Hey educators . . . can you help us??!!

  1. What can the nursing educators do to help the profession of nursing deal with the challenges facing us today. Things like inadequate staffing, pay cuts, brutal cost cutting measures that compromise patient care?

    And by the way--where is the meaningful research that us nurses "out there" fighting all of this stuff can use to state our case? What is our case? Nursing care makes a direct, positive impact on patient outcomes and financial performance for the organization.

    Help us out please you in academia. I visited the NIH NINR web site to see what the "nursing research experts" were looking into these day and I was very dissappointed to see we are up to the same old stuff. Nothing of any use for real world issues to prove that nursing is a profession worth saving and paying for.

    The 5 themes of the future for nursing research are (dated 4/03)

    1. Changing lifestyle behaviors for better health.
    2. Managing effects of chronic illness to improve qual. of life.
    3. Identifying effective strategies to reduce health disparaties.
    4. Harnessing advanced technology to serve human needs.
    5. Enhancing end of life experiences for patients and their families.

    Some of this sounded good and I was excited, for a moment until I read more detail. For example, within the harnessing advanced technologies theme was-----development and testing of creative ways to use the internet. Give me a break guys!!! Other dissappointments---multidisciplinary approaches to research, how many times does it take to know it works?

    Cost effective research interventions. Come on guys!! We need some help out here to demonstrate to hardcore for-profit accountants, MBAs, and taxpayers that nursing makes a real difference in patient outcomes. Please give us some evidence we can use in the fight, and it is a fight!!!!!!!!
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  2. 11 Comments

  3. by   ainz
    No responses?? Where are you??
  4. by   jnette


    I hear you calling, Ainz, and I wish I was the one to say "HERE I AM !" I have what you need ! Let's get to work !"

    But I'm not, and I don't. I'm just a brand-spankin' new nurse of 5 mos., and that at 53. But the fire in my gut is akin to yours and I feel your intensity and sincerity.. and despair.

    I will tell you just ONE thing that I feel should be changed, and that is ANA membership dues. I wanted very much to join once I got my degree, and was appalled when I saw the cost. As a new nurse, in MY AREA, I start out at a paltry $15.00/hr. Suks, right?

    So why can the ANA not develop new guidelines re membership costs, so EVERYONE can afford to join? I know they offer a discount, but my goodness, that's just for the 1st 6 months ! Give me a break ! Not ALL the RNs out there make 30, 40, 50, even 60k a year ! I think it would be better to charge membership according to one's income.. this way everyone has a shot at being a member and having their voice heard. I DO UNDERSTAND that it takes $$ to persue things, but if EVERYONE could afford to join (at a lower, even WAY lower) rate, their membership and revenue (even at lower cost) would SOAR !

    Anyway, that's JMHO.
  5. by   llg
    I believe that one reason there is not much nursing research on the topic of nursing administrative issues is that few nurse managers and administrators do research. The person doing the research gets to pick the topic -- and there won't be more nursing administration research done until more managers and administrators start going back to graduate school and start doing research. The culture of management/administration is not academically oriented -- and the people in those positions have simply not done the work.

    Along the same lines, while most advanced practice nursing positions (e.g. CNS, NP, nurse anesthetists, nurse midwife, etc) have required Master's Degrees for many years, most managers and administrators have resisted higher education for people in their specialty. Few hospitals require graduate degrees for the head nurse positions -- while at the same time requiring them for their staff development instructors, CNS's, etc.

    Isn't it interesting that those same administrators who require graduate degrees of the people who work for them in advanced clinical postions or teaching positions do not feel that a similar graduate degree is necessary for a management/administrative postion?

