Opinions and Observations

1. Disposable Nurses
2. Just a Nurse?

 

 

 

Disposable Nurses

By Butch

Business Manager, Canyon View Nursing

As public and private groups try to figure out how to solve the present nursing shortage, few, if any, understand why we have such a shortage in the first place. The nursing shortage is no different than any other problem. Before a cure can be prescribed, a diagnosed must be made. 

Talk to any nurse any where, and chances are you will be able to sum up the cause within minutes in one word. It is called dissatisfaction. Rather than being treated as the “Professionals” they are, and treated as an important indispensable part of the health and healing care process, they are tossed to and fro with crazy schedules, insulted by manager, doctors, patients and family member of the patients. At least the patients and their family members have the excuse that they didn’t know that the nurse is stressed out by either being handed to many patients because the facility is trying to cut cost, or its refusal to allocate adequate funds to properly pay the nurses it does hire or to hire an adequate nursing staff.

For all their efforts, contemptible schedules, obnoxious disrespect and educational time and expense, nurses are further disgraced by receiving the lowest pay, often by as much as 60%, of other professions with the same educational time and level.

In response to this problem, most government official, appointees and legislators seem indifferent to the problems or realistic solution. Take the case of Patricia Munn, RN BSN. During the 2003 legislative session, she sent e-mails to twenty-five State senators and representatives. Out of the twenty-five, only one responded. And even that one proved completely fruitless. The complete apathy by such individuals is assurance that not only is the nursing shortage here to stay, but that it is likely to get worse. When nurses attempt to open dialog and discussion, they are further treated with indifference and disrespect.

It is nothing less that wonderment as to why the legislature is not passing meaningful legislation before the shortage gets any worse. Whistle blower legislation would allow nurses to come forward when patient care and even patients lives are threatened by facility policy and practices. While most remain silent to such activity, some had even been required to “cover up” when it is necessary to protect either a doctor or the facility. At least twenty-eight States have passed nurse-to-patient ratios laws. Many others have barred the practice of forced overtime. Many more have passed laws making it a felony to attack or assault a nurse. Yet the best the Wyoming Legislator can do is pass out low interest loans for nursing students.

Statistics show that 20% - 30% of new grads quit and leave the nursing profession within one year. Legislation allowing low or no interest loans to those who attend nursing school will only serve to increase the speed of the revolving door. Once these “no interest students” get into the field and find out the rest of the story - that they have little family life because of crazy schedules, are treated with a complete lack of respect, and that the compensation is way below that of other professions with the same educational level, they will defect in even higher numbers to other careers and professions that are less stressful and more financially rewarding. Low and no interest loans does nothing to cure the causes which have resulted in a shortage of nurses to begin with. 

The public, the government, insurance companies, doctors and facilities seem to forget that nurses are the backbone of the health care industry. A patient can go a whole day without seeing a doctor; but let a patient go thirty minutes without seeing a nurse and you have a crisis. I submit that the primary caregiver is the nurse - not the doctor. She or he is there at the call of a light. It is the nurse that treats the wound and passes the medication. Whether it is a bath or needing assistance to the toilet, it is the nurse that provides these services - not the doctor, insurance company or the facility’s management. It is the nurse that has to deal with the patients’ family members and all their problems, concerns and emotions.

In addition to requiring specialized training and education, nurses are, hour by hour - day by day, responsible for life and limb. Respect for the person who can manage and handle such responsibility seem only appropriate. Respect from legislators by listening to their concerns regarding patient care. They are the ones on the front lines after all. Respect from insurance companies by acknowledging that nurses and nursing services are not only important, but indispensable to patient care and recovery. Respect from doctors who not only demand so much from nurses, but actually depend upon the nurses’ expertise and attentiveness to their patients. Respect from the facilities by recognizing that without the nurses, they would be out of business. It is ironic that facilities would rather pay attorneys hundreds of dollars to get out of or settle a law suit, rather than adequately pay quality nurses to avoid law suits to begin with. 

