Where Have All the Nurses Gone?

Nurses Activism

Published

[color=#993300]where have all the nurses gone?

[color=#333333]the impact of the nursing shortage on american healthcare bit.gif[color=#ffffff].... faye satterly, r.n.

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[color=#ffffff]...."...an important book...a wake-up call..." --bookviews.com

at 6:30 a.m. a head nurse reviews room assignments and the day's challenges ahead: twenty-nine patients, most of them seriously ill, and four nurses to care for them. that means a barely manageable and potentially risky patient-nurse ratio of seven to one, with one nurse taking eight patients. unfortunately, this dismal scenario is played out again and again in hospitals across the country.

this in-depth, behind-the-scene's account of a healthcare system under stress and the declining quality of medical treatment in america should serve as a wakeup call to the public. faye satterly, a registered nurse with over two decades of experience, spells out the alarming statistics: the average nurse today is forty-five years old and anticipating retirement. only 12 percent of nurses are under age thirty. at the same time, nursing schools report decreasing enrollments and fewer graduates. the result is that the nurses who are on the front lines of healthcare are feeling overwhelmed and leaving the field for less stressful opportunities outside hospital settings.

compounding the looming crisis is the fact that just as nurses are becoming scarce, the need for them is becoming ever greater. over the next decade, aging baby boomers will swell the ranks of the over-fifty-five population, a group that experiences higher healthcare needs than those in their thirties and forties.

there are answers, the author insists, but they will require an honest public debate about our choices and expectations. what are we willing to do and how much are we willing to pay for safe, effective delivery of healthcare?

this fascinating and disturbing account by a veteran nurse with extensive experience is a compelling call for action to counter the nursing shortage and ensure that "caring" regains its premium status in healthcare.

faye satterly, r.n. (charlottesville, va), is cancer services director at martha jefferson hospital. she has been a registered nurse for twenty years, and served as cancer services director for twelve years.

http://www.prometheusbooks.com/catalog/book_1458.html

Specializes in Case Management, Home Health, UM.
Not a shift goes by that one of my coworkers does not talk about getting out. Now threatening to leave and actually leaving are two different things. Most of them would like to get out but can't afford to stop having pay checks. If the economy continues to improve and people can get better jobs they will leave in droves.

Same here. Two nurses have left our department since March, and at least two more are going to be leaving during the next few weeks. Things just seem to be going to hell in a handbasket. I'm looking for another job...before I walk out.

Facilities are already solving the problem of nurses leaving and too few to replace them...just import 'em.

Not a shift goes by that one of my coworkers does not talk about getting out. Now threatening to leave and actually leaving are two different things. Most of them would like to get out but can't afford to stop having pay checks. If the economy continues to improve and people can get better jobs they will leave in droves.

I want to clairify what I said here. Yes, we too have lost nurses in last year, more than needed be. You see they went on a cost cutting binge about six months ago and results were that we lost people. At one point the med/surg floor down the hall lost FOUR people to VA. They all handed in their resignations the same day, since then 2 more nurses have quit. My unit since Feb. has lost 1 RN to OB, one to GI lab and one LPN has retired. There are 2 more LPNs retiring in next 6 months. There is a delay between the time they leave and when we replace them and it stresses everyone out dealing with the situation. However, little by little they are replacing them.

Respecting loyalty and experience while helping new and returning nurses are truly PART of the solution.

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Not a shift goes by that one of my coworkers does not talk about getting out. Now threatening to leave and actually leaving are two different things. Most of them would like to get out but can't afford to stop having pay checks. If the economy continues to improve and people can get better

jobs they will leave in droves.

I hear the same thing every day. If I could find a job that as well if not better that I would like, I would be out of nursing in a flash....

Nursing is no longer what it once was when I graduated from nursing school 38 odd years ago. Back in those days it was about Patient CARE!! not about the bottom line.