    Most nurse researchers begin their research programs while in graduate school. So, the topics they choose relate to their area of clinical interest. Educators teach for a living ... so, the topics for research they choose will relate to either their clinic are of teaching or to the process of teaching itself. The people whose "job it is" to do research on management and adminstrative issue, resource utilization, etc. is the managers and administrators -- not the educators who are teaching clinical skills! (unless they are teaching management and administration, of course)

    I could throw that challenge right back at you, ainz (in a friendly, collegial way and not in a negative way) -- If you value that type of research so much, why aren't you doing it? What have you done to facilite it being done in your institution? Does your institution conduct such research? Do you provide support within your organization for people who wish to do such research? You're a nurse administrator, aren't you? Why haven't you been doing it?

    Also, the federal government has not supported graduate programs in nursing administration nearly as much as they have supported certain other "favorite" programs -- in particular, nurse practitioner programs. In fact, at one point during the 1990's, funding for graduate programs in nursing administration programs was virtually eliminated while funds were diverted to nurse practitioner education because of anticipated MD shortages. Where was the ANA then? Why aren't they sponsoring more research in these areas?

    Finally, there is some good research being done -- it is just not as voluminous as the patient-focuses stuff, which is easier to get the taxpayers to pay for. While ainz is probably already familiar with the journals "Nursing Economics," "The Journal of Nursing Administration," and "Nursing Administration Quarterly," I offer these as a few places those of you not familiar with the field can start becoming familiar with administration research.

    llg
    Last edit by llg on Jul 25, '03
  6. by   llg
    In another thread on this same topic, Washyouhands (Linda) reminded me that clinical journals publish articles on how certain nursing practices help patients all the time! We just need to learn to use that information better to present our cases for the causes we want to support.

    llg
  7. by   traumaRUs
    I'm currently enrolled in an ADN to BSN/MSN. Our hospital is applying for Magnet status and one of the requirements will be to support nursing research. You might look to the magnet hospitals in your area...???
  8. by   ainz
    llg--thanks for your response. I have been in hospital administration, not nursing administration, for a few years currently a chief operating officer. My job is to focus on running the internal operations of the hospital. In my role I work with administrators, CEOs, corporate executives, and others on the "business side" of healthcare. It is certainly a different and eye-opening experience. These people do not speak the same language as nurses. They do not understand what motivates nurses. They do not value the same things that nurses value. Nurses are viewed as hourly employees that are expendable and expensive but hard to get rid of. Nurses are seen as "high maintenance" because they chronically complain about almost everything. Nurses are inflammatory when they approach administration with issues. It is a mess.

    As I observed this going on for the past 3 years, it became clear that administration does not link the value of nursing care to their bottom-line. Nurses are viewed as expensive consumers of resources, not revenue generators. My assumption is that nurses in fact do generate revenue and began to look for nursing research to prove it---it is not there.

    I took research in graduate school and really do not like it. It is a science of its own in my opinion. However, it is vitally needed. I have inquired about entering a PhD program with a focus on looking at management styles influence on employee productivity, patient outcomes, and financial performance. Within that I can certainly look at nursing interventions and their role in patient outcomes and financial performance.

    At this point I would need some help from a professional researcher to engage in research as I do not have the skills or knowledge to get it off of the ground. I would welcome talking with someone that did have the skills and approaching whatever entity necessary to try and obtain funding.

    Thanks for your response. If we had nursing research that clearly demonstrated the economic value of nurses to companies' bottom-lines, then we would not be in this mess.
  9. by   layna
    How do we "bridge the gap" between administration and nursing staff? How do we teach nursing staff to become a group of people that analyse "process" versus just complaining about things that need to be changed? Both groups- administration and nursing- need to educate EACH OTHER and make TIME to meet together to become a unified body of professional problem solvers. When that happens, then the nursing research can begin with appropriate direction. Maybe then, the government and people higher up in that area can also do something to recognize the value that nursing has on the front line. It is my dream to be involved in such meetings and research. My personal goals for education will lead me there...at least that is my plan!

