This document contains tweets from EllenRichter and others discussing topics for an #RNchat Twitter chat about nursing issues. EllenRichter provides links to articles about elderly hospital patients, delirium, nurse staffing ratios, and new nurse turnover. Others introduce themselves and their locations. The chat then begins discussing the impacts and challenges of mandated nurse-to-patient ratio laws.

1. EllenRichter: Some interesting reading related to #RNchat tonight "Hospital Delirium | Delirium in
Elderly Patients | Caring.com" http://j.mp/9UuIIa
6/23/2010 19:58
EllenRichter: Another good article for #RNchat topic tonight "Hallucinations in Hospital Pose Risk to
Elderly - NYTimes.com" http://j.mp/akcXBe
6/23/2010 20:01
EllenRichter: Excellent tips for patient safety!"Triage: Delirium in elderly patients: an often overlooked
problem" http://j.mp/agTSnQ #RNchat
6/23/2010 20:04
EllenRichter: Article identifies key points for care "Elderly hospital patients facing risk of delirium |
Deseret News" http://j.mp/cqTwNs #RNchat
6/23/2010 20:06
EllenRichter: "Bill Text - 111th Congress (2009-2010) - Registered Nurse Safe Staffing Act of 2010"
http://j.mp/d74Hzi #RNchat Topic for tonight's chat
6/23/2010 20:19
EllenRichter: A wonderful blog for #RNchat topic tonite "Aging: When the Elderly Have a Sudden Onset
of Confusion...?" http://j.mp/d4YRFA
6/23/2010 20:28
nursingpins: Geriatric Medicine in the Hospital Setting…Very Common Mistakes!
http://tinyurl.com/23wzaxj #RNchat
6/23/2010 20:32
EllenRichter: Do improved nurse:pt ratios really help with pt outcomes? "States Consider Merits of
Mandated Staffing Ratios" http://j.mp/cgH49g #RNchat
6/23/2010 20:39
nursingpins: What is "active ageing"? (W.H.O) http://www.who.int/ageing/active_ageing/en/index.html
#RNchat
6/23/2010 20:39
EllenRichter: "Mandatory Hospital Nurse to Patient Staffing Ratios: The Argument For & Against
Mandatory Staffing Ratios" http://j.mp/cl97RB #RNchat
6/23/2010 20:46
EllenRichter: Great #RNchat topic read! "Surprises in Work Environment Contribute to High Turnover
Rates of New Nurses - RWJF" http://j.mp/d1ERXT
6/23/2010 20:53
EllenRichter: #RNchat nurse:pt ratios "Implications of the California Nurse Staffing Mandate for Other
States (PubMed Abstract only) http://j.mp/c7KQIS
6/23/2010 20:55
rnchat: Just to clear up any possible confusion, tonite @EllenRichter (thats me) will be typing
under the guise of this account name for #RNchat :)
6/23/2010 20:58
rnchat: Signing into TweetGrid for #RNchat (wish the site would remember the password for me)
:)
6/23/2010 20:59
chemosabe: hello all working on the floor, will try to keep up. #rnchat

2. 6/23/2010 21:00
rnchat: RT @nursingpins: My favorite study re:Ratios - http://scrubsmag.com/nurse-staffing-
ratios-save-lives/ #rnchat
6/23/2010 21:01
MatthewBrowning: Go Ellen!! :-) RT @PhilBaumann: Dropping in to say Hi at #RNchat while manic-tasking -
@EllenRichter does an amazing job, doesn't she!
6/23/2010 21:02
rnchat: Hello everyone who is joining in tonite! This is #RNchat & I am moderating tonite for
@philbaumann ~Welcome nurses & health care professnals
6/23/2010 21:03
rnchat: @chemosabe Appreciate how difficult it is to chat while at work!! #RNchat
6/23/2010 21:03
nursingpins: Vernon -critical care in new orleans - hi all -thanks for hosting tonight Ellen. #rnchat
6/23/2010 21:04
rnchat: Lets begin with our usual introductions. Please say hello & tell us a tiny bit about
yourselves! #RNchat
6/23/2010 21:04
rnchat: @nursingpins LOL you beat me to it! :) #RNchat
6/23/2010 21:05
seejanenurse: Telemetry Janey here, hello #RNchat
6/23/2010 21:05
chemosabe: I'm searching for #rnchat live on TweetGrid Search - http://tweetgrid.com/search?
