ANA President speaks up

[NRSKarenRN, BSN, RN]

from medscape nurses

(free registration required) from the editor

may 2004: an interview with ana president barbara blakeney

posted 05/05/2004

susan b. yox, rn, edd

http://www.medscape.com/viewarticle/474867?src=mp

in recognition of national nurses week 2004, i spoke with barbara blakeney, ms, aprn, bc, anp, president of the american nurses association (ana), asking her some of the questions i hear most often from medscape's nurse readers.

there are 2.7 million registered nurses (rns) in the united states, and 2.2 million of them are actively employed. with the theme of nurses week 2004, "nurses: your voice, your health, your life," i asked first about the nursing shortage and nurse staffing, likely the issues at the top of everyone's list of concerns.

medscape: the number one issue is obviously the nursing shortage. how bad is it, and is this shortage any different from shortages we've seen in the past?

"to put it simply, there are certainly not enough of us to get the work done that needs to be done," blakeney said. she pointed out that although we have weathered nursing shortages in the past, this one is quite different. why? because in addition to not having enough nurses, the nurses working now are older. as a result, many aging nurses, feeling tired, overworked, and underpaid, are retiring early. in fact, estimates are that the number of rns will fall to 12% below the demand by 2010, with a 20% shortage by 2015.

medscape: what about the related concern of too few nursing faculty? is it true that many qualified applicants to nursing programs are being turned away because there are not enough faculty members to teach them?

"that is absolutely true. we don't have the academic infrastructure to accommodate the young people who would like to go into nursing as well as the older career changers, who see nursing as a viable option." blakeney went on to explain that at the bs level, 11,000 well-qualified applicants were turned away in 2003. "these are people with grade point averages of 3.7, 3.8, and 3.9, and we don't have enough room in our programs to accept them."

the aging of nursing faculty members is even more acute than the aging of the nursing population as a whole. the average age of nursing faculty is now 55 years. these experienced teachers are not paid as well as they could be; consequently, as they get older, many are moving quickly toward retirement, without enough replacements in the ranks. "some states have as many as 30% of their nursing faculty eligible to retire," blakeney pointed out. in addition, in times of financial belt-tightening, programs in the public sector often suffer cuts first. the reality is that a full two thirds of the bs education in nursing takes place in public universities, so these programs are even less able to expand and recruit faculty in the current environment.

medscape: where is ana focusing the most effort this year in dealing with the escalating nursing shortage?

blakeney described numerous legislative efforts to improve funding for nurses. ana continues to lobby congress to increase funding of the nurse reinvestment act, legislation that targets nursing workforce development via programs designed to attract more students into nursing programs; improve the workplace for nursing; support schools of nursing to provide faculty and updated curricula; recruit a more diverse student population; provide assistance to students to enable them to complete nursing studies; and ensure the collection and analysis of current nursing workforce data to guide the appropriate implementation of these programs. blakeney explained that $205 million is being requested this year, the fourth annual increase for this important legislation.

"because inappropriate nurse staffing is the number one concern of nurses today," blakeney continued, the ana is strongly supporting the rn safe staffing act (s. 991), legislation introduced by senator daniel inouye (d-hi) on the eve of national nurses week in 2003. companion legislation in the us house of representatives, the quality nursing care act (h.r.3656), was introduced by representative lois capps (d-ca), an rn, in december 2003.

blakeney believes that this particular piece of legislation is "the smartest bill to date on staffing." rather than mandating specific patient-to-nurse ratios, the rn safe staffing act builds in some flexibility to allow for variations in various settings, nurses' experience and skills, and patient populations. in addition, the nurses practicing on a particular unit will have a big part in determining the ratios in their own setting. hospitals will need to publicize their process for both determining the needed ratios in their facility and their success in meeting them.

a safe nursing environment is essential to keep nurses working as well. a survey done in 2001 indicated that the majority of nurses report that health and safety concerns play a major role in their decision about remaining in the profession. for example, more than 80% of needlestick injuries can be prevented through the use of safer devices. the ana's safe needles save lives campaign has been successful in passing legislation requiring hospitals to use safe needles or needleless technology where appropriate.

handle with care is a more recent ana ergonomic initiative aimed at preventing work-related musculoskeletal disorders through greater use of assistive equipment and patient-handling devices. "studies of back-related workers' compensation claims reveal that nursing personnel have the highest claim rates of any occupation or industry, even higher than construction workers," noted blakeney. in an ana survey, more than 59% of the nurses surveyed listed a "disabling back injury" as one of their top health and safety concerns, and nearly 84% of the nurses surveyed said they continued to work despite experiencing back pain.

using the ana position statement elimination of manual patient handling to prevent work-related musculoskeletal disorders as a foundation, the handle with care campaign educates nurses regarding advances in science and technology that support ana's goal of securing a nationwide "no-lifting" policy.

ana has partnered with audrey nelson, phd, rn, faan, director of the tampa veterans' health administration patient safety center of inquiry, in implementing the goals of the campaign. nelson is a nurse researcher who designs evidence-based interventions that reduce the risk of occupational injury related to patient handling by the use of technology and equipment.

medscape: we often hear about the concerns of nurses with disabilities. these nurses explain that even though they have years of experience and expert knowledge, they are no longer considered useful in a workplace that seems to value only those with "healthy bodies and strong backs." are we perhaps overlooking a valuable resource by not offering creative workplace options for all nurses who have something to offer?

agreeing with these sentiments, blakeney emphasized, "employers need to hire rns for their brains and not brawn." she continued, "when a nurse enters a patient's room, most just see the nurse walk in, do a task, and leave. the casual observer doesn't realize all that goes on while the nurse is with a patient. the rn's biggest contribution is her assessment skills."

medscape: how can we encourage employers (and even other nurses) to work more creatively with aging nurses or nurses with disabilities?

