By Kathlyn M. Logan, RN

Good afternoon, my name is Kathlyn Logan and I am a nurse in the central Massachusetts area. I have been in the nursing field for over twenty-five years with experiences in medical surgical, cardiology, home care, and intravenous therapy specialties. I am a member of the Mass Nurses Association and chair of my hospital's staffing advisory committee. I am here today, to tell you that in this past decade, nursing at the bedside has become an almost impossible accomplishment.

The current atmosphere of inpatient acute care has reached a level of increased stress, inadequate staffing, increased levels of acuity, and unacceptable scheduling patterns. Today a nurse can not go into work, knowing that she/he will go home at the end of his or her designated shift. Today a nurse can not go into work knowing that he or she will be able to deliver the best care that the patients deserve. Today a nurse can not go into work without the fear of working with an unsafe nurse-to-patient ratio. Today, a nurse finds it almost impossible to take an uninterrupted meal break or to receive any incidental time off.

The focus of the patient's comfort needs has been put aside for increased technology, increased responsibility and an overwhelming patient load. Nursing is not about bedside care anymore; nursing has become the catalyst for the patient's revolving door. We need to find a balance.

Increased mandatory overtime, which is forcing a nurse to work extra hoursbeyond their scheduled shifts, is purely a symptom of not having enough staffing. Studies have shown those understaffed and exhausted nurses contribute to increase medication errors, complications, infections, and other
poor patient outcomes. In addition to patient safety concerns, nurses have valid concerns about the impact of mandatory overtime on their family life, and on their social lives.. Most of our nurses are mothers with young children with childcare concerns. Many times, these mothers have been put in a position to choose between patient abandonment and their children.

Recently I heard a physician speak on a radio talk show about sleep deprivation. She was speaking about the affects of day light savings time and what the loss of one hour can do to the body's biorhythm. Imagine, she was speaking about one hour. What about two, three, four, and sometimes as much as eight hours of sleep a nurse is deprived of when she/he is forced to stay beyond their working shift? I know, because I have done it. When you return to work on the following shift you drink so much coffee, you shake. When you walk, you stagger. When you speak, you sometimes slur. When an emergent situation comes up, your ability to respond and process data quickly is affected. You are in a state that resembles drunkenness. When you leave, you pray to God you make it home safely without causing any harm to yourself or others on the highway.

Nurses today are forced to overextend themselves both physically and emotionally in an atmosphere that demands astute, sharp assessment skills and increased physical stamina. Regulations have been put on truck drivers for the amount of times that they can safely be on the road. As nurses, we administer high doses of cardiac medications, narcotics, and chemotherapy. We monitor heart rhythms; we set up and administer intravenous infusion pumps. All of this, plus more, done incorrectly can have a lethal ending.

In today's current healthcare, the average age of a nurse is mid-forties. Schools of nursing have dramatically decreased enrollment. The plate will soon be empty. If we are not in a crisis now, we soon will be. The silent layoff has taken its toll. The current trend of inadequate working conditions, that produce over-worked, over-exhausted nurses and unsatisfied patient care
delivery must come to an end. Without legislation that regulates the amount of time a nurse can safely work, without legislation that regulates the amount of patients that a nurse can safely administer care to, eventually, there will no longer be a nurse at the bedside.

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