I'm from the midwest. What scares me is the number of people entering the nursing proffesion simply because it's one of the few jobs available. The person who has worked at GM for 20 yrs and gets layed off, so decides to "get into nursing because it pays well and is a steady job". I guess I'm one of those people who believe nursing is something you are, something inside of you. You can teach almost anyone the technical aspects of nursing, you cannot however, teach compassion, tolerance and a love for the proffesion. I started as an A.D.N. R.N. However, I believe the A.N.A. and we as nurses are very much to blame for our situation. If we had 1/4 the lobby on capital hill as physicians, our conditions and patients satisfaction and safety would improve. If nurses want to be treated as TRUE proffessionals, then some things must change. (Including my spelling) Minimum education for R.N. 4 Yrs. Stronger lobbying and advertising including recruitment. Every nurse knows that we are the eyes, ears and senses of the physicians. If a nurse fails to be a patient advocate, or is overextended with patients and misses a symptom, dire consequences can happen. Where was the A.N.A when the study came out concerning the number of healthcare related mistakes resulting in death and injury each year. How many were due to poor physician handwriting. How many were due to understaffing or undertraining. Why are so many nurses leaving the field and why do so few enter. These are all questions that the public needs to be made aware of. Physician's don't have to sign time sheets, don't have to wear certain outfits and are not treated like they work at Dairy Queen by Human Resources. They also have true autonomy. Even more importantly, physicians can define themselves and there role specifically. They diagnose an illness, and they treat it. Granted Advanced Nurse Practitioners have made great strides in these areas and we need more of them. However, the average R.N. and nursing in general has a much tougher time in defining themselves and what they do. This is the area where I believe the A.N.A. has failed us most. Caring, compassion and technical skills are very important but hard to define in quantitative terms. There is much much more that is required of nurses these days. "Professionals" are treated as such and are paid as such because they have skills, talent and so on that not just anyone can master. But most of all, it's what's in their mind that is most important and valued. This is where nursing suffers because that old relationship of the DR. "treating" the patient and the nurses "taking care of" the patients stiil exists. As long as nurses continue to pick up meal trays, perform hotel services, give patients baths and empty bedpans, things will never change. OH, I can here every instructor out there right now typing away. Responding that baths, and all the other things I mentioned above are an intergal part of nursing and qualifying their remarks with reams of data siting the reasons they are important. The point is missed, I don't mind doing any of the above services and if a patient is lying in feces and urine and I'm the only one there, then that patient is going to get thouroughly cleaned and taken care of by me. But you should not have to do those types of things as requirements of your profession. Is that what you go to school for 2,4,6 yrs to learn ? Why would you want to pay some one $20.00 hour to pass ice water to 36 pt's on the unit. When this is brought up, many respond "do you think your to good to empty a bedpan or change a bed"? My response would be "of course not". I have worked with physicians who would help turn, reposition and even clean up a patient in a bind. But ask yourselves this, If physicians had to pass ice water, make beds, and so on, would they be able to treat and diagnose their patients adequetly. Even more relevent, would patient's and the public in general hold them in such high esteem if they did those type of things on a routine basis ? Until nursing comes to grips with this, and figures out how to define itself, it will continue to falter. The only way change can come about is by legislation and participation. When was the last time you voted on anything. Are you a member of a medical orginization? Do you know what kind of legislation is floating around on capital hill ? I love nursing, I could not think of anything else I would rather do including practicing as a physician. That being said, I think we owe it to ourselves and our patients to keep an open and "active" mind to todays healthcare environment.

Thanks

As long as nurses continue to pick up meal trays, perform hotel services, give patients baths and empty bedpans, things will never change.

Does anyone else find it odd that the unlicensed personnel, whose positions were created for these very duties, are now being cross-trained to do EKGs, draw labs, PASS MEDS (WTF???!!!), so that nurses can perform the above mentioned tasks? The problem is that too many nurses feel like they have to prove that they do not feel that they are too good to do these things. The problem is that when unlicensed personnel are asked to do the above tasks and leave the procedures to the nurses, they start in on the "you think you're better than us" rant. If they want to be nurses, there are schools out there for that. Being taught HOW to do something is not the same as learning why it is being done, and why in some cases it may not be appropriate, and what potential complications/consequences might occur.

