When I Go On Medicare . . . Who Will Change My Bedpan?
by Jan Jennings
In ten short years I will reach age 65 and will be enrolled in one form or another of the Medicare Program. But, when I inevitably become sick, who will change my bedpan? Today I am in the workforce of baby boomers, the single largest demographic of American society. Actually, born in 1946, I am in the lead year of my peers who were born between 1946 and 1965. Our generation represents 2.3 workers for each current retiree. When we retire, our current workforce shortages will look like the golden era of human resources management.
Twenty years from today, in 2022, when I am 75 years of age, only one half of the baby boomers will have entered retirement. However, even in 2022, there will be only 1.3 workers to support and/or care for each retiree. How will the generation that follows the baby boom meet the usual and customary obligations to seniors?
The press has widely covered the economic dilemma that generation faces in terms of financing Social Security and Medicare. The challenge of paying for these programs pale by comparison to the stark reality that there simply will not be sufficient workers to provide hands on service to the baby boom population.
How could the current circumstance possibly get worse? It is difficult to imagine? Receiving "quality service" has become the standard by which all other oxymorons are judged. In the interest of fairness, I will pick on my favorite restaurant... McDonalds. As a shareholder and an almost daily customer for nearly forty years, I feel empowered to make several observations. Forty years ago, I was never quite good enough to secure a position at McDonalds. It was extremely competitive and a mark of distinction to join the rarified circle of those selected to work at McDonalds.
Today, the McDonalds Corporation faces unique opportunities and challenges. On the one hand, it is a mature industrial giant. The McDonalds Corporation displaced the Chrysler Corporation to join the prestigious circle of 30 corporations that comprise the DOW 30. On the other hand, have you visited a McDonalds recently?
The drive thru line is frequently so long one becomes worried about the engine overheating. At the root of this problem is the quality and quantity of the workforce from which the local McDonalds draws from to make up its employment. It is no longer a mark of distinction to work for McDonalds.
For the American Hospital the challenges of maintaining a viable workforce are far more complex. The typical U.S. Hospital has 75 to 90 functional departments. It is difficult to recruit service employees in housekeeping, security and nursing assistants. The shortage of professional nurses is well known to the general public. There are other profound shortages in technical and professional positions.
For examples, there is an inadequate supply of pharmacists, physical therapists, radiographic technologists, laboratory technicians and others. A Certified Registered Nurse Anesthetist
(CRNA) starts in Pittsburgh with an annual base compensation, before overtime, at between $100,000 and $125,000.
The predicted glut of physicians has become a public policy joke. Try to name one physician specialty or sub-specialty in over-supply. The shortages are critical. Money is not the answer, although it is in play. Driving up compensation has a way of distributing the short supply of physicians, but no amount of money can eliminate the shortage in absolute terms. There are too few anesthesiologists, radiologists, rheumatologists, endocrinologists, emergency room physicians, family physicians and on and on.
Most of us are so busy trying to keep the operating rooms open tomorrow we dare not waste a moment thinking about the problems of 10, 20 and 30 years from now. On the other hand, can we afford not to plan for the future? And are there any real solutions? Well, as it turns out, there is hope for a brighter future! We need to go to the industrialized nations of Europe to find our future today. Because of the disproportionate loss of life among young men in Europe during WWII, they did not experience the same level of baby boom that the United States experienced.
Appropriately, the Europeans refer to their birthrate following WWII as a "boomlet." However, Western Europe developed the same taste for service and the same technological explosion that occurred in American Society. With these changes came the same kind of growth and demand for new and different jobs. The gap has been filled with the modification and reform of immigration policies that encourage service workers, technical and professional staff to come largely from the third world or underdeveloped nations.
And so, the character of Europe is changing. If you have dinner next month in a Paris restaurant, your maitre d' may be French, but it is unlikely that any of the wait or service staff will be French. If you are admitted to an Italian hospital, you may have an entirely new concept of the term "foreign medical graduate." And if you visit a friend in a German hospital, you might find that the nurse who greets you has a first language from the Philippines or Indonesia. This is a part of our future as well. The remaining questions relate to how well will this be planned as opposed to whether or not it happens.
American immigration policies will change and a whole new wave of people from many lands will sweep into America on a level even greater than the immigration period of our grandparents 100 years ago. These immigrants are likely to arrive more comfortably. For the protection of our heritage, we should never forget the inscription of the base of the Statute of Liberty which refers to "...your tired, your poor, your huddled masses...." The next wave of immigrants should also see a new inscription on the base of the Statute of Liberty which says something like, "...Give us your bright, your enterprising, your innovative and your energetic.... "
Jan Jennings is CEO and President of Jefferson Regional Medical Center. You can reach Jan Jennings at email@example.com
???? Another letter writing campaign in the making here.
Oct 19, '02
This guy is really irritating me. Hes the same one who wrote that pity-the-poor-doctor-working-in-unhealthy-conditions-for-not-more-than-21%-annual-increases article in the thread titled "Physicians vote with their feet --- to early retirement".
So whats this hospital CEO saying now? Recruit all your hospital service workers & healthcare professionals from overseas. And he thinks the reason we are needed is to empty bedpans. If this is the typical thinking of our CEOs, is it any wonder they cant find people to work for them. What an insult.
And whats the point about this comment? What is he inferring by sticking in that line about the CRNA salary where it doesnt even fit what hes talking about.....and is the only salary he chose to mention:
For examples, there is an inadequate supply of pharmacists, physical therapists, radiographic technologists, laboratory technicians and others. A Certified Registered Nurse Anesthetist (CRNA) starts in Pittsburgh with an annual base compensation, before overtime, at between $100,000 and $125,000.
