The Safety Net: Nursing In Public Hospitals

[NRSKarenRN, BSN, RN]

[color=#231f20]tsn-the safety net

[color=#231f20]

[color=#231f20]is published by the

[color=#231f20]national association of public hospitals and health systems.

summer 2005 • vol. 19, no.1

from editors note:

margo hilliard alford, md

[color=#0085b6][color=#231f20]attentiveness to the role of nursing in safety net hospitals and [color=#0085b6][color=#231f20]health systems is emerging as a common theme in most if [color=#0085b6][color=#231f20]not all of naph member hospitals. nurses continue to make mportant contributions to the delivery and efficiency of the services that we provide our patients.

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as a physician, i think one of the most important roles for nursing

today is to help expand health care delivery systems to include more opportunities for nurses to engage in a wide variety of advanced practice work. advanced practice work – such as that performed by nurse practitioners, clinical nurse specialists, nurse midwives, infusion nurses, and nurse anesthetists – is an example of innovative nursing resources critical to the delivery of quality care to the whole patient.

this is particularly important in the public hospital setting, where

demand for services far exceeds capacity, and where tight resources mandate tighter cost controls. we see examples of this approach in the article “a continuum of care: the role of nurses in chronic disease management” that starts on page 8.

in addition to such obvious areas as innovation in health care delivery, nurses can help us reshape their working environment.

as shown in the article on the uhc nursing work environment

study (“seminal collaboration exposes excellence, opportunities for

naph members,” p. 15), we need to be attentive to factors known to influence the nursing work environment to create an organizational culture for patient safety and to strengthen the role of the nurseleaders in executive management. we also must emphasize nursingtraining and address such perennial, yet essential hr issues as staffnurse turnover, vacancy, and hours worked.

hospital ceos shouldexercise leadership on this issue and work with their nurse leadersto implement structural changes in the nursingwork environment to address these concerns.

closely related to all of these issues is diversity in our patient

population and the cultural competence of our nursing staffs. the

diversity of our nurses and other health care professionals is part of the solution to addressing health care disparities. this is a challenge that the leadership of naph member hospitals must and will take on. as so correctly pointed out by dr. polly bednash, executive director of the american association of colleges of nursing and a member ofthe sullivan commission on diversity in the healthcare workforce, in her interview with tsn (p. 22), “ceos and chief nursing and medical officers have to give a clear message that expanding a diverse workforce is key in meeting the needs of a multi-cultural society; hence, it is essential that they understand diversity in the broadest context.”

in this issue of tsn, you will fi nd examples of innovative community outreach strategies that improve patient outcomes and address theissue of health care disparities among our patients.

empowering nurses with decision-making and leadership opportunitiesand liberating them from strictly defined traditional roles willgreatly enhance the quality and availability of health care for millionsof americans. i encourage our readers to view this issue not simply asa tribute to the way nurses shape health care today, but as part of a larger dialog of how they will shape it tomorrow.