Florence Project NL: A cry for health

  1. Here is an article from the San Francisco Chronicle from the Florence Project Newsletter. I thought this was good and wanted to share with you here.

    Click here: A cry for health / Poor working conditions driving nurses out of


    Poor working conditions driving nurses out of hospitals

    Sunday, May 20, 2001
    San Francisco Chronicle

    A homeless psychiatric patient turned violent at San Francisco General
    Hospital, attacking three nurses because he did not want to be discharged.
    One nurse, Rex Spray, was so badly injured that he needed surgery to fuse his
    spine and could not work for almost two years. The case is unusual, not
    because nurses were hurt, but because Spray still works there. The other two
    nurses quit working in hospitals after the attack. Dangerous situations like
    this are one reason why one in three U.S. nurses under age 30 - and two in 10
    overall - plan to quit within the next year, according to a study released
    this month. The study, funded by the National Institutes of Health, found
    that poor working conditions are driving nurses away from hospital work. The
    survey found that nurses are increasingly frustrated - to the point of
    burnout - by rising patient loads, shrinking staff, declining quality of
    patient care and even physical and verbal abuse. "It's a very risky job,"
    said Spray, vice president of the Service Employees International Union Local
    790, which represents many of the nurses in San Francisco. "We're chronically
    short-staffed," he said. "The patients have incredible needs. The burnout
    comes from the disparity between wanting to do a good job and your ability to
    do a good job." Spray, who now works in the outpatient clinic, was disturbed
    but not surprised by the results of the survey which studied 13,471
    registered nurses in Pennsylvania hospitals in 1998 and 1999. Among the
    findings: -- 43 percent of hospital nurses scored high on a "burnout
    inventory" measuring emotional exhaustion. -- 53 percent had experienced
    "ward rage" in the form of verbal abuse from patients. -- 45 percent said the
    quality of care in their hospital has deteriorated in the past year. -- 41
    percent were dissatisfied with their job. Patients direct their frustration
    at nurses because they are the only professionals who are there around the
    clock, said Linda Aiken, director of the University of Pennsylvania School of
    Nursing's Center for Health Outcomes and Policy Research. The center oversaw
    the survey of 43,329 registered nurses at 711 hospitals in five countries.
    The January-February issue of "Revolution," published by the California
    Nurses Association, features a story about an "epidemic" of workplace
    violence against nurses. More than 30 percent of registered nurses have been
    assaulted at work, mostly by patients, said a recent seven-state study cited
    in the magazine. The magazine tells the story of a psychiatric nurse who was
    told to take a potentially violent patient into a dead-end corridor for a
    cigarette. "He threw a blanket over her head, bashed her against the wall,
    pushed her to the floor and began pummeling her and smashing her face into
    the floor," the story said. Then he started to strangle her. She was saved,
    not by staff or management, but by another patient. In the East Bay, a nurse
    in a rehabilitation unit was assaulted four years ago by a male patient who
    was being treated for severe head injuries he received in a bicycle accident.
    It took a supervisor and a security guard to pull the man away. The nurse,
    who worked at the hospital for seven years, was fired a month after she filed
    a lawsuit against the patient. The U.S. Occupational Safety and Health
    Administration rates nursing as the third-most hazardous occupation in the
    nation. "The patients we see are hurting . . . tempers flare, they get
    impatient," said Spray. "Nurses have to make choices in terms of priorities
    and the patient who is being sidestepped doesn't always understand what is
    going on." Once admitted to the hospital, however, "the care they get is
    pretty outstanding," he said. "I'm very proud of my colleagues." The
    frustration leveled at nurses does not only come from patients. "I think we
    accept a lot of it as standard operating procedure," said Lorraine Thiebaud,
    who works in the recovery room at San Francisco General. "I see doctors who
    are completely frustrated. They take it out on us. They're tired, they've got
    too many patients, they have all the hospital rules to follow. They get
    upset," Thiebaud said. "You think 'poor guy,' he's got 12 other patients he's
    trying to write orders for." The problem is not so much the supply of nurses,
    but the supply of nurses in hospitals, says Charles Idelson, spokesman for
    the California Nurses Association, a union representing 37,000 nurses. The
    American Nursing Association agrees, saying there are enough registered
    nurses, but they are choosing not to work in hospital settings, especially in
    emergency rooms, critical care, labor and delivery, and long-term care.
    Nationwide, the nursing workforce has risen from 2.1 million in 1996 to 2.2
    million in 2000. But fewer nurses below the age of 30 are entering the
    profession and fewer are earning advanced degrees and training. The state
    nurses association calls the hospital shortage "a self-inflicted industry
    wound." "They have driven nurses out of the profession," Idelson said,
    "through layoffs, reckless restructuring programs and other changes in the
    delivery of care that are motivated by their drive for an increase in profits
    and revenues. " In the Bay Area, the high cost of living scares many good
    nurses away. Fully qualified registered nurses have traveled to San Francisco
    General and said they'd like to accept a job offer but can't because they
    can't afford the rents charged here. Hospitals belonging to the American
    Hospital Association say they are already working to reverse the trends
    outlined in the Pennsylvania report. Pam Thompson, head of the American
    Organization of Nurse Executives, said the keys to recruiting and keeping
    nurses include more flexible hours, continuing education and more teamwork
    between nurses and managers. In the past 10 years, more than 1,000 hospitals
    and 1,100 emergency rooms in the United States have closed, and others have
    had to cut back because of cuts in payments from Medicare and managed-care
    plans. "We've obviously noticed this was a problem for a long time," Idelson
    said. The best way to attract and retain nurses is to mandate better patient
    care, nurses say. To that end, a coalition of nursing organizations recently
    called on Congress and President Bush to adopt a proposal to train nurses and
    keep them in the profession. The California Nurses Association sponsored a
    first-in-the-nation bill that requires the state Department of Health
    Services to establish minimum nurse-to- patient ratios by January.
    Complicating the situation is the fact that hospital nurses are getting
    older. The average hospital nurse is in her mid-40s. "We will probably be
    retiring in droves," said one longtime Bay Area nurse. "Our bodies are really
    breaking down from the physicality of our work. It's worrisome to think that
    the younger nurses are feeling like they are not going to last. I can
    understand why." Lorraine Thiebaud has watched all this for nearly 20 years
    at San Francisco General. Younger nurses are turning away from hospitals,
    finding less stressful work in places like clinics and insurance agencies.
    "This is why everyone is so freaked out," said Thiebaud, also president of
    the RN chapter of Local 790. "We're going to be moving out and no one's
    coming in after us. Who's going to take care of me?"

    E-mail Torri Minton at: tminton@sfchronicle.com
  2. Visit Chellyse66 profile page

    About Chellyse66

    Joined: Oct '00; Posts: 156; Likes: 9
    R.N. Long Term Care


  3. by   Chellyse66
    I just read the Conn. post by Peggy and realized JT had already posted the article on that thread. But I guess it deserves a post of it's own, for all you guys who have not read it. Look at the stats on workplace injuries, and as JT pointed out the cost of insurance for nurses. As you know in Florida we have had two such psychiatric nurses being attacked in the last 2 months. This does not include ER, and LTC, which I know is a daily occurence. I got out of psych in 1996 because of insufficient staff and safety. Several weeks after I left my particular unit, a nurse was brutally attacked, beaten to unconsciousness, left for dead. She survived but will never work again. Safety MUST be a priority!!!