When this is brought up, many respond "do you think your to good to empty a bedpan or change a bed"? My response would be "of course not". I have worked with physicians who would help turn, reposition and even clean up a patient in a bind. But ask yourselves this, If physicians had to pass ice water, make beds, and so on, would they be able to treat and diagnose their patients adequetly. Even more relevent, would patient's and the public in general hold them in such high esteem if they did those type of things on a routine basis?

Of course not. When a physician does it, they are "helping out". When a nurse does it, "it's his/her JOB." Everything the patient wants, they perceive to be the nurse's job. Everything they don't like, they perceive to be the nurse's fault. When the media tells people what to expect/look for in the hospital, they do not mention the fact that not every person that walks through the door in a set of scrubs is a nurse. The person with the mop in his/her hand: scrubs-yes, nurse-no.

Does anyone else think that civilian nursing would benefit tremendously by taking on the military nursing approach? (RN/BSN is officer, all others are enlisted. Everyone has their own place/value on the team). I feel it would advance the profession a great deal. I feel that RN/BSNs EARN this degree of professionalism in obtaining a level of education beyond that which is "functional" (i.e. many enlisted hospital corpsmen, etc. are ADNs and LPNs). Surely I can't be alone in feeling this way.

Even the UAP's out there are more vocal about defining their jobs than nurses.

I've worked with UAP's who state arogantly to the nurses" You need to get that patient off the bedpan, I have fingersticks to do."

When will nurses learn? If we don't take an active role in defining our role and our future, someone else will always do it for us.

Specializes in Vents, Telemetry, Home Care, Home infusion.
i'm from the midwest. what scares me is the number of people entering the nursing proffesion simply because it's one of the few jobs available. ....however, i believe the a.n.a. and we as nurses are very much to blame for our situation. if we had 1/4 the lobby on capital hill as physicians, our conditions and patients satisfaction and safety would improve. if nurses want to be treated as true proffessionals, then some things must change. (including my spelling) minimum education for r.n. 4 yrs. stronger lobbying and advertising including recruitment. every nurse knows that we are the eyes, ears and senses of the physicians. if a nurse fails to be a patient advocate, or is overextended with patients and misses a symptom, dire consequences can happen. where was the a.n.a when the study came out concerning the number of healthcare related mistakes resulting in death and injury each year. how many were due to poor physician handwriting. how many were due to understaffing or undertraining. why are so many nurses leaving the field and why do so few enter. these are all questions that the public needs to be made aware of. ...

however, the average r.n. and nursing in general has a much tougher time in defining themselves and what they do. this is the area where i believe the a.n.a. has failed us most.

these two articles in ojin and nursing's agenda for the future answer your question "where was the a.n.a when the study came out concerning the number of healthcare related mistakes resulting in death and injury each year"

since 2001, ana has focussed on these concerns. bringing together nursing organizations to discuss and determine what needs to be done to promote, protect and propell our profession forward.

nursing's agenda for the future released april 2002, is a result of this collaboration:

nursing profession unveils strategic plan to ensure safe, quality patient care and address root causes of growing shortage www.nursingworld.org/naf

it was posted at allnurses:nursing's agenda for the future ; received 185 views and only two responses. to me, the lack of response says something about staff nurses real concern and commitment today to our profession.

there is a difference in being educated to perform a job versus preparation for a professional career, in which we are stakeholders in upholding standards and promoting the our profession. karen

ojin articles:

nursing in the next decade: implications for health care and for patient safety

katherine a. kany, bs, rn (may 31, 2004)

dissipating the perfect storm - responses from nursing and the health care industry to protect the public's health

michael r. bleich, phd, rn, cnaa-bc

peggy o. hewlett, phd, rn (may 31, 2004)

This book was written by my cousin.

At one point in time I wanted to be a nurse. After getting almost all of my pre-reqs I changed my mind. I read Faye's book and talked to a LOT of nurses and got scared. After dropping the ball on my ed for a few years (personal life/finanaces...I'm in my 30's with kids) and few years later I've come full circle and want to pursue nursing again. I know it will be hard and maybe I won't change the world but I can make a little difference in my little world.

You know what? That is enough. Running away certainly won't help.

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