We may need fewer nurses in the hospital...

[Chin up]

WCVB channel five Boston, is now airing, Healthcare Uncovered. A live panel show discussing healthcare and it's cost in Boston. The moderator, Timothy Johnson, MD. One of the panelist, Zane, the CEO of Tufts Medical Center whose 1100 RN's just voted 70%, to authorize a one day strike. This is what I just heard and this is verbatim.

"We may need fewer nurses in the hospital, but we will need more in the community, helping patients to stay healthy. so there maybe some modest job losses, I think there is a great opportunity to retrain caregivers in new professions."

"Doesn't the rank and file worry though, if I am dislocated as a healthcare worker. The job that may be available for me on the other end is nothing of the caliber of the job I trained for and gone to school for as a RN or whatever."

They avoid that question and go on about being unable to sustain the hospital budgets. Over half of budgets are employee salaries(nurses). We must address these salaries and benefits and look into job revocation. They go on to justify this thinking, due to small business unable to afford healthcare here in Mass and therefore leaving the state. There are great opportunities to shift our thinking from acute care to physician and patient remaining well. (paraphrase).

Helen Zane: what the trajectory we are on, the public will not tolerate. Better we get ahead of it. ( she is addressing nurses who want better nurse/ patient ratios). Fueling her position, against the nurses.

They go on and defend physicians who do needless test...talk about salaries and fraud in the same sentence. Implying, nurses must make sacrifices...my reading between the lines. Then go to prevention and teaching. Intervention is most important right now. (agree,but, where are nurses in this) Their focus, doctors, PA and NP.

You all need to watch this, there is so much more. Primary care doctors aren't paid enough, but no mention of professional nursing. Again, ANA where are you?? BSN's you are not being addressed at all. They are talking about eliminating your job. They are talking about retraining you and "retooling" your career. And you all are worried about the difficult patient? We need to get busy...are we even listening to what is happening right before our eyes? Are you all satisfied with your degrees when you have no say in policy? Do we even care?

The lie has been told so much, ever since I can remember 27 years ago. All we needed was BSN to get taken seriously...really?

[pedicurn, LPN, RN]

You're so lucky there where you have so much unspoiled beautiful land. A big part of me agrees with you; a few nights ago I was even looking at undeveloped acreage in northern great lakes state - even though I absolutely hate the cold I can just see that land becoming very valuable in my lifetime (aka an abundance of fresh water). Like minded nurses take heed. :-)

.

Yes interesting idea. But energy will probably be really expensive so need to pick somewhere with lots of fresh water plus milder winters ??? the south.

I have read that the SW could have water issues in the future which is not good. If I were from the US I would love to live in the deserty SW as it's so beautiful but the water issue will be a worry

[WIN007]

make sure that it is not biased to the left in any way, right?

I said I was talking about ONLY federal income taxes, because all the others DO vary according to where one chooses to live and I believe that is a great way to really see who pays what (by removing all other taxes from the equation). How is it fair to include a state like mine (WA) where no state income taxes are paid with a state that does? .

PS -

FICA taxes, medicare, the federal gasoline tax, taxes on airline tickets, the booze you buy, to name a few do not vary by where you live. they still are making up a huge piece of the total pie the FEDERAL govt collects annually. See prior posts for composition. I agree state taxes vary, but usually with regressive taxes they get you in one pocket if not the other. In Texas no state tax but they got me good in other places, higher vehicle registration fees, higher sales taxes, etc.

Anyway, my intent was certainly not to split hairs or upset anyone so on that note I'll leave the rest of you to enjoy the thread and move on to the clinical topics.

[WIN007]

Yes interesting idea. But energy will probably be really expensive so need to pick somewhere with lots of fresh water plus milder winters ??? the south.

I have read that the SW could have water issues in the future which is not good. If I were from the US I would love to live in the deserty SW as it's so beautiful but the water issue will be a worry

I love the desert too tho I admit a little goes a long way for me. Yep, many cities in the southwest have pretty much depleted water tables and have been importing water from outside sources (Colorado river, lakes in northern california, etc) for sometime and has sometimes gotten sticky both politically and legally where this has involved tapping into the resources of other states. Tho it's branched into the southeast as well - Georgia had a serious water problem a couple years ago and droughts have hit Florida and Texas as well.