q=%23rnchat
6/23/2010 21:05
chemosabe: #rnchat
6/23/2010 21:05
rnchat: I'm @EllenRichter a critical care nurse & legal nurse consultant. I currently live in south
Florida & its hurricane season! :) #RNchat
6/23/2010 21:06
nursingpins: @chemosabe TweetChat works well most of the time. #rnchat
6/23/2010 21:07
chemosabe: I'm @chemosabe, Oncology NUM, Brisbane, Australia. 11am Thursday down here, and
we now have new PM #rnchat
6/23/2010 21:07
rnchat: Just want to say that #RNchat is a way for nurses (& all others in health care!) to meet,
tweet & share feelings, thoughts & ideas~
6/23/2010 21:07
chemosabe: have issues using work computer with both tweetchat and tweetgrid #rnchat
6/23/2010 21:08
MatthewBrowning: RT @RNchat: Just want to say that #RNchat is a way for nurses (& others in health
care!) to meet, tweet & share feelings, thoughts & ideas~
6/23/2010 21:08

3. rnchat: The topics will be labeled T1, T2, etc. Please remember to type topic label & hashtag
#RNchat to ea tweet so we can track your responses!
6/23/2010 21:08
rnchat: T1 Looking to Cali RNs for help to discuss our 1st topic. It has to do with mandated
staffing ratios #RNchat
6/23/2010 21:11
hiremysisterrn: #RNchat - I'm' @hiremysisterRN. Sis is a GN/RN looking for work in critical care field,
near Philadelphia, PA. Nice to meet you all!
6/23/2010 21:12
rnchat: T1 How can RNs work with hospital admin to ensure compliance with mandated ratios
when there are staffing problems, sick calls, etc? #RNchat
6/23/2010 21:14
seejanenurse: T1 I wonder if it is only CA that has mandated ratios, or do unionized nurses also have
ratios enforcement? #RNchat
6/23/2010 21:14
nursingpins: T1 I think ratios will event. have to be mandated. Hospitals will never allow safe staffing
due to cost perceptions. #rnchat
6/23/2010 21:14
rnchat: T1 If RN:pt staffing ratios are mandated by law, how responsible are individual nurses to
help maintain compliance? #RNchat
6/23/2010 21:15
seejanenurse: T1 I think that RNs could sign up for on call, overtime for staffing problems, sick calls etc,
if ratios were enforced. #RNchat
6/23/2010 21:15
chemosabe: T1 Qld uses Business Planning Framework to budget and run units, supposedly including
staffing ratios..lol #rnchat
6/23/2010 21:16
rnchat: @seejanenurse T1 Good question. Does anyone work in a state where RN:pt ratios are
mandated by law? #RNchat
6/23/2010 21:16
seejanenurse: T1 I am personally doing the overtime now, due to understaffing and this just enables
admin to "not hire" more. #RNchat
6/23/2010 21:17
nursingpins: T1 nurses maintain what they can of safe staffing now, ANY improv would help. Would
not worry so much about call-ins etc #rnchat
6/23/2010 21:17
rnchat: @seejanenurse T1 But doesnt mandated overtime cause RN burnout & that ripple effect
goes to the patient? #RNchat
6/23/2010 21:18
chemosabe: T1 our hospital uses casual pool, then agency, then parttimers, then OT. #rnchat
6/23/2010 21:19
rnchat: T1 Are you content with the staffing numbers on the unit you work in? #RNchat

4. 6/23/2010 21:19
seejanenurse: T1 Yes, I get cranky sometimes from working overtime, I can't do it every week. #RNchat
6/23/2010 21:20
nursingpins: T1- I tweeted an informal study 2 weeks ago. Over 80% of nurses at 5 hospitals here
had OT - 40% had more than 16hrs. #rnchat
6/23/2010 21:21
dlwdillon: RT @nursingpins: Vernon -critical care in new orleans - hi all -thanks for hosting tonight
Ellen. #rnchat
6/23/2010 21:21
chemosabe: T1 personally looking at an acuity based staffing model for ambulatory oncology unit
#rnchat
6/23/2010 21:21
rnchat: @nursingpins T1 And were those nurses who did more than 16 hrs OT still happy &
enjoying their work? #RNchat
6/23/2010 21:22
seejanenurse: @nursingpins T1 16 hours in 1 shift, is sick. I once worked from 0700-2300 I almost died.