"that is an area where we need to do a great deal of work. creating flexibility on how nurses are used on a unit or in another setting is a start," blakeney said. she continued by giving some workable examples such as using older nurses or nurses with disabilities to mentor younger, less experienced nurses, or by using staffing systems that allow nurses more control over their work hours.

medscape: as nurses consider their chosen profession this nurses week 2004, can you provide any words of wisdom or encouragement?

"there are a lot of challenges facing our profession right now," blakeney said, "but likely we all went into nursing for specific reasons." blakeney believes that nurses "have a unique chance to make a real difference every day," including the opportunity to save a life. "take pride in the importance of what you do each and every day, as patients and their families will remember all the good you have done."

the take-home message blakeney emphasized was for more nurses to get involved in changing things. estimates are that only about 10% of nurses are actively involved in the profession. she pointed out that active involvement "can be as simple as joining a professional or specialty practice organization, or getting involved in designing or lobbying for legislation, developing standards of practice, or assisting a hospital to obtain magnet certification." just becoming a member of a professional organization is an important first step toward the need for all of us to "tend to our profession."

if you have comments or questions about this interview or about medscape nurses, you may contact the editor at [email protected]

susan b. yox, rn, edd, site editor/program director, medscape nurses

[NRSKarenRN, BSN, RN]

ANA has been working aggressively to eliminate manual moving of patients. Hope more nurses accross the board support these efforts and LEARN what equipment is available and USE IT to save their backs.

[Dixiedi]

ANA has been working aggressively to eliminate manual moving of patients. Hope more nurses across the board support these efforts and LEARN what equipment is available and USE IT to save their backs.

I know it would be difficult for the ANA to suggest this... but why don't they tell the RNs they represent to ask any nurse trained in a hospital setting instead of a university. I would bet my next paychack that ALL (RN and LPN) nurses trained in a hospital already know what equipment is available and how to use it!

[NRSKarenRN, BSN, RN]

nurses work in a variety of settings, just not hospitals.

i've come across many rn's who have never heard of or used a hoyer lift in home care or even in a hospital setting.

there are many devices on the market that some nurses have never heard of or have available to them.

see our previous discussions:

are r.n's prone to serious back injury?

does your hospital have a lift team

[oramar]

That is the first time I have heard anything about job related injuries from anyone at the ANA. It is possible they have been discussing it all along and it just did not register with me. Either way, two thumbs up to ANA for bringing this subject to forefront.

[pickledpepperRN]

Good!

There are many NEW devices too. The hoyer lift is a help.

I love the cardiac chairs that change from a cart with the patient flat to a chair - complete with arm and foot rests.

It took out committee 15 years to get them. When they promised what was purchased was NOT a proper cardiac chait. It was a veru nice comfortable chair for patients we could get into it.

And I brought brochures from more than one company back from NTI year after year.

THEN they had blown the equipment budget.

Finally we have ONE for critical care and ONE for the rest of the house.

GOOD FOR ANA!

[pickledpepperRN]

http://www.calnurse.org

May 28, 2004

California Assembly Passes Bill to Reduce Hospital Workplace Injuries

Bill to Reduce Injuries, Cut Hospital Costs Approved

AB 2532, authored by Assembly member Loni Hancock (D-Berkeley), requires hospitals to have a plan to prevent back injuries and to provide specially trained lift team staff and equipment. The bill would help reduce debilitating back injuries for RNs and other healthcare workers.

Hospital industry lobbyists opposed AB 2532 even though the bill will reduce hospital costs.

Work-related back injuries and other musculoskeletan disorders occur more frequently to healthcare employees than to any other American workers. In 2000, for example, the Bureau of Labor Statistics reported 62,332 such injuries to RNs, licensed vocational nurses and nurses aides. Recent studies found that 52% of all nurses report chronic back pain and 12% of nurses who leave the profession cite back injuries as the main, or a significant contributing factor.

Many of the injuries are associated with lifting patients, at a time when national obesity has been rising and the nursing workforce ages. Hospitals that use lift teams report a sharp drop in such injuries. Kaiser Permanente, for example, saw a 46% reduction in nursing staff injuries following the introduction of lift teams trained to handle the increase of heavy patients. Tampa General Hospital in Tampa Bay, Fl. cut patient handling injuries by 62% in the first year after implementing the use of lift teams.

AB 2532, said Burger, will reduce hospital costs in both workers compensation claims and the expenditures needed to train replacements when a nurse or other employee is injured. In a Spring 2003 article, the Journal of Healthcare Safety found significant across the board savings for hospitals employing lift teams.

One 500-bed hospital using lift teams reported a 69% reduction in injury claims and 95% cut in employee lost days. The hospital saw average costs per injury dropped from nearly $10,000 to just over $1,000 - and a total medical cost savings of $690,504. Another 400-bed hospital reported reduced workers compensation costs and medical costs from a three year average of $242,000 to $14,000.

Hospitals also save in retraining costs. Turnover costs hospitals at least $40,000 to $60,000 per RN in training and orienting expenditures.