If the public wants proper treatment and care from nurses when it is needed, the public must demand that nursing and nurses are given the proper professional respect that they have earned and deserve. Anything less and we will continue to have what we have - a shortage of disposal nurses.

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Just a Nurse?

Spread the word: Nurses make a difference

By Anne Nowlin, BS, BSN, RN

In today's busy work environment, pausing long enough to consider nursings' impact can be demanding — but we must. Do you realize the value of your contributions to healthcare? Unless we make time, healthcare issues will continue to be seen through eyes of doctors and businessmen.

Some physicians are vocal about the value and importance of nurses.

"In the fragile ecosystem of medical care, nurses are the ones who create the protective environment essential to the well-being of both doctors and patients. We cannot function without them. Their job is to provide knowledge, comfort, care and compassion," noted Michael Greenberg, MD, a dermatologist in Elk Grove Village, IL1

Even though some physicians feel this way, we must continue to raise awareness of what we know and do. We must fully grasp our contributions to healthcare and pass them on to the public, media and legislators. If just 10 percent of the 2.7 million U.S. nurses2 voiced what we do and our thoughts on other healthcare issues, can you imagine the impact of our 270,000 voices?

Following are some areas we've all studied and involve in our daily practice. Even though just the "tip of the iceberg, " we must communicate this information proudly to listeners.

Wealth of Knowledge

Nurses know anatomy, physiology, pharmacology, microbiology, chemistry, nutrition and psychology. We've mastered critical thinking, nursing interventions and approaches to care. Our assessments are physical and holistic. We know the significance of lab values and vital signs, and are responsible for notifying the doctor of changes.

Nurses assess pain — sometimes recommending pain medications — know pulse oximetry and what might cause abnormalities. We know actions of other meds, side effects, when to give them and when they may need to be held.

Nurses know normal body systems, what causes problems and how they heal. We understand the heart, read ECGs, know why and how to treat fatal and other irregular rhythms, and have a responsibility to consult with the doctor. Fluid status is evaluated in many ways; sometimes we detect dehydration by a gentle pinch of a patient's skin. We use most of our senses to assess wounds, notifying the doctor of poor healing and signs of infection, at the same time evaluating nutritional status.

Nurses teach patients and families about medications, diagnoses, treatments and procedures. This prevents unnecessary complications, while another part of our teaching is individualized discharge instruction.

How often do doctors deliver upsetting information to a patient, only to leave a nurse to "pick up the pieces"? Their training isn't always in calming anxious patients; not only do nurses have that ability, but it is also one of our unique qualities. Isn't it the nurse who remains at the bedside to console and care for the dying patient, and help the patient and family understand stages of grief?

In addition, nurses assess and reprioritize, care for IVs, change dressings, toilet, walk patients and draw blood. We all know the list goes on as we help those who can't help themselves. Frequently, we work late or without breaks to complete and document care. While absent from our patients' eyes, still we work. This is what we do. Committed to our profession and devoted to our patients, respect for nurses has been absent for too long.

Stand Proud

So, the next time you're asked what you do, and are tempted to say, "I'm just a nurse," hold your head high, silently pat yourself on the back and toot your horn, choosing stories or a few things you do daily. Rehearse first with teachers, firefighters, EMTs and policemen; people who already know our importance.

If we all do this, we'll raise awareness of our knowledge, practice and advocacy. This education of public, media, legislators and patients can help increase respect for our profession; this lack of respect is one reason we face a shortage of nurses.

References

1. Greenberg, M. (2002, Jan. 28). Hailing one of health care's priceless resources nurses. Retrieved May 14, 2003 from the World Wide Web: http://www.ama-assn.org/sci-pubs/ amnews/amn_02/edca0128.htm

2. Hall. K. (2001, Feb. 13). Testimony of the American Nurses Association on the nursing shortage and its impact on America's health care delivery system. Retrieved May 14, 2003 from the World Wide Web: http://www.nursingworld.org/gova/federal/legis/testimon/2001/shortage.htm

Anne Nowlin resides in Des Plaines, IL. She has worked for 11 years in med/surg and was a hospice case manager for 9 years until 2001.

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