Petition for Adequate Nursing and Ancillary Staffing

To: Mid-Hudson Regional Hospital - Erin Starr - Nurse Manager, Christopher Howard - Nurse Director and Sharon Marino - VP Associate Executive Director of Clinical Operations

From: 5 Cooke Nurses and Personal Care Technician Staff

Date: July 31, 2024

Subject: Urgent Need for Adequate Nursing and Personal Care Technician Staffing

Dear Erin, Chris, and Sharon:

We, the undersigned nurses and staff of 5 Cooke, are writing to express our urgent concern regarding the insufficient number of nursing staff and personal care technicians (PCTs) currently assigned to our unit. The current staffing levels are inadequate for the acuity and number of patients we are tasked with caring for, leading to a host of critical issues that jeopardize patient safety, staff well-being and our nursing licenses.

Over the past year, we have observed a significant increase in patient acuity and volume. Despite this, staffing levels have remained insufficient, resulting in the following severe issues:

1. **Patient Falls:**The high nurse-to-patient ratio prevents us from adequately monitoring patients, increasing the risk of falls and associated injuries. Which also recently caused a patient's death

2. **Risk of Medical Errors:** The overwhelming workload and time constraints increase the likelihood of medical errors, which can have serious, even fatal, consequences for patients.

3. **Missed Breaks and Meals:** Nurses are frequently unable to take their legally mandated breaks and meals, leading to fatigue and decreased performance, further endangering patient care. Nurses are also ask to cover sitters for breaks, which leaves he unit without appropriate nursing staff.

4. **Excessive Overtime:** The chronic understaffing forces us to work excessive overtime hours, contributing to burnout, job dissatisfaction, and a negative impact on our personal lives.

5. **Compromised Patient Care:** Insufficient staffing levels prevent us from delivering the personalized and timely care each patient needs, leading to delays in treatments and interventions.

6. **Lack of Ancillary Staff:** There is not enough ancillary staff to support our unit. We are often left without a secretary and PCTs. When we do have PCTs, they are frequently taken off the floor to sit with patients or to break sitters. This leaves nurses with the added responsibility of performing the tasks of PCTs and secretaries, further detracting from our ability to provide quality patient care.

To address these critical issues, we respectfully request the following actions:

1. **Increase Nursing Staff: Immediately hire additional registered nurses and travel nurses to ensure a safe nurse-to-patient ratio that aligns with national standards, best practices for patient care, and our agreed-upon contract. Additionally, develop and implement an effective plan to retain staff once hired, ensuring long-term stability and continuity of care.

2. **Hire More Personal Care Technicians:** Employ additional personal care technicians and/or sitters to support the nursing staff with routine patient care tasks, allowing nurses to focus on more complex clinical duties.

3. **Ensure Adequate Ancillary Staff:** Hire and maintain sufficient ancillary staff, including secretaries and PCTs, ensuring that they are available to perform their designated roles without being frequently reassigned.

4. **Review and Adjust Staffing Levels Regularly:** Implement a system to continuously assess patient acuity and adjust staffing levels accordingly, ensuring that we can meet the changing needs of our patient population hourly.

5. **Ensure Adequate Breaks and Meals:** Implement measures to ensure that all staff can take their legally mandated breaks and meals, promoting their health and well-being. Hire a breaking nurse to relieve nurses for breaks.

6. **Limit Mandatory Overtime:** Develop and enforce policies to limit mandatory overtime, allowing staff to maintain a healthier work-life balance and reducing the risk of burnout.

We are committed to providing the best possible care to our patients and believe that these changes are essential to achieving that goal. We urge you to take immediate action to address our staffing concerns and ensure the safety and well-being of both our patients and staff.

Thank you for your attention to this matter. We look forward to your prompt response and to working together to resolve this critical issue.

Sincerely,

5 Cooke Nursing/PCTs and Ancillary Staff