[ZippyGBR, BSN, RN]

:argue: Can't we find common ground in this nation and apply our efforts toward a common goal? When America does that, we really shine.

from my right-pondian view

because the conservatives, McCarthyites, rednecks and conspiraloons can't distinguish between 'common good' and 'communism' and socialised and socialist ...

the USA despite being the 'land of the free' is the only nation i'm aware of where 'liberal' is used as an insult ... Liberalism and Conservatism in UK adhering generally to Churchill's sentiment of " if you are not a liberal at 20 you have no heart and if you are not a conservative at 40 you have no brain " (deliberate small 'l' and small 'c' )

[nursel56]

from my right-pondian view

because the conservatives, McCarthyites, rednecks and conspiraloons can't distinguish between 'common good' and 'communism' and socialised and socialist ...

the USA despite being the 'land of the free' is the only nation i'm aware of where 'liberal' is used as an insult ... Liberalism and Conservatism in UK adhering generally to Churchill's sentiment of " if you are not a liberal at 20 you have no heart and if you are not a conservative at 40 you have no brain " (deliberate small 'l' and small 'c' )

A lot of that ridiculousness can be traced to the way campaigns are run here in the US. The reason the term "liberal" fell out of favor is that one side was successfully able to link the other guy to an unpopular policy or a goofy PR mistake. It irritates me as the newer term "progressive" is not the same as the Progressive Era politics of the TR-Wilson-Taft era.

I've recently stopped commenting on issues based on who's "group" I'm in -- meaning that I don't think the term "conservative" tells me enough about a person to conclude they are a racist or stupid. And why people get on the telly and blab about Obama being an agent of a subversive commie plot to create a One World Socialist entity when they think Social Security and Medicare are just grand - I don't know - but cracking a history book would probably be in order as that is total BS.

I've had my fill of the vicious attacks on the personshoods of people we disagree with in the political arena.

[All4Seasons]

Interesting discussion. I'm in Australia and I sometimes think that perhaps people don't fully understand what is meant by preventative interventions.

It's not just about quitting smoking and eating better and losing weight although of course that's a big part of it.

Women over a certain age (I think it's 50, might be 45) are entitled to free mammograms. And it's easy - you just go to the breast screen clinic or, if in a small town, the mobile breast screen caravan visits the area at regular intervals. When you turn 50 and when you turn 55 you are sent a faecal occult blood kit for bowel cancer screening. Again it's easy, you collect the sample according the instructions and post if off (no postage costs). Nobody is made to do these things and there is no 'comeback' later if it turns out you have breast cancer or whatever and the free test may have picked it up earlier.

My daughter-in-law recently had a baby. The midwife visited her twice at home after discharge from hospital just to make sure there were no problems. There is no charge for this. She can take the baby to the nearby 'baby clinic' if she's worried about anything, and mothers are encouraged to go regularly to get the baby weighed and measured, for a health check from the midwife, and for general baby care advice. Again, there is no cost and you generally don't need to make an appointment. If you live in a very small town there may not be a permanent clinic, instead there will be a visiting clinic once a week or whatever.

My son and daughter-in-law were encouraged to have free whooping cough immunisations after the baby was born. The government is also funding free whooping cough immunisations for grandparents of babies under 6 months for a limited time.

Visits to the doctor are free if you're lucky enough to have a doctor who 'bulk bills' but even if your doctor doesn't do this, the cost is reasonable.

These may seem like small things, but they do help to identify problems early, help to manage chronic conditions, and help to keep people out of hospital.

Naturally things aren't perfect in our health system, far from it, but all things considered, I'm happy with it. Oh, and yep, this isn't really 'free', we pay for it with our taxes. But that's the thing, everybody pays and it's there for everybody.

You've pretty much described the health care here in Canada as well. I'll take the higher tax rate any day over losing the federally supported system we have here. Of course it's not perfect,wait times can be a trial, but there are continually updated provincial wait times online for every province - and you are encouraged seek referral to another centre with a shorter wait list for whatever it is you need.

[Spikey9001, BSN, RN]

We pay college educated nurses to clean poop, make the bed, and empty the trash. How does that make financial sense? Maybe we need fewer nurses who spend more time doing that require their education and experience (assessment, RN skills, meds) thus better justifying money spent on their salary (which might even go up), and the unskilled tasks can be left to low paid techs.

(I know many of you are now looking for the ANTI-Kudos button for my post )

This is exactly why I'm getting my RN.

[billyboblewis]

Anyone who is job hunting knows we already have way too many RN's.

[talaxandra]

I disagree - study after study demonstrates that the more educated the staff, the better patient outcomes. Where I work (tertiary care) we have no aides and only a handful of Enrolled Nurses.

Our cleaners empty bins; as a CNS I perform holistic care for my patients, which includes attending to hygeine needs. When I "clean poop, make beds" I'm also assessing skin, encouraging self care, comparing how well the patient can turn/breath/move compared with yesterday and - most importantly - connecting with my patient.

I believe it's this non-division of care that has had three patients tell me about childhood abuse that they've never disclosed to anyone else, and that allows patients in general to discuss fears, and concerns, in a way that would be more difficult if they had different staff performing various interventions.