NY Tmes OpEd: Nursing Wounds

[NRSKarenRN, BSN, RN]

Forwarded by Michele Campell, Exec Director PSNA ([email protected]) :

Op Ed from 6/10/03 New York Times

Nursing Wounds

By CLAIRE FAGIN and CORINNE RIEDER

Thanks to news coverage, advertising campaigns and word of mouth, an increasing number of people are aware of the nation's nursing crisis. Hospitals around the country are reporting full-time shortages of registered nurses as high as 19 percent. Nurses are being recruited from as far away as India and the Philippines. Industry experts say that by 2020, this country could have 800,000 fewer nurses than it needs.

We've even begun to understand, as studies from the University of Pennsylvania and other places suggest, that there is a direct connection between the ratio of nurses to patients and mortality rates. The fewer nurses, the higher the rate.

The good news is that more students are interested in nursing. A 2002 Harris poll found that 62 percent of 18- to 24-year-olds have discussed a nursing career for themselves or a friend. Nursing school applications in many places have soared. Baccalaureate nursing school enrollments, according to the American Association of Colleges of Nursing, rose 8 percent last year. In February, Congress approved $20 million for nurse education programs that include scholarships and continuing-education grants for practicing nurses.

These hopeful developments, however, have brought to light an even more troubling problem in the academic pipeline. On a recent visit we made to California, we were startled to hear that there is a three-year waiting list of students seeking entry into the state's public nursing schools. The situation in New York City is no less disturbing. Hunter College, for example, is admitting 80 students to its undergraduate nursing program this year. As recently as 2000, the nation's nursing schools turned away nearly 5,900 qualified applicants, mostly because of a lack of faculty and classroom space, as well as budget cutbacks.

Unless these shortcomings are corrected, the nursing field will be unable to capitalize on an increased interest in the profession. Luckily, there are things we can do to solve the problems.

First, Congress needs to reauthorize the Nurse Education Act, which focuses on faculty development, geriatric training and other work force improvement programs. Financing for the program needs to be raised to $175 million in 2004 to address the crisis. In addition, federal and state governments need to reinstitute a highly successful program, the capitation grant program, used in the early 1970's to increase the number of students admitted to schools of nursing.

Geriatric training for nurses also needs to be expanded. More than half of all hospital patients are over 65, and their numbers are expected to rise during the next 20 years. Finally, the American Hospital Association needs to promote the designation of magnet hospitals. The designation, which is certified by the American Nurses Credentialing Center, raises nursing care standards, as well as improves the recruitment and retention of nurses.

Nurses are an essential element of our health care system. Research consistently shows that nurses increase the cost effectiveness and quality of care and improve the efficacy of a wide range of interventions, from heart surgeries to depression treatments. Qualified people are answering our nation's call for more nurses. Let's do what we can not to lose them.

Claire Fagin is dean emerita at the University of Pennsylvania School of Nursing. Corinne Rieder is executive director of the John A. Hartford Foundation.

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A Century of Nursing Leadership - 1903-2003

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More Information... http://www.psna.org/PSNAinfo/100.htm

[Hellllllo Nurse, BSN, RN]

This article was posted earlier today on another thread. It's good that the issue of the nursing "shortage" is being discussed in main stream media. But, as usual, I think this article totally misses the real issue:

Working conditions.

[nursenoelle]

Originally posted by Hellllllo Nurse

This article was posted earlier today on another thread. It's good that the issue of the nursing "shortage" is being discussed in main stream media. But, as usual, I think this article totally misses the real issue:

Working conditions.

Amen !

[roxannekkb]

Well look at who the authors are. One an academic and one who works for some foundation. I wonder how long its been since they actually worked as a nurse in the "real" world. It is rather tedious to keep hearing the same things over and over again, while they completely ignore the real issues--working conditions and the hospital's refusal to do anything about it.

There are enough nurses right now to fill each and every hole in the healthcare system. Problem is, they're not going to come back to nursing as long as the situation exists as is.

[tonchitoRN]

roxanne you are exactly right. the nurses are out there. they are just saying no more to the poor working conditions in the hospitals. they can spit as much money as they want to the educational system but it is not going to make too much difference until they address the real issues.

[sjoe]

And a further "amen" to the above responses. How easy it is for the "experts" to completely miss the point.

[roxannekkb]

I remember the same thing when I was in nursing school. It was during the 80s, there was a big nursing shortage, and the same discussions, the same studies, the same surveys, the same demands for more nursing schools, scholarships, sign-on bonuses, etc. Everything except improving the life of the nurse. Working conditions remained poor and have gotten worse over the years. My guess is that hospitals really don't want to change anything. They're better off bringing in new nurses at lower wages, or getting foreign nurses that they can enslave for a few years. Or even better, replacing RNs with cheaper, lesser-trained attendants. I am wondering if that is going to be the future of healthcare.

There are currently 500,000 licensed nurses in the US who are not working in healthcare. Some are retired, disabled, and so on, but about 150,000 are working fulltime outside of healthcare. Many more may be doing part time work, be entrepreneurs, and so on. Other nurses have gone into non-patient settings, while still remaining in healthcare. We're talking about enough nurses to more than fill every vacancy.