I would never, ever say yes to that again. #RNchat
6/23/2010 21:22
nursingpins: T1 most hospitals have quit using agency here - 2 of the large agencys closed - they let
you sink or swim! #rnchat
6/23/2010 21:22
rnchat: @chemosabe T1 We have used acuity-based staffing models but they are only good on
paper. Not easily fulfilled with hi acuity #RNchat
6/23/2010 21:23
KentBottles: RT @EllenRichter #RNchat topic read! "Surprises in Work Environment Contribute to High
Turnover Rates of New Nurses" http://j.mp/d1ERXT
6/23/2010 21:24
chemosabe: @rnchat Thanks Ellen, doing the research currently, always happy to take advice or
experience #rnchat
6/23/2010 21:24
nursingpins: T1 most appreciate the OT - but do not enjoy the work - the nursing profession (what is
left of it) is changing fast. #rnchat
6/23/2010 21:24
rnchat: T1 Do mandated minimum nurse:patient ratios really impact on patient safety and improve
patient outcomes upon hospital discharge? #RNchat
6/23/2010 21:24
cyclingwidow: T1 what are your feelings on MANDATORY overtime and how much is too much (from a
safety perspective)? #RNChat
6/23/2010 21:24
rnchat: @KentBottles Thanks for that link RT :) #RNchat
6/23/2010 21:25
nursingpins: T1 there will be no meaningful improvement in hc until we have safe staffing. #rnchat
6/23/2010 21:25

5. rnchat: @cyclingwidow T1 Great question. I hope folks answer it! :) #RNchat
6/23/2010 21:25
chemosabe: T1 all mandatory staffing issues are only as good as the staff working, skill mix etc...
#rnchat
6/23/2010 21:25
seejanenurse: @cyclingwidow I don't think any overtime should be mandatory, I just don't understand
that concept at all. #RNchat
6/23/2010 21:26
rnchat: T1 If nurses are mandated by law to work with minimum safe staffing ratios, then we are
all obligated to help maintain those ratios #RNchat
6/23/2010 21:27
nursingpins: T1 we have used acuity-based staffing for years - bottom line - you get the same # of
nurses regardless - just change the#'s #rnchat
6/23/2010 21:27
chemosabe: T1 no such thing as Mandatory OT in Qld public hospitals #rnchat
6/23/2010 21:27
cyclingwidow: T1 Hate working overtime only to find my check LESS than normal because of taxes. That
REALLY discourages #RNCHAT
6/23/2010 21:28
seejanenurse: @rnchat I agree, if ratios were mandated, I would understand the responsibility, even if it
meant working overtime (I do it anyway!) #RNchat
6/23/2010 21:28
rnchat: T1 There needs to be a part-time pool of nurses to fill in holes in staffing---we shouldn't
use staff for mandatory OT #RNchat
6/23/2010 21:29
nursingpins: T1 As long as hospitals do the #'s - there will be no improvement - Nursing needs to be
outside hospital control. #rnchat
6/23/2010 21:30
cyclingwidow: @seejanenurse I don't either. Unscheduled MO especially. Yes we are nurses, yes we are
dedicated to patients but we have lives too #RNCHAT
6/23/2010 21:30
rnchat: T1 So does anyone feel mandatory minimum safe staffing numbers shows improvement in
patient outcomes? Or RN satisfaction? #RNchat
6/23/2010 21:30
seejanenurse: T1 bottom line, I am working overtime anyway, where are the mandated ratios to go along
with it? #RNchat
6/23/2010 21:30
rnchat: T1 Are patients and nursing staff happier in hospitals where staffing is better? #RNchat
6/23/2010 21:31
nursingpins: T1 most hospitals have prn/pt pools - used for reg staffing - never call unless call-ins
#rnchat
6/23/2010 21:31

6. cyclingwidow: @rnchat Honestly, I think it depends on how the minimum numbers are met, skill levels,
overtime, etc #RNCHAT
6/23/2010 21:31
seejanenurse: T1 I have not read the research, but I bet the nurses are more effective, and patient
