Commentary on Health Affairs Article: Registered Nurse Supply- shortage not over - page 2

American Association Colleges of Nursing (AACN) commentary/talking points regarding journal Health Affairs article: Registered Nurse Supply Grows Faster than Projected Amid Surge in New Entrants Ages... Read More

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    About the compare/contrast nursing with other professions in this down economy...

    A big problem that having an RN license gives one is that you often cannot work below your license level. So, those "little jobs" others can easily take that they know and their employer knows they are very much overqualified for, BUT ARE STILL AN OPTION, are not an option for us. As well as the idea that nurses don't "fit" in business (unless you used to be in business in a previous career). Nursing can really screw you as far as options go, if you can't get employment as a nurse.

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    yet another piece of the intricate puzzle that is the “nursing shortage”
    i have been doing a great deal of thinking about this as it affects all of us, but new and recent grads in particular who have been unable to complete the training which they began in nursing school. the inertia of nursing schools, other than to enroll more and more students, only contributes to the problem. by inertia, i mean that nursing schools should be looking into collaborating with health care agencies and institutions to devise bridge programs for all these students so that they can successfully transition to practice rather than languishing as an employee of starbucks, or some similar organization, as their hard-won skills atrophy over time. however, there is a good reason that such programs have not been implemented and never will be. implementing such programs would, by definition, imply that there are positions in existence for all these graduates – which there are not.
    this brings us to the next point of my little “opinion piece”. the mass graduation of new nurses is not going to solve the nursing shortage, contrary to what conventional wisdom is preaching. let us take my state, new york, as an example. i have calculated that new york state, over all its nursing schools, graduates about 2,500 new nurses per year. i have been keeping track of the number of new graduates hired by certain local health organizations over the past year; i have obtained this information by various different means – mostly by word of mouth as none of this is openly published. these numbers have been obtained from institutions in poughkeepsie, new york all the way down to institutions in new york city. no institution that i have been able to gather information on has hired more than 20 new grads per year. most hire an average of 10 and those are selected from within, from the pool of people who have been c.n.a.’s.
    if these numbers are indicative of a solution to the nursing shortage, i would like to know what that solution is. if each institution is accepting, for completion of training, 10 new grads per year this will not even make a dent in the nursing shortage. instead, what you have is a bottle-neck of a tremendous number of new grads trying to force their way thru a small hole to join the small population of employed new grads. just like the sperm who do not make it into the egg, once one has already penetrated, they will languish and die on the outside; the nursing shortage will not be improved by this method currently in place.
    in addition, there are other forces on the horizon which nursing schools are either unaware of or choose to ignore. if they are unaware of these forces, then one must question their masters and doctoral degrees if they are not even aware of what is about to descend on their own profession.
    i would direct all of you to look at one of the recent advance for nurses magazines that many of us get free in the mail, dated 11/7/11 vol 11, no 18 northeast. on page 6, there is an editorial entitled “virtual nurses: will you be replaced by a computer?” there is now, apparently, a virtual discharge nurse computer program that is available now for “deployment in hospitals”. mass institute of tech published an update on this technology on one of their websites at the beginning of november. a clinical trial of the software has been in progress for 3 years at boston medical center. the program is an interactive one wherein the patient punches computer keys and answers programmed questions and is also educated about their disease, any after care and is given discharge instructions by the computer. the computer will also “confirm that the patient understands key concepts”. the computer is even programmed to make conversation with the patient to make them feel more at ease. the software is already licensed and is currently available to be leased by institutions. what is really damaging for all of us is that “the system has proved to reduce readmissions by over 30% and reduce costs by over 33%”. the magazine article also states that “patients using the device display a more thorough understanding of their condition than after traditional interactions.”
    the article finishes with the following comment, “…it comes back to saving money by eliminating the need for nurses. about 60% of the cost of delivering healthcare comes from human resources, so even if you can train more people, it is not an ideal way to improve costs.”
    in addition, i am attaching a you tube address to view a video on japanese nurse-robots which will further replace even more of us.
    there is also a video called “robonurse cares for the elderly”. like the u.s., japan also has a burgeoning crop of elderly and this video depicts their response and solution to this massive financial problem:
    just like we were told in nursing school, “it is all about the money”. in addition, keep in mind that medicare and medicaid will be experiencing severe cuts over the next 10 years or so. some of these are already happening and are hitting nursing homes and home care. these cuts will mean nurses being saddled with untenable and unsafe patient loads. one article i read stated that a nursing home facility would be laying off nurse’s aides and requiring the nurse to perform all the tasks of an aide as well as those of a nurse, to save money. the alternative will be to lose one’s job. type in medicare/medicaid cuts and the effect on nursing homes as a search term and see what comes up. of course, the cuts to medicare and medicaid will be made at the state level, meaning that the fed government will provide less and less funding to each state. it will give them a lump sum and expect them to make due with it. therefore, as this situation unfolds, you will see some states being harder hit than others (at first) but eventually all states will suffer to the same degree.
    i know, i know, this is negativity, but it is also fact. i also know that some people will say that medicine needs a human touch which indeed it does. customer service, by definition, should have a human touch and many of us protested against companies putting automated systems in place to answer phones and direct customers to the right area. but, despite our protests, these systems were put in place all the same. i doubt there is very much we can do about any of this. protesting will not make corporations change their minds, especially when study results seem to report the fact that not only is money being saved but that patients have a better understanding of key concepts than when human nurses teach them.
    one wonders what will be next? will robots have to be licensed? take boards? and if an error is made through the computer’s software and the patient is given wrong info, who will the patient sue? the hospital for buying the equipment? the manufacturer of the hardware? the manufacturer of the software? the programmer who inadvertently created a programming glitch? or all of the above?
    netglow likes this.
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    You sure are right. Every effort is being made to figure out how to reduce the hospital RN census.

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