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Nursing Shortage? (Reply to this comment)
by ljacosta
The Author is correct, there a so many areas of expertise, and so much MONEY involved there will always be a nursing shortage.
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Dec 04 '02
6:12 am PST
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Explosions in technology cause increased expectations (Reply to this comment)
by oeming
I agree with the view that nursing has become a grueling occupation for many because of:
1) increased patient loads
2) increased acuities
3) increased demands for technological expertise.
As far as the money-as-bottom line factor, I agree that there is an element of that at work.
However, I think that the cost-cutting and cost-watching is not entirely the product of self-centeredness and greed on the part of management.
I think a big part of the reason money has become such an issue is because there has been an amazing and wonderful explosion of new medicnes and life-prolonging and life-enhancing medical technologies--approaches only dreamed of 50 years ago.
Unfortunately these treatments and meds don't come cheap.
Whereas, 50 years ago, doctors and nurses could honestly say, "There's nothing more we can do," and would then be free to offer relatively laid-back palliative care and comfort measures, nowadays there IS something that can be done--but, alas, that "something" is very often expertise-intensive and dauntingly expensive.
It's like: "Toto, I don't think we're in Kansas anymore."
This added stress to nurses that comes from having to administer pricey, demanding state-of-the art care, which was once the exclusive province of doctors, is compounded by the reality that these well-taken-care-of patients live longer during a high-maintenance old age--which makes them return customers, which increases the average hospital acuity levels yet higher.
The situation is made yet worse by the information revolution--the internet, and sattelite TV, and so forth--which, more and more, is educating patients about the latest cutting-edge, breathtakingly expensive treatments and medicines. Understandably, these patients demand these expensive treatments with the fiery vigor and focus that can only come from being from being at death's door. So, whereas in the past, the doctor could silently and without challenge withhold available treatments because of unavailability or expense (such as kidney dialysis in the early sixties), now the doctors risk massive lawsuits and emotional punishment if a conceivably-available treatment or medicine is withheld.
(In that vein, I heard that there were once "kidney boards" in various cities, who would decide which fortunate individuals would get dialysis--and which ones wouldn't. I heard that the criteria was based often on common-sense factors, such as the size of the candidate's family; whether the candidate ran a business that many people relied on for a their livelihoods, and so forth. Nowadays, this picking and choosing would more likely to be seen as profiling and discrimination, and would subjuct the members of the kidney board to indignant lawsuits.)
So, many patients, instead of being allowed to die because of lack of resourses, are now packed into ICUs and med-surg floors in an attempt to give as many people as possible medicines and technologies that everyone CANNOT AFFORD. And the resultant overload is being felt by everyone--the patients, the nurses, the doctors--everyone.
The sad fact is, just because a new treatment or meidicine exists, NOT EVERYONE CAN HAVE IT. Whether we like it or not, Darwinism exists in medicine--and much of that Darwinism is based on money. If you don't have the money to get the cure, you die. Simple as that. No matter how much we wish it weren't so; no matter how much we pester the insurance companies and the governments for more money; there is always going to be some treatment or medicine that is just too-pricey or too limited in availability, or too cutting-edge for everyone to have. At some point, somewhere, someone is the person to say in one way or another, "You don't have the money, so you are about to die." But since that is really hard for most people to do, all-too-often peole are admitted to the hospital who can't pay, to the detriment of all of the other patients. The insurance compnaies catch a lot heat for being mean and uncaring financial gatekeepers at the hospital doors, but what else can they do? They can't pay for $400 tubes of Regranex for evey 75-year-old indigent with foot ulcers who walks in off the street. They can't give quadruple bypasses to every cig-smoking, fat-eating octagenarian who wants one.
Unfortunately, the nurse is often blamed for the inadequate care that results from trying to give pricey treatments to those who cannot afford it.
Summing it up: Great advancemnts in meds and treartment cast big bucks. Not everyone can afford it. We all have to become clear about the fact some people die earlier because they don't have the money to pay. Trying to deny this fact by overstuffing the hospitals isn't going to help--there will still be people who can't pay. The "problem" (if you want to call it that) is from bottle-rocket-like medical technology advancements that have raced ahead of our society's ability to deliver. Of all the problems we could have, certainly this is one of the more pleasant ones.
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Nov 21 '01
12:09 pm PST
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LowPaidNurse (Reply to this comment)
by Lowpaidnurse
You said it like it is! God Bless You!
In addition, I would also like to add that because the medical profession has become a "business," hospital administration (CEO's, CNO's) on down, patronize the Physicians in order to keep their patients flowing thru the doors.
Many times in recent years I have witnessed terrible verbal abuse by Physicians to some poor nurse trying to do his/her best with the time allotted. The worst part of this is, the nurse has little or no recourse. The bottom line here is the almighty dollar wins again, for the Physicians and their patients keep the hospital doors open. How sad. :(
With the introduction of Managed Care and more changes to come, it is little wonder that there is a shortage of nurses, and I foresee an even greater shortage in the years ahead.
Numerous very caring and wonderful nurse friends of mine have already left the field, (or have the intention to do so), in order to pursue a less stressful and more respected career.
On a positive note, I would say it is high time for all nurses everywhere to ban together, (something we have never done), put their ego's aside, and fight to keep the profession what it can and should be.
After 32 years of ER, GI, Home Health, and