outcomes should follow that, naturally. #RNchat
6/23/2010 21:32
nursingpins: T1 - hard to say if they are happy are not - have not worked in a well staffed hospital in
years. #rnchat
6/23/2010 21:32
nursingpins: T1 I must say - staffing in critical areas has gotten better in the past 5 years. #rnchat
6/23/2010 21:33
seejanenurse: @nursingpins gangbang staffing for years! Oh help us. #RNchat
6/23/2010 21:33
cyclingwidow: @rnchat Staffing at my current facility is great. When we opened 9 yrs ago everyone was
happy. Oh how we forget how good we have it #RNCHAT
6/23/2010 21:33
rnchat: T1 My ICU is supposed to be 2 patients to 1 RN, but with staffing shortages, they easily
add a 3rd patient to our load #RNchat
6/23/2010 21:33
nursingpins: T1 Hospitals must hire people to run the hospitals and let nurses nurse - we can no
longer do it all. #rnchat
6/23/2010 21:34
rnchat: So so true! > RT @nursingpins: T1 Hospitals must hire people to run the hospitals and let
nurses nurse - we can no longer do it all. #rnchat
6/23/2010 21:34
medicalconnect: RT @nursingpins: T1 Hospitals must hire people to run the hospitals and let nurses nurse
- we can no longer do it all. #rnchat
6/23/2010 21:35
rnchat: T1 I will bring an end to this topic with a link to the bill: Registered Nurse Safe Staffing
Act of 2010" http://j.mp/d74Hzi #RNchat
6/23/2010 21:36
chemosabe: @rnchat is that ventilated patients? #rnchat
6/23/2010 21:36
rnchat: @chemosabe T1 At some hospitals, chronic ventilators are 4:1 or even on step-down
units #RNchat
6/23/2010 21:37
seejanenurse: @rnchat T1 Thanks for the link. #RNchat
6/23/2010 21:37
philbaumann: @rnchat That used to happen to me. I'd get 3 or 4 criticals, or like 2 criticals plus 2 or 3
tele's with dementia. #RNchat
6/23/2010 21:38
rnchat: @philbaumann Dementia....our next topic! :) #RNchat

7. 6/23/2010 21:38
nursechenene: T1 mandated nurse/pt ratios can improve safety w/ fewer pts to care for-but higher nurse
demand may trend toward needing a warm body #rnchat
6/23/2010 21:38
rnchat: OK folks, moving right along to our next topic. We can surely talk about staffing for days
on end! :) #RNchat
6/23/2010 21:39
nursingpins: T1 - where ratios will be important is the fast growing postacute/acute units where hosps
say a nurse cant take 5-often with 3 vents #rnchat
6/23/2010 21:40
rnchat: T2 Anyone who's cared for elderly pts understands how quickly delirium sets in when
they're hospitalized! #RNchat
6/23/2010 21:40
seejanenurse: T2 Yes, put the elderly in an unfamiliar environment, where the <bleep> never ends, they
will get delirious (so would I) #RNchat
6/23/2010 21:41
cyclingwidow: @rnchat Add anesthesia to that hospitalization and you've practically got a sure thing
#RNCHAT
6/23/2010 21:41
rnchat: T2 We are aware of safety risks when elderly get confused. What measures can we act
on to prevent injury while hospitalizd? #RNchat
6/23/2010 21:42
rnchat: I keep getting my T1 & T2 discombobulated :) #RNchat
6/23/2010 21:42
NursePru: T2 We have alarms built into the bed. Any patient that isn't oriented x 3 has the alarm
activated to prevent falls. #rnchat
6/23/2010 21:43
seejanenurse: T2 even young patients, transfer from ICU to telemetry with delirium, they call it ICU
psychosis. I never believed it, but it true. #RNchat
6/23/2010 21:43
chemosabe: T2 @rnchat is that your delirium setting in #rnchat
6/23/2010 21:43
seejanenurse: T2 I love our bed alarms, they have a voice option. I record, "Stay in bed, wait for your
nurse." #RNchat
6/23/2010 21:44
rnchat: @chemosabe LOLLLLLLLLLL #RNchat
6/23/2010 21:44
