Stress, physically exhausting, unsafe, demanding: Gone Public

Oh my, the word is starting to get out to the public with mainstream articles.

This brushes the surface and may be a shock to all those folks who think of nursing as a quaint pastime of giving backrubs amongst the capped sisterhood.

The overwhelming high pressure and abuse from management isn't mentioned, but this is educational for a beginning public newspaper article:

[ Fair Use: For Educational / Research / Discussion Purposes Only ]
http://www.oregonlive.com/news/orego...3619514171.xml
01/09/02, by Wendy Y. Lawton

Nurses open office to lift ailing profession

Deborah Burton is a chameleon.

The 47-year-old nurse has treated intensive care patients, helped run rural health departments and supervised an Army hospital in Italy. She's earned three nursing degrees and teaches at the University of Portland. She has served as a union officer, hospital administrator, regulator and researcher. Burton is also a political operative who briefed Hillary Clinton and lunched with Barbara Bush.

Her next act: Point person for the state's nursing shortage.

As interim executive director of the Oregon Center for Nursing, which opened last week, Burton must get nurses, executives, educators and politicians to work together to fill an estimated 3,600 nursing positions in Oregon by 2010.

The Boring resident sat down in her still-bare office Tuesday to talk about the shortage, solutions and the nurses strike at Oregon Health & Science University.


Why should the public care about the nursing shortage?

Because the public is aging. And if there aren't enough nurses around when they reach old age, they're going to be in sorry shape. Quality of life is directly tied to access to health services -- and nurses by far are the largest component of the health care infrastructure. In other words, if you care about quality of life, you gotta have nurses.


Nursing shortages routinely crop up. Is this one any different?

This one is completely different, because in the past there was a simple imbalance between supply and demand. We didn't have enough nurses. So all we did is throw in a little money and some incentives, like nursing school tuition support, and we recalibrated quickly.

This shortage is a demographic shortage. The average age of nurses is 47, and we don't have anywhere near the number of young students choosing nursing as a career to replace those of us who are aging -- let alone meet the enormous increase in demand for nurses in the future.

So we don't have the numbers, even if we had the incentives. And even if everyone could have a free scholarship for nursing, we don't have enough people to teach. The average age of nursing faculty in Oregon is 50. So we need to prepare more faculty as well.


What is the most important step Oregon must take to combat the shortage?

Publicize it. Let the public know their health is in jeopardy. Let them know we have to do something about it. Period. But there's a second thing. We have to fix the pipeline. We need to make sure we can produce as many nurses as possible.


Why aren't more people going into nursing? And why aren't they staying?

First of all, 96 percent of nurses have been women, historically. There are tremendous other opportunities for bright, capable women now, which there weren't in the past. Before it was teaching, librarianship and nursing. So it's a good thing that there are other opportunities.

But there isn't an accurate and positive public image of nursing. The work is challenging. It's intellectual. It's autonomous. You can do just about anything, go just about anywhere. And you can change what you want to do over the life of your career. But we need to publicize that.

Now why aren't nurses staying? There's too much stress. It's too physically exhausting. There's fear of unsafe outcomes simply because the demands are too high. So it's a little of everything. But most of all, we need to go back to the relationship between the nurse and patient. The reason this profession exists is to support people through health and illness. If you don't have enough time to do what is needed, patient outcomes won't be what you want. And the work won't be satisfying.


One of your tasks is to convince hospitals, nursing homes and other places nurses work to adopt high quality standards for nursing care. How will this help?

There's now enough research to say that if you implement certain standards, the outcomes for your patients and the outcomes for reducing turnover and improving satisfaction are validated.

When you orient a nurse well, give her a job that satisfies her, and keep her working for 40 years, it's cheap, really, to improve staffing and assignments. If you overstress nurses and your turnover rates go higher, eventually the economics are going to hit you between the eyes. We have to get out of emotionality, and we have to talk about what it really costs when a nurse leaves. And how much it costs to have to pay temporary agencies to fill staffing holes.


Fixing the shortage will be very expensive. At the same time, you can't force solutions on nursing schools or hospitals. So how realistic are the center's goals?

The center's goals hopefully reflect the values and philosophy of the state of Oregon. Quality of life is everything here. If you think of the fact that 40 percent of people over the age of 85 need some kind of nursing care just to stay independent and functional, you can quickly figure out that the future of Oregon in 10 to 20 years will be directly related to access to health services.


Are the shortage and the OHSU strike related?

Yes. First of all, they're related because the noncompensation issues being raised by the nurses are the same reasons that cause nurses everywhere to leave the bedside. Also, one way or another, public opinion about nurses on strike will affect perceptions about the profession itself. It's too soon to tell if it will go in a positive way or a negative way.


How do you think it will affect public opinion?

You know what? I don't know. Just talking with regular folks who have nothing to do with nursing, it seems polarized. Either people want to walk the picket line with nurses or they're appalled and think nurses should never go on strike. I don't hear a lot in between.


The strike points up a lot of frustration in health care. How will you get front-line nurses and health care executives to work together to solve staffing problems?

It will take common ground. And not waiting until frustration gets so high that everyone gets too polarized. Trying to get people together might sound naive, but it's the right thing to do.

( You can reach Wendy Y. Lawton at 503-294-5019 or by e-mail at wendylawton@news.oregonian.com )

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