    We can get more done as a team,

    Layna
  10. by   SteelTownRN
    I read a comment about ANA dues being high in this thread. I agree, but you pay for what you get in this world. If you paid $25, you wouldn't see such a productive and powerful organization. If it is worth it to you to be a member, you will find a way to scrape up the dues. I believe that dues are around $250 annually, if I remember correctly. I found a manageable way to pay dues through a monthly draft from my checking account. For as little as $23/month (an oil change, two pizzas, etc...), I don't miss that chump change, and it is manageable for my budget. Much easier than coughing up the big bucks once a year.
  11. by   llg
    Originally posted by ainz
    llg--thanks for your response. .... .....
    At this point I would need some help from a professional researcher to engage in research as I do not have the skills or knowledge to get it off of the ground. I would welcome talking with someone that did have the skills and approaching whatever entity necessary to try and obtain funding.
    Thanks, ainz, for taking my earlier post in the friendly (but challenging) light it was intended. I am happy to see that it did not start a flame war or anything.

    About getting hooked up with a knowledgable nurse researcher. If I were you, my first stop would be the local schools of nursing and/or hospital administration. Some of their faculty might be able to help you. In fact, they might be thrilled to find someone in admnistration such as yourself who would like to collaborate on a project and who would have good access to an institutiojn and/or population of research subjects to use.

    You might also find researchers with whom to collaborate at research oriented conferences, meetings, etc. Is there a local or regional chapter of Sigma Theta Tau you could join? Are there other regional organizations you could participate in that would help you establish relationships with nurses with academic careers? Do any of the nursing schools in your region have research centers who provide consultation for a fee? etc. etc. etc. In the end, it's just old-fashioned networking -- just getting to know the academic folks instead of hanging out with your fellow administrators.

    Good luck,
    llg
  12. by   jtfreel
    This is exciting! I have straddled the Aministrative and Education worlds for years and have attempted to be a negotiator or lines of communication between the two. I am currently in Nursing Education and have found that some of my fellow faculty members have little concept of the 'real world.' By this I mean the pressures and stresses faced by the bedside nurse and that will include our graduates. We have a one 2 credit hour course dealing with leadership and management issues with pressure to include the traditional approach and not realisitic strategies for professional and personal survival and success. Likewise, most faculty members believe that nurses are viewed by hospital and corporte leadership to be critical members of the health care teams and vital to the financial bottom line of the organization. There are some who do, but as Ainz beautifully stated, many do not.

    Likewise, I have found that some nurses in management cannot understand why nurses are being taught concepts like assertive communications, conflict resolution and scopes of practice. To illustrate, an RN was pulled to a unit because of severe staffing shortages and was scheduled to take report on 13 post-surgical patient. She refused to take report immediately until she had rapidly assessed the group of patients as a whole (this took about 20 minutes). She then stated that she would accept report on 9 patients and proceeded to calmly and professionally state her rationale. She was threatened by the day supervisor to take report. She again stated per position and that she would promptly take report on the most unstable 9 patients. The day supervisor called the Assistant Director of Nursing who threatened the nurse with suspension and potential loss of license if she 'abandoned her patients.' She explained that no abandoment would occur if she had not accepted responsibility for their care. He was furious and called in another RN to provide supplemental staffing. The nurse was told that this was an unnecessary expense, that 'other nurses had accepted this assignment' and that because of her another nurse had to give up a day off.

    I was asked if we taught our students about patient abandoment and scopes of practice and stated yes. Did we teach them when professional responsibility began? Yes. Did we teach them how to refuse assignments? I stated we taught them about being pulled, utilizing appropriate chains of command, professional behaviors and communications, delegation, time management, the nurse practice act and professional accountabilities.

    Later this member of administration stated that most of his stress came from attempting to achieve higher professional recognition for professional nurses within the facilities while 'living withing the financial realities of the corporate world.' I ask him when these world collide, who normally loses. You know his reply.
  13. by   renerian
    I would love to join the ANA but with four kids in college and a hubby in college, I just got out of a BS/MS program there is no money.

    Interesting thread though.
    renerian

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