cyclingwidow: @rnchat T2 Keep the family involved and make room for a loved one to be with them at
any time (or all times if they wish) #RNCHAT
6/23/2010 21:44
rnchat: T2 Touchy subject: should staffing be increased on units when patients become acutely
delirious & confused? 1:1 aides? #RNchat
6/23/2010 21:45

8. seejanenurse: @cyclingwidow T1 I am not sure if the night nurse will be happy with that option. I love
the helpful family. #RNchat
6/23/2010 21:45
abegler: RT @EllenRichter: "Mandatory Hospital Nurse Patient Staff Ratios:Argument For &
Against Mandatory Staff Ratios" http://j.mp/cl97RB #RNchat
6/23/2010 21:46
nursingpins: T2 older pts will always be a fall risk-again it gets down to staff-"People"must watch
them-some will cont to fall unless watched. #rnchat
6/23/2010 21:46
rnchat: @cyclingwidow T2 Yes, involving the family from the onset is very important when acute
confusion is identified in the hospital #RNchat
6/23/2010 21:47
NursePru: T2 @nursingpins so true. Sometimes alarms aren't enough if staff doesn't get there in
time. #rnchat
6/23/2010 21:47
seejanenurse: T1 The 1:1 option with aides, short staffs the floor, unfortunately. It is as if we are being
punished even more. #RNchat
6/23/2010 21:47
seejanenurse: Ooops I meant T2 I am delirious now too. #RNchat
6/23/2010 21:48
rnchat: T2 Involving the family also prevents them from pointing a finger at the staff for not
keeping a close eye. They understand better #RNchat
6/23/2010 21:48
dlwdillon: RT @nursingpins: T1 most hospitals have quit using agency here - 2 of the large
agencys closed - they let you sink or swim! #rnchat
6/23/2010 21:48
NursePru: T2 For the confused and really impulsive patient's that can't sit still...a sitter is the only
true way to keep a patient safe. #rnchat
6/23/2010 21:48
dlwdillon: RT @nursingpins: T1 there will be no meaningful improvement in hc until we have safe
staffing. #rnchat
6/23/2010 21:48
cyclingwidow: @seejanenurse We try to practice Family Centered care (helps that we are a Women's
hospital--OB/GYN--but the GYN do suffer dementia) #RNCHAT
6/23/2010 21:49
nursingpins: T2 always better when family stays -but we need more NA's too-often 1 NA for each 12 -
15pts+plus all they do AND help watch pts. #rnchat
6/23/2010 21:49
dlwdillon: RT @nursingpins: T1 at most hospitals "acuity-based staffing" is a joke. It is meaningless
as presently used. #rnchat
6/23/2010 21:49
MatthewBrowning: RT @dlwdillon: RT @nursingpins: T1 there will be no meaningful improvement in hc until

9. we have safe staffing. #rnchat
6/23/2010 21:50
wantnews: RT @rnchat: T1 I will bring an end to this topic with a link to the bill: Registered Nurse
Safe Staffing Act of 2010" http://j.mp/d74Hzi #RNchat
6/23/2010 21:50
cyclingwidow: T2 Hate bring a patient to the desk but have resorted to that, in a recliner chair so that
someone would be with the pt at all times #RNCHAT
6/23/2010 21:50
nursingpins: T2 -so many problems would go away if hospitals just hired enough people to take care
of the patients. #rnchat
6/23/2010 21:51
MatthewBrowning: T2 sorry for late join- Agree Family involvement is huge- IF they have some involved-
largest need is more CNA/HHA to meet demand #RNChat
6/23/2010 21:51
AbbieCitron: Lurking all chat RT @NursePru: T2 For the confused-really impulsive patients a sitter is
the only true way to keep a patient safe. #rnchat
6/23/2010 21:51
rnchat: @nursingpins T2 I imagine there are also challenges on the side of administration to
budget more nursing staff for safe staffing #RNchat
6/23/2010 21:52
nursingpins: @cyclingwidow pts to the desk at small units works well - but in busy units - not possible.
