Florence Project NL: A cry for health

[Chellyse]

Here is an article from the San Francisco Chronicle from the Florence Project Newsletter. I thought this was good and wanted to share with you here.

Michele

Click here: A cry for health / Poor working conditions driving nurses out of

hospitals

http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2001/05/20/A

W135757.DTL

Poor working conditions driving nurses out of hospitals

Sunday, May 20, 2001

San Francisco Chronicle

A homeless psychiatric patient turned violent at San Francisco General

Hospital, attacking three nurses because he did not want to be discharged.

One nurse, Rex Spray, was so badly injured that he needed surgery to fuse his

spine and could not work for almost two years. The case is unusual, not

because nurses were hurt, but because Spray still works there. The other two

nurses quit working in hospitals after the attack. Dangerous situations like

this are one reason why one in three U.S. nurses under age 30 - and two in 10

overall - plan to quit within the next year, according to a study released

this month. The study, funded by the National Institutes of Health, found

that poor working conditions are driving nurses away from hospital work. The

survey found that nurses are increasingly frustrated - to the point of

burnout - by rising patient loads, shrinking staff, declining quality of

patient care and even physical and verbal abuse. "It's a very risky job,"

said Spray, vice president of the Service Employees International Union Local

790, which represents many of the nurses in San Francisco. "We're chronically

short-staffed," he said. "The patients have incredible needs. The burnout

comes from the disparity between wanting to do a good job and your ability to

do a good job." Spray, who now works in the outpatient clinic, was disturbed

but not surprised by the results of the survey which studied 13,471

registered nurses in Pennsylvania hospitals in 1998 and 1999. Among the

findings: -- 43 percent of hospital nurses scored high on a "burnout

inventory" measuring emotional exhaustion. -- 53 percent had experienced

"ward rage" in the form of verbal abuse from patients. -- 45 percent said the

quality of care in their hospital has deteriorated in the past year. -- 41

percent were dissatisfied with their job. Patients direct their frustration

at nurses because they are the only professionals who are there around the

clock, said Linda Aiken, director of the University of Pennsylvania School of

Nursing's Center for Health Outcomes and Policy Research. The center oversaw

the survey of 43,329 registered nurses at 711 hospitals in five countries.

The January-February issue of "Revolution," published by the California

Nurses Association, features a story about an "epidemic" of workplace

violence against nurses. More than 30 percent of registered nurses have been

assaulted at work, mostly by patients, said a recent seven-state study cited

in the magazine. The magazine tells the story of a psychiatric nurse who was

told to take a potentially violent patient into a dead-end corridor for a

cigarette. "He threw a blanket over her head, bashed her against the wall,

pushed her to the floor and began pummeling her and smashing her face into

the floor," the story said. Then he started to strangle her. She was saved,

not by staff or management, but by another patient. In the East Bay, a nurse

in a rehabilitation unit was assaulted four years ago by a male patient who

was being treated for severe head injuries he received in a bicycle accident.

It took a supervisor and a security guard to pull the man away. The nurse,

who worked at the hospital for seven years, was fired a month after she filed

a lawsuit against the patient. The U.S. Occupational Safety and Health

Administration rates nursing as the third-most hazardous occupation in the

nation. "The patients we see are hurting . . . tempers flare, they get

impatient," said Spray. "Nurses have to make choices in terms of priorities

and the patient who is being sidestepped doesn't always understand what is

going on." Once admitted to the hospital, however, "the care they get is

pretty outstanding," he said. "I'm very proud of my colleagues." The

frustration leveled at nurses does not only come from patients. "I think we

accept a lot of it as standard operating procedure," said Lorraine Thiebaud,

who works in the recovery room at San Francisco General. "I see doctors who

are completely frustrated. They take it out on us. They're tired, they've got

too many patients, they have all the hospital rules to follow. They get

upset," Thiebaud said. "You think 'poor guy,' he's got 12 other patients he's

trying to write orders for." The problem is not so much the supply of nurses,

but the supply of nurses in hospitals, says Charles Idelson, spokesman for

the California Nurses Association, a union representing 37,000 nurses. The

American Nursing Association agrees, saying there are enough registered

nurses, but they are choosing not to work in hospital settings, especially in

emergency rooms, critical care, labor and delivery, and long-term care.

Nationwide, the nursing workforce has risen from 2.1 million in 1996 to 2.2

million in 2000. But fewer nurses below the age of 30 are entering the

profession and fewer are earning advanced degrees and training. The state

nurses association calls the hospital shortage "a self-inflicted industry

wound." "They have driven nurses out of the profession," Idelson said,

"through layoffs, reckless restructuring programs and other changes in the

delivery of care that are motivated by their drive for an increase in profits

and revenues. " In the Bay Area, the high cost of living scares many good

nurses away. Fully qualified registered nurses have traveled to San Francisco

General and said they'd like to accept a job offer but can't because they

can't afford the rents charged here. Hospitals belonging to the American

Hospital Association say they are already working to reverse the trends

outlined in the Pennsylvania report. Pam Thompson, head of the American

Organization of Nurse Executives, said the keys to recruiting and keeping

nurses include more flexible hours, continuing education and more teamwork

between nurses and managers. In the past 10 years, more than 1,000 hospitals

and 1,100 emergency rooms in the United States have closed, and others have

had to cut back because of cuts in payments from Medicare and managed-care

plans. "We've obviously noticed this was a problem for a long time," Idelson

said. The best way to attract and retain nurses is to mandate better patient

care, nurses say. To that end, a coalition of nursing organizations recently

called on Congress and President Bush to adopt a proposal to train nurses and

keep them in the profession. The California Nurses Association sponsored a

first-in-the-nation bill that requires the state Department of Health

Services to establish minimum nurse-to- patient ratios by January.

Complicating the situation is the fact that hospital nurses are getting

older. The average hospital nurse is in her mid-40s. "We will probably be

retiring in droves," said one longtime Bay Area nurse. "Our bodies are really

breaking down from the physicality of our work. It's worrisome to think that

the younger nurses are feeling like they are not going to last. I can

understand why." Lorraine Thiebaud has watched all this for nearly 20 years

at San Francisco General. Younger nurses are turning away from hospitals,

finding less stressful work in places like clinics and insurance agencies.

"This is why everyone is so freaked out," said Thiebaud, also president of

the RN chapter of Local 790. "We're going to be moving out and no one's

coming in after us. Who's going to take care of me?"

E-mail Torri Minton at: [email protected]

[Chellyse]

I just read the Conn. post by Peggy and realized JT had already posted the article on that thread. But I guess it deserves a post of it's own, for all you guys who have not read it. Look at the stats on workplace injuries, and as JT pointed out the cost of insurance for nurses. As you know in Florida we have had two such psychiatric nurses being attacked in the last 2 months. This does not include ER, and LTC, which I know is a daily occurence. I got out of psych in 1996 because of insufficient staff and safety. Several weeks after I left my particular unit, a nurse was brutally attacked, beaten to unconsciousness, left for dead. She survived but will never work again. Safety MUST be a priority!!!