There are several compelling studies which clearly demonstrate that mortality (death) rates and morbitidy (complication) rates are reduced with the presence of baccalaureate prepared registered nurses in satisfactory intensity (how much direct patient nursing care) and acuity (how much high tech and constant nursing observation)patient ratios. Linda Aiken of the University of Pennsylvania is the primary investigator, and you can read the Institute Of Medicine Quality Study Series at:http://www.iom.edu/CMS/8089.aspx and in particular, the Keeping Patients Safe – Transforming the Work Environment of Nurses study at: http://www.iom.edu/?id=19376

There are also major problems with overburdened emergency department nurses and patient access to inpatient beds.

Read my posts, The Shell Game, Professional Practice Groups for Nursing, Nursing: key Demographics, Get Rid of the Nurse, and Nurses: Nurse Nurses for starters.

I’ll be happy to entertain questions – and readers.

Thanks for writing this. It’s important to keep this in front of readers. Also – the recent NLRB ruling that puts clinical nurses who assume shift charge duty in the role of supervisor is going to make big waves. It burdens the already overwhelmed nurse who is caring for patients, and makes her assume managerial duties without overtime eligibility.

I’ve seen the Neveda nurse story on a few blogs. I’d like to point out that the nurses at Northern Michigan Hospital in Petoskey, MI have been on strike for 4 years! And now NMH has declared their strike over. Not because anything has been settled, but because the hospital decided it has effectively replaced the nurses!

http://www.record-eagle.com/2006/oct/27strike.htm

What’s happening to nurses (and other health industry staff) in the health industry is indicative of what’s happening to the majority of professionals in the labor industry in the US. Nursing isn’t manufacturing and you can’t treat it as such. Not to mention that we’ve seen what’s happened to manufacturing in this country. Health Care, Insurance industry, Big Pharma does not make for a good equation.

It’s sad that on most patient’s hospital bills “nursing care” doesn’t even appear anywhere. Instead it’s lumped into “housekeeping”.

What you just said about the general trends in manufacturing reminds me of a book by Heather Menzies, Fast Forward and out of Control. It’s about how even professional jobs are fast becoming MacJobs. Administrators/Management start to invest heavily in technology and see employees as cogs in the wheel operating the technology. It all leads to an ugly management philosophy that sees employees as human resources “ideally” working in an automated style. I know doctors who fear this is happening to the profession. But BigPharma and Insurance are all vectors that play into & influence this all. Some insurance companies are convinced that doctors’ roles should be one of merely medication maintenance, since BigPharma has them convinced that their drugs are most efficient and the one-on-one particularly in mental health is no longer needed.
I hope I got that right, since I am not good at grasping the philosophical stuff.

And Jane! This is an uphill battle, but a good one and I think extremely important. I’ve been in the mindset, because I’ve had this role conferred on me by virtue of growing up in a “medical family.”

Julia (juls) Rosen @
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Glad you picked it up Jane. This really is about saving lives v. corporate profits. These nurses are fighting the good fight. I am so glad to see the blogosphere support them

Veryy good post and nice blog, Julia. Thanks for your insights.

Thanks. It is all of about 3 weeks old. Today, will be a good traffic day, now that you Matt and Taylor linked to the post :)

Glad you picked it up Jane. This really is about saving lives v. corporate profits. These nurses are fighting the good fight. I am so glad to see the blogosphere support them

Veryy good post and nice blog, Julia. Thanks for your insights.

http://www.record-eagle.com/2006/oct/27strike.htm

What’s happening to nurses (and other health industry staff) in the health industry is indicative of what’s happening to the majority of professionals in the labor industry in the US. Nursing isn’t manufacturing and you can’t treat it as such. Not to mention that we’ve seen what’s happened to manufacturing in this country. Health Care, Insurance industry, Big Pharma does not make for a good equation.

It’s sad that on most patient’s hospital bills “nursing care” doesn’t even appear anywhere. Instead it’s lumped into “housekeeping”.

Staffing ratios have crept up but there are additional issues that have made the job harder and harder. First is the transition from the standard 8 hr shifts to 12’s. That is when I found that I was just too old to work full time. Try working 4 12hr sifts doing the heavy physical work standing, walking and running throughout the sift on floors with indoor carpet on concrete floors.

The next cost cutting is attendent help, such as aids and orderlies, they are either cutting their numbers while RN’s are doing more or they are cutting the number of RN’s and adding attendent help which means the RN’s are supervising more staff. Also the latest changes in the NLRB change in what defines a supervisor which are excempt from being in a union, Team leaders or Charge nurses are now prevented from being in a union. The issue is that they do not have hiring or firing responsibility, they are just the person who is ultimately responsible for that shift.

Also there state laws which make it harder. First I was rated as “emergency” staff which exempt me from breaks and lunch periods from the labor laws. This means that even getting a bathroom break can be a logistical event!

If my next shift replacement did not show, I was required to stay regardless if I just finished 12hr shift or be charged with felony abandonment. Many a double shift was worked for a no show or the DON (director of nurses) could not find a agency nurse.

Then, there is the issue of agency nurses, (rent-a-nurse). Trying working with fresh Ortho-Neuro postop patients with three agency nurses who have NO clue how to care for that type of patient.

The average age of nurses in the USA is between 45-50 yrs old. Nursing education centers are not opening new slots to train new nurses fast enough to replace the aging workforce.
More info about nursing shortages can be found here- http://www.nurseweek.com/news/nursingshortage.asp

I have been waiting for years for someone to finally listen to the call of help that the nursing profession has been screaming for years.

In NYC 70K wasn’t all that much to try to live on when I left NYC in 1990. Today it’s barely enough to live decently on, given the cost of living there.