#rnchat
6/23/2010 21:52
MatthewBrowning: @nursingpins even a large contingency pool with a great communications system would
improve care- Right now #RNChat
6/23/2010 21:52
rnchat: T2 In ICUs we cant take them to a desk. They are wired in their rooms. Its a challenge to
provide safe envirnmt for confused in ICU #RNchat
6/23/2010 21:53
cyclingwidow: @nursingpins T2 we shouldn't have to resort to that on any unit. #RNCHAT
6/23/2010 21:55
nursechenene: #RNChat T2 nurse:pt ratio and budget justification is not a job I would want.
6/23/2010 21:55
MatthewBrowning: @rnchat T2 challenges for certain but patient safety can no longer be a cost-benefit
equation- When MY patient is injured bc no help #RNChat
6/23/2010 21:55
AbbieCitron: T2 involving family is important, but can't hold them accountable to keep pt. safe. Often
they fall asleep too. #rnchat
6/23/2010 21:55
nursingpins: @MatthewBrowning A large pool would be wonderful! #rnchat
6/23/2010 21:55
MatthewBrowning: amen! RT @nursechenene: #RNChat T2 nurse:pt ratio and budget justification is not a

10. job I would want.
6/23/2010 21:55
cyclingwidow: T2 have also taken turns with other staff, saved our charting to do while sitting with
pleasantly confused patients. Not ideal #RNCHAT
6/23/2010 21:56
rnchat: A large pool of the right gene pool too! >> RT @nursingpins: @MatthewBrowning A large
pool would be wonderful! #rnchat #RNchat
6/23/2010 21:56
rnchat: @cyclingwidow T2 Charting in a confused patient's room is an excellent idea. Any staff
coverage counts in #ptsafety issues #RNchat
6/23/2010 21:57
cyclingwidow: @cyclingwidow T2 and definately not possible most of the time. AND not fair to the other
patients that are receiving less attention #RNCHAT
6/23/2010 21:58
MatthewBrowning: minimum safe staffing ratios with no efficient coverage for absences = Short Staffing, avg
nurse vacancy 7-9% #RNChat
6/23/2010 21:58
DebErupts: Adequate nursing staff in the long run SAVES the hospital money. Nurses are worth every
penny. #RNChat
6/23/2010 21:58
rnchat: I tweeted a few links to some good reading on points that can send a person, espec
elderly, into a confused state when hospitalized #RNchat
6/23/2010 21:59
chemosabe: hey y'all have to go access TIVAD, may miss rest of chat. take care, chat soon. Thanks
Ellen and all #rnchat
6/23/2010 22:00
cyclingwidow: Thanks to all. Must sign out and get 2 little ladies off to bed. #RNCHAT
6/23/2010 22:00
DebErupts: Understaffed hospitals have more errors, bad outcomes, longer stays, lawsuits. Proper
staffing is key to good quality care. #RNChat
6/23/2010 22:01
MatthewBrowning: @nursingpins turnover, pt and staff safety, pt outcomes, med errors, surgical errors and
fatalities ALL tied to poor staffing #RNChat
6/23/2010 22:01
nursingpins: @DebErupts studies have shown safe staffing saves noney - infections, turnover, errors,
lawsuits - on and on. #rnchat
6/23/2010 22:01
nursechenene: #rnchat And I feel the EMR's are including alot of charting that protects the facility and not
the nurse.
