses in the surgery department. The experience inspired her to go to school to become a nurse herself.

Henderson spent five years as a nurse in the psychiatry department, which she found interesting and rewarding. Yet she wanted to get back to surgery, where she’d been an administrative assistant, “to prove I could, because they never had people of color there.” Henderson figured she’d stay five years in surgery, then move on to the emergency department. Seventeen years later, she’s still in the OR.

“I haven’t made it back to the ER yet,” she says with a chuckle.

Along with safe staffing, workplace safety — including violence prevention — is another key focus for nurses. From 2002 to 2013, according to U.S. Bureau of Labor Statistics data, workers in the health care and social assistance sectors experienced workplace violence-related injuries at a rate more than four times higher than workers in the private sector overall.

In 2013, 80 percent of serious violent incidents reported in healthcare settings were caused by interactions with patients. The most common causes of violent injuries in healthcare occupations were hitting, kicking, beating, and/or shoving. 

In 2015, MNA helped pass a state law requiring hospitals to develop plans to prevent violence before it happens, not to simply respond to it after an incident. Currently, enhanced penalties only apply to assaults occurring in a hospital’s emergency department. This year, MNA supports a bill that increases criminal penalties for assaulting a nurse, physician, or other healthcare provider anywhere in a hospital.

Violence at hospitals, Henderson notes, doesn’t have boundaries. “There have to be safety measures throughout the hospital,” she says. 

In addition to violence, nurses’ jobs expose them to a variety of health issues. Back problems, shoulder injuries, and “bad feet” are common, she says.  Henderson considers herself fortunate that her health issues have consisted mainly of catching colds from patients, and getting chicken pox — at age 35 — after a youngster impulsively gave her a hug and kiss. She also hurt her knee catching a patient who tried to climb out of bed, and later re-injured it helping a patient to the restroom. Henderson kept working for eight months before having surgery, because “the pain wasn’t that bad.” She walks with a mild limp. 

“I have been lucky,” she sums up, “but 17 years is considered a new nurse, so ask me again in another 17 years.”

Clearly, nursing is mentally, physically, and emotionally demanding. But it only takes “one thank you or one patient squeezing your hand and offering you a small smile to let a nurse know why we do what we do,” says Henderson.

The demands of nursing — mentally, physically, and emotionally — are challenging. To relax, Henderson reads and takes vacations. 

She also volunteers on behalf of people who are homeless or otherwise in need. For example, she spearheaded operating room drives to collect cotton socks for people at emergency shelters and backpacks for low-income students. “We pick a school or a shelter,” says Henderson. “We go where the need is greatest.”

In that spirit, MNA’s platform also calls for affordable housing, as well as affordable child care, a $15/hour minimum wage, immigrant rights, and gun violence prevention. “As nurses, we’re always going to take care of people,” Henderson notes, “whether it’s at work or out on the street.”