Many would love to return to nursing, or return to patient care, I'm sure, but not as long as nothing changes. So tell me, what really is the problem here?

[-jt]

Working conditions.>

no she didnt miss the issue about working conditions. She said it with "Finally, the American Hospital Association needs to promote the designation of magnet hospitals. The designation, which is certified by the American Nurses Credentialing Center, raises nursing care standards, as well as improves the recruitment and retention of nurses."

Maybe article print space didnt allow her to elaborate for those who dont know what the Magnet designation is, but she could have made it more clear. The Magnet designation is ALL about nurses working conditions, creating a positive work environment for nurses, and giving the nurses a real voice in the hospital. That what it was established for. The designation is only about nurses and its an award given to hospitals that have met the criteria of a list of optimum working conditions and foster a culture of respect, valuation, and inclusion of the bedside RN in policy making and all other aspects of the hospitals function.

Theres not many that have achieved this designation (most are in NJ), but the ones that have achieved it do not have such high RN vacancy & turn over rates, if any at all, and many even have waiting lists of nurses who want jobs there. And its all because of the focus Magnet designation puts on the working conditions.

A hospital that has labor battles with its nursing staff, or abuses like forced overtime and unsafe staffing ratios, etc is not fostering a positive work environment for nurses and is not granted Magnet status. Since achieving Magnet designation is prestigious and advertising that your facility has won this award has become a marketing tool that is attracting not only the best nurses but also the best doctors, other professionals, and pts, it would behoove the hospital to strive for the designation. The way they do that is to follow the criteria to improve nurses working conditions and change their culture to one that respects, values, and includes the staff nurse in all aspects. So the article writer certainly did get to the real issue. Her article needed to be longer so she could explain that.

The Rules of Attraction

Hospitals that refine their culture and policies can capture the coveted magnet status, turning their workplaces into RN havens and drawing more staff their way......

http://www.nurseweek.com/news/features/02-10/magnet.asp

A WORKING MODEL

the story of one of the first Magnet Award winners - The University of Washington Medical Center (UWMC) in Seattle....

see the American Nurses association website -http://nursingworld.org/ajn/2002/feb/issues.htm

and

http://nursingworld.org/ancc/magnet/magnet.htm

[roxannekkb]

Yes, she did mention it, but it seemed like an afterthought. The main point of her article was the need to get more students into nursing schools, and not to push for better working conditions. And most people, even many nurses, have no idea what a magnet hospital even is.

Her article made it sound like the nursing shortage would be resolved if only we could get more students into nursing, and the rest was secondary. It should have been reversed.

Also, it was interesting how she noted that the demand for nursing school has risen, and that students are "answering the call," or something like that. She seems to have overlooked one small fact--in times of economic downturn, health professions always increase in popularity because people are looking for stability. This has always happened, and with millions of people out of work or underemployed, nursing and other jobs in healthcare appear increasingly attractive. A person who enters nursing for those reasons is going to be gone very quickly, once other opportunities open up again and/or the economy picks up.

The magnet hospitals have been very successful in keeping nursing. I believe that Hackensack hospital in New Jersey actually has a waiting list of nurses who want to work there. So that really does say something about the "nursing shortage." If Hackensack can have a waiting list--and it's not like they are the only hospital in a 1,000 mile radius so nurses have no choice where to work--other hospitals can easily solve their problems.

[Hellllllo Nurse, BSN, RN]

""Finally, the American Hospital Association needs to promote the designation of magnet hospitals. The designation, which is certified by the American Nurses Credentialing Center, raises nursing care standards, as well as improves the recruitment and retention of nurses."

NOTHING about WORKING CONDITIONS in there. Nursing care standards refers to standards of pt care.

[-jt]

There is, but its encompassed in the reference to the Magnet designation. With the way the she wrote that article, if you dont know what the Magnet designation is all about, then you dont know that she IS referring to nurses working conditions. Maybe we should send our comments about that to her & enlighten her.

Magnet designation raises the nursing care standards thru working condition improvements like safe staffing levels, ergonomic equipment, adequate support staff, & involvement of staff RNs in every aspect of the hospitals functioning - including its financial committees and policy making. And because of things like that, those hospitals that win the award have made themselves into attractive places where RNs want to work & they are able to recruit and retain more nurses.

Hackensack General in NJ does have a waiting list of RNs who want to work there - as do other Magnet award winning facilities -while other places around them that havent made this committment to improving nurses working conditions in accordance with the Magnet designation criterion "can't find nurses". And they all wonder why.

[roxannekkb]

The other hospitals really aren't wondering why they can't find nurses---unless they are truly dumber than we thought. I don't think they want to find nurses, and invest the money in keeping them. This is truly a great opportunity to bring in foreign nurses that they can overwork and underpay, or hire unlicensed staff to take over nursing jobs. And to take it a step further, I think they're glad when more senior nurses quit, so they can hire new grads at lower pay, dole out less benefits, and so on.

If this is not the case, don't you think that say, the hospital next door to Hackensack with a 20% turnover rate, would do something to change it?