6/23/2010 22:01
rnchat: Well, unfortunately our hour has come to an end! Please continue any topic of
conversations without me! This was great! #RNchat
6/23/2010 22:02

11. MatthewBrowning: RT @DebErupts: Adequate nursing staff in the long run SAVES the hospital money.
Nurses are worth every penny. #RNChat
6/23/2010 22:02
nursechenene: #rnchat pt # plus ever changing EMR does frustrate a person. Feel att'n to detail has to
be rushed
6/23/2010 22:03
MatthewBrowning: My company, YourNurseIsOn.com was created solely to put the right nurse in the right
place at the right time-no nurses=no healthcare #RNChat
6/23/2010 22:04
rnchat: @nursechenene Yes, a good EMR program will work to the benefit of both the hospital &
RNs if it is utilized correctly & completely #RNchat
6/23/2010 22:04
DebErupts: New study examines impact of nurse-patient ratios law, California: http://bit.ly/b63C5u
#RNChat
6/23/2010 22:04
MatthewBrowning: RT @nursingpins: @DebErupts studies have shown safe staffing saves noney -
infections, turnover, errors, lawsuits - on and on. #rnchat
6/23/2010 22:04
rnchat: I want to thank all of our participants tonight for great tweeting on our topics of discussion.
This is truly a wonderful group!! #RNchat
6/23/2010 22:05
MatthewBrowning: I got so tired of ALWAYS having to call nurses 1 at a time- 30/hr HOPING 1 would say
"yes" -We are ALL short staffed- all the time #RNChat
6/23/2010 22:06
nursingpins: Hospitals must start explaining EMR to nurses - many have no clue - and it will be a big
problem at the last min. #rnchat
6/23/2010 22:06
rnchat: Do improved nurse:pt ratios really help with pt outcomes? "States Consider Merits of
Mandated Staffing Ratios" http://j.mp/cgH49g #RNchat
6/23/2010 22:07
MatthewBrowning: short staffing also increases "mental health" days, burnout, and causes nurses to LEAVE
the profession voluntarily or injured #RNChat
6/23/2010 22:07
DebErupts: And, Mathew, as a nurse I hated getting those calls every day I had off. Felt guilty if I
said, "no." #RNChat
6/23/2010 22:07
rnchat: Mandatory Hospital Nurse to Patient Staffing Ratios: The Argument For & Against
Mandatory Staffing Ratios" http://j.mp/cl97RB #RNchat
6/23/2010 22:08
rnchat: Great #RNchat topic read! "Surprises in Work Environment Contribute to High Turnover
Rates of New Nurses - RWJF" http://j.mp/d1ERXT
6/23/2010 22:08
MatthewBrowning: @rnchat Thanks for hosting Ellen! @nursingpins Nurse Informatics is becoming HUGE

12. opportunity for nurses to teach nurses #RNChat
6/23/2010 22:08
DebErupts: RT @rnchat: Great #RNchat topic read! "Surprises in Work Environment Contribute to
High Turnover Rates of New Nurses - RWJF" http://j.mp/d1ERXT
6/23/2010 22:09
MatthewBrowning: Too True! RT @DebErupts: And, Mathew, as a nurse I hated getting those calls every
day I had off. Felt guilty if I said, "no." #RNChat
6/23/2010 22:09
MatthewBrowning: @DebErupts That is why we made our system collaborative- if we are not available -we
should NOT be bothered-If we R, PLEASE call ;-) #RNChat
6/23/2010 22:10
rnchat: @PhilBaumann @seejanenurse @AbbieCitron @cyclingwidow @nursingpins
@MatthewBrowning @DebErupts @chemosabe You all make #RNchat great!
