Nurses Week 2009 How's It Going Nurses?

So once again, Nurses week rolls around.  Only this Nurses’ Week, I gather things aren’t too great.  I’d love people to write in and tell me if their hospitals have cut back on or completely eliminated Nurses’ Week celebrations because of the economic crisis.  Please post and let me know.  I’d also like to know if hospitals are cutting back on nursing positions, laying people off, or not filling vacancies.  I’ve heard that the nursing shortage of just yesterday has miraculously been solved today.  That hospitals don’t have vacancies or openings.  That they can get plenty of nurses. So what I want to know is, how are things at your place of work?  Is the shortage over and how do we measure that?  By the amount of vacancies a hospital posts?  Or by the amount of work a nurse is asked to shoulder?  Is your workload suddenly more manageable on the floors and in the clinics and in home care?  Do you have loads of help from other nurses because suddenly — no shortage — they have more time and can help you?  Are patient falls, UIT’s CVC line infections decreasing because there’s more nursing care available because, after all , there ‘s no shortage?  If you’re a manager, do you have three units to manage or one?  If you’re a manager to you have time to actually learn what’s going on on your unit?  This is how we should measure whether or not  the shortage is over.

I think we need to make a distinction between a shortage of nurses and a shortage of nursing care.  With the former, not enough people want to be nurses and not enough will stay in the workplace delivering direct care.  That means if you want to hire more nurses and provide more nursing care, you can’t because there just aren’t enough bodies with educated brains to do the work.  That’s a shortage of nurses.  A shortage of nursing care, on the other hand, means that hospitals could deem that they have hired sufficient nurses but the reality is that those nurses cannot possibly deliver the high quality care each and every patient deserves.  That’s because there are not enough bodies with enough educated brains to deliver the intensity of care patients with skyrocketing acuity need today.  If you make this distinction, you can easily have a situation in which there is no “shortage of nurses,” but there is a “shortage of nursing care.”

I fear this is precisely the situation we are in today and that this shortage of nursing care will soon produce another shortage of nurses.  Why?  Because the babyboomers are poised to hit the hospital bed big time — with not just one disease but mulitple co-morbidities  Then we have a whole cohort of nurses –babyboomers themselves –poised to retire.  These nurses will stop giving care  and  start needing it themselves.  If, however, nurses are being laid off or cannot get hired, well then, guess what, the word gets out and then people don’t enroll in nursing school.  So then, when the patient demand increases, the older nurses  have retired, and the economy has improved and suddenly hospitals and policy makers and politicians rediscover nurses and nursing, well, we won’t have enough students in the pipeline to produce the nurses we need.

The point here is the society has to begin to understand that there is no faucet whose spigot can be turned on to instantly provide a supply of nurses when we need it and turned off when employers and our society deems, sorry we can’t afford it, we don’t need it.  To produce a compentent nurse — and I mean competent not expert, takes at least six to nine years.  To produce an expert nurse takes more.  Wouldn’t it be nice if just for one nurses’ week we celebrated nurses competence and expertise instead of how sweet and kind and compassionate they are?  Wouldn’t it be nice if just for one Nurses’ Week we demonstrated that we understand that kindness and compassion depend not on the heart but actually on the brain and how educated and experienced it is?

Showing 7 comments
  • Judy Dugan
    Reply

    Whether there is or isn’t a right-now nursing shortage, your point about the boomers turning into geezers is spot on. Arizona, for instance, is a flash point. (I was just there visiting a relative even older than I am, so it’s on my mind).
    Here’s a paragraph from a student piece at the University of Arizona ( http://media.wildcat.arizona.edu/media/storage/paper997/news/2009/05/04/Opinions/Az.Nursing.Shortage.Worsened.By.Education.Cuts-3735639.shtml )

    “A 2008 study revealed that Arizona will need to gain almost 50,000 new registered nurses in the next nine years to hope to meet the state’s health care needs. The nursing shortage is a national issue, but is more pressing in Arizona because of the state’s explosive growth, as well as an aging nursing population on the verge of retirement.”

    The problem at the university, says the piece, is the inability to admit all the qualified would-be nursing students in the degree programs. The same thing is happening in California, and I assume other states.

    Plus, all of the even remotely credible health reform proposals in DC depend on expanding the role of nurses. No matter what is or is not the case right now, we know what the situation will be in a couple of years.