The predicted glut of physicians has become a public policy joke. Try to name one physician specialty or sub-specialty in over-supply. The shortages are critical.
I think he has an issue with RN salaries.
And about all that recruit-from-oversees stuff.... I just hope he hears from the Pennsylvania Nurses Assoc on that.
Message to Congress from the ANA:
<<<<<.......ANA believes that the U. S. healthcare industry has failed to maintain a work environment that is conducive to safe, quality nursing practice and that retains experienced U. S. nurses within patient care. ANA supports continuation of the current certification process to apply to all foreign-educated health care workers regardless of their visa or other entry status. ANA OPPOSES efforts to exempt foreign-educated nurses from current H-1B visa program requirements.
The influx of foreign-trained nurses only serves to further delay debate and action on the serious workplace issues that continue to drive American nurses away from the profession.
We must begin by improving the environment for nursing.
There are serious ethical questions about recruiting nurses from other countries when there is a world-wide shortage of nurses. The removal of foreign-trained nurses from areas such as South Africa, India, and the Caribbean deprives their home countries of highly trained health care practitioners upon whose skills and talents their countries heavily rely. ANA CONDEMS the practice of recruiting nurses from countries with their own nursing shortage.
Foreign-educated nurses brought into the United States tend to be placed in jobs with unacceptable working conditions with the expectation that these nurses, as temporary residents and foreigners, would not be in a position to complain.
Immigrant nurses are too often exploited because employers know that fears of retaliation will keep them from speaking up. There are numerous, disturbing examples from our experience with the expired H-1A nurse visa. In fact, several cases came from Illinois. The INS Chicago District issued a $1.29 million fine against FHC Enterprises, Inc. for 645 immigration document violations. FHC, Inc. fraudulently obtained 225 H-1A visas which were used to employ Filipino nurses as lower-paid nurse aides ($6.50 per hour) instead of as registered nurses ($12.50 per hour). The Catholic Archdiocese of Chicago agreed to pay $50,000 in fines and $384,700 in back wages to 99 Filipino nurses who were underpaid. In Kansas, 66 Filipino nurses were awarded $2.1 million to settle a discrimination case in which the Filipino nurses were not paid the same wage rate as U.S.-born registered nurses at the same facility. These are just a few of the cases that have come to light over the last decade.
The practice of changing immigration law to facilitate the use of foreign-educated nurses is a short-term solution that serves only the interests of the hospital industry, not the interests of patients, domestic nurses, or foreign-educated nurses. The cause of instability in the nursing workforce must be addressed. Over-reliance on foreign-educated nurses serves only to postpone efforts required to address the needs of the U.S. nursing workforce. We must begin by improving the workplace environment for nursing.
Last edit by -jt on Oct 19, '02
Oct 20, '02
< Here is what I sent. I copied the ANA stuff, hope you don't mind.>>
Thats what its there for!!!
Nice letter. I like that part about the Irish.
What do you think the odds are that this medical publication will print the voice of nurses?
<<Last thought, the better question to ask instead of who will change my bedpan, is who will be there to make sure I get appropriate care.>>
I told him almost the same thing last night:
With all due respect, as a Registered Nurse I find the title of your article to be insulting. If this is all our CEOs think of us, is it any wonder we dont want to work in hospitals anymore? If something is not done soon about the workplace environment and conditions, devaluation and disrespect that are driving us away and keeping us away, you will have much bigger things to worry about than your bedpan.
who will notice that your breathing pattern has changed ever so slightly, indicating a potential life threatening complication may be developing and who will take immediate action to stop it in its tracks? Who will notice the early, subtle signs of infection after your surgery and intervene to prevent life threatening complications? Who will administer your blood transfusions, chemotherapy, hemodialysis, and manage the mechanical life support systems that may be keeping you alive? Who will be at your bedside to save your life?
Its not your physician --- it's your Registered Nurse, but hospital administrators are driving us away, so I dont know who it will be when you get to medicare.
CEOs must start recognizing that RNs do much more than empty bedpans, that we are an integral part of their insititutions, that the physicians cannot do their jobs without us, and that the patients cannot survive without us. If there is to be a sufficient number of nurses to do the job in hospitals across this country, an investment must be made in them by the employers. Their workplace environment and conditions of employment must be drastically improved - starting with the administration's perspective of and attitude towards them.
As for your recommedation that hospital staff be recruited from overseas, the American Nurses Association has already taken a strong stand on that:
<<Message to Congress from the American Nurses Association (ANA):
.......ANA believes that the U. S. healthcare industry has failed to........
Last edit by -jt on Oct 20, '02
Oct 21, '02
I think this guy is making a valid point. In 10-30 years, even without the baby boomers hitting the health care system, there will not be sufficient care givers to take care of them. Not to empty a bedpan, and not to do more highly trained nursing duties.
His vision for the future is a grand influx of foreign trained nurses. I sincerely hope not. It is my strong belief that there are enough nurses, enough young men and women who would gladly enter the nursing profession, IF the problems within our profession were solved.
To me that means the free-for-all Wall Street race to provide bigger investor dividend checks must be stopped. Millions of investors are getting rich at the expense of nursing benefits, wages, working conditions, staffing ratios, equipment, supplies, and patient care. As long as CEOs' focus is on quarterly profits, then the looming disaster that the author predicts will most assuredly happen, but it will be worse than he imagines. If I had my way, every health care facility in the United States would be "not-for-profit" and a nursing union would be in every one of them.
He says he doesn't know how to solve the problems. Funny. We do.
Last edit by Youda on Oct 21, '02