6/23/2010 22:11
MatthewBrowning: RT @rnchat: T1 There needs to be a part-time pool of nurses to fill in holes in staffing---
we shouldn't use staff for mandatory OT #RNchat
6/23/2010 22:12
nursingpins: Pub awareness/education will help ratios before the hospitals will,hospitals have seen
nurses as servants since the TS/Diploma days #rnchat
6/23/2010 22:13
nursingpins: RT @MatthewBrowning:RT @rnchat: T1There needs to be a pt pool of nur to fill in holes
in staffing-we shouldnt use staff for mand OT #rnchat
6/23/2010 22:14
rnchat: For those who missed tonight's chat, watch for the transcript link to be posted by
@PhilBaumann #RNchat
6/23/2010 22:14
chemosabe: back in time for the end, cheers all. #rnchat
6/23/2010 22:16
rnchat: @nursingpins There are more & more authors writing articles & blogs that address the
RN:pt ratio issues which raise public awareness #RNchat
6/23/2010 22:16
nursingpins: T1 many nurses can't find jobs- now would be the time for hospitals to hire and train them
-before nurses refuse to go back to them. #rnchat
6/23/2010 22:17
MatthewBrowning: @rnchat If we cannot contact the right nurse in time- the ratios become hard to meet-
add in flex-time and call volume is impossible #RNChat
6/23/2010 22:18
nursingpins: @rnchat Have seen them too - as more people realize the risk they put themselves in by
going into the hospital - will help ratios. #rnchat
6/23/2010 22:19
MatthewBrowning: @nursingpins LOTS of schools are beginning Nurse Informatics degrees this fall because
of HUGE Gov't funding for #HIT Great Opp!! #RNChat
6/23/2010 22:20

13. nursingpins: T1 mant hospitals do not even try to replace call-ins - pts are redivided and nurses do the
best they can. #rnchat
6/23/2010 22:20
MatthewBrowning: I do not believe the Boomers will accept same care we give their parents- and aging in
place will increase need for homecare nurses #RNChat
6/23/2010 22:21
nursingpins: @MatthewBrowning I noticed - I think informatics is a wonderful opportunity. The best
future for nurses will be Nurse Practioners. #rnchat
6/23/2010 22:23
EllenRichter: @nursingpins "the best they can do" is not always the answer that will fly when something
bad occurs as a result of poor staffing #RNchat
6/23/2010 22:24
MatthewBrowning: RT @rnchat: For those who missed tonight's chat, watch for the transcript link to be
posted by @PhilBaumann #RNchat
6/23/2010 22:24
MatthewBrowning: RT @rnchat @PhilBaumann @seejanenurse @AbbieCitron @cyclingwidow @nursingpins
@MatthewBrowning @DebErupts @chemosabe You make #RNchat great!
6/23/2010 22:25
EllenRichter: @MatthewBrowning Yes geriatric medicine is a growing field--much has to do with
refusing to be treated like our grandparents were #RNchat
6/23/2010 22:26
nursingpins: Many jobs will open up outside hosps - in the near future hosps will not be able to hire
enough nurses, they will not work for them #rnchat
6/23/2010 22:26
ColoradoHealth: RT @EllenRichter: @MatthewBrowning Yes geriatric medicine is a growing field--much
has to do with refusing to be treated like our grandparents were #RNchat
6/23/2010 22:26
MatthewBrowning: @nursingpins hmmm. maybe- I am FNP and went entrepreneur - the system needs major
repair- I hope to fix one little area- staff comm #RNChat
6/23/2010 22:27
MatthewBrowning: @EllenRichter Anything to do with Geri will be hot for next 25 yrs!! #RNChat
6/23/2010 22:29
nursingpins: @MatthewBrowning There is so much that needs fixing - I agree, staffing is #1 - poor
staffing is a major problem of our hc. #rnchat
6/23/2010 22:31
MatthewBrowning: @nursingpins my vision with #YNIO is to scan 3000 staff for 300 qualified and available
staff and confirm 1 in under 5 minutes ;-) #RNChat
6/23/2010 22:31
MatthewBrowning: Whoops- gotta run- night all! #RNChat
6/23/2010 22:32
nursingpins: @MatthewBrowning Your system will do well -when people get access to hc they have
been needing for years hosps will be overflowing. #rnchat
6/23/2010 22:34

14. nursingpins: @nursingpins But hospitals have done so much to ruin the profession -(Treated so badly)
many will not go back when needed. #rnchat
6/23/2010 22:36
TeriRN: @RNchat oh my I was off today and never saw that there was an #RNChat tonight. Darn
looked like a great chat. ={
6/23/2010 22:51
stshno: We are aware that safe nurse/patient ratios saves lives.Our ratios are among the best in
the city.The ANA: http://tinyurl.com/nycdyc #rnchat
6/23/2010 23:00
Wanderer_RN: @seejanenurse I love it when family stays with the delirious - when they're helpful. Often
all they do is call us and don't help. #rnchat
6/24/2010 03:43