  • Jennifer Henry, RN
    Reply

    Thank you for being one of nursing’s greatest advocates!

    We are holding our own at Vermont’s largest healthcare system, Fletcher Allen Health Care. I am so thankful that we organized our union and set to work immediately to solve safety and quality of care issues like staffing. We have 600 more nurses today then we had in 2002 when we organized, with fewer inpatient beds. Our quality indicators are now “average” when they used to be embarassingly substandard. Now we must remain strong to continue to improve.

    Nurses are so used to doing the best we can with what we have, our greatest challenge is to keep our optimism, our pride, our integrity and courage. We must find the energy and inspire our colleagues to join together and create the change our patients and communities deserve.

    Patients must remain every healthcare facility’s top priority and everyone wins when direct care, front-line healthcare professionals have a protected voice! We are proud to have the technical professionals at FAHC joining our union. We are stronger together.

    Thanks again for your dedication and support! Have a GREAT nurses week!

    PS – the illusion of a vanishing nursing shortage, the lack of care providers, the lack of posted positions at hospitals due to the economy, the lack of health”care”, and cuts to programs that affect patients and nurses speaks to the confusion about what the priorities in healthcare must be. Where healthcare facilities dedicate their resources speaks to their priorities. Are the resources, human and financial, dedicated to executive salaries and bonuses, programs purchased from high priced consultants, bricks and mortar or is it on people and programs that improve the safety and quality of care?

    With our union full of active, intelligent, vibrant members, we can say with confidence that we ensure our hospital’s priorities stay focused on patients!

  • Kathy Montgomery
    Reply

    I appreciate your distinction between a shortage of nurses vs a shortage of nursing care. It is important to be clear on what the impact of this distinction will bring to patients and to the present and future workforce. For all too long it was a matter of how many nurses instead of how well prepared and educated the nurse is for the work that needs to be done. The nurse is a “knowlege worker “(Drucker) not simply caring in the absence of serious knowledge, capacity to synthsize and competency to act.

  • Reply

    As always Suzanne you bring up comments and concerns that truly impact the nursing profession. However, I am going to take the political stand on the fact that the profession created Nurses’ Day/Week. It is an embarrassment and simply makes nurses look like school kids. Nurses’ Day is plain damn stupid and foolish.

  • Cecilia
    Reply

    Hi Suzanne and Colleagues! My thoughts about nurses’ week are from Italy so it might be very different from yours. Our National Health Care system and our professional history are very different from US. I belong to the Italian Nurses Association affiliated to ICN and we do try to celebrate Nurses’ Day as we can. Our National Nurses Board started to celebrate the 12th of May as well. However, as far as I know, no Hospital trust or Health care organisation in Italy does anything for nurses in this day/week!

  • Melissa Moore
    Reply

    I think you have the right idea when you say that there is a “shortage of nursing care”. My facility, as well as many others in Kentucky, expect nurses to deliver more aspects of patient care, do more nursing based on “evidence-based practice”, and keep the patient satisfaction survey result high, but at the same time we are expected to do this while taking care of as many as 10 patients! Facilities want more with less people. That just doesn’t make sense. Like I have said before, the research and study results that our nursing practices of today are based on and recommended to be based on are really nice and pretty and sound wonderful in the perfect nursing world that they come from. However, they are not very realistic with the staffing ratios that are implemented at many hospitals. I also think that if the people that make the policies and procedures at hospital facilities had to get out on the floor and do what they expect their nurses to do, well, we wouldn’t have hospitals……because they wouldn’t do it!

  • Jane McCall
    Reply

    Well, we’ve actually had a pretty good nurse’s week here at St. Paul’s in Vancouver. The organization organized a one and a half day conference for nurses where we got together to reprise the presentations and posters that nurses from St. Paul’s have done in the last year. It was a celebratory event which was helped along by the fact that it was held in one of Vancouver’s better hotels and there was lots of great food. We still have staffing shortages but at least we have organizational support for bringing people in on overtime if we need them so it could be worse. Still, we are challenged every day to provide the right kind of care for our patients in the face of government cutbacks. It has always been thus. We need to do a much better job of advocating for our patients. We are a very large and potentially influential group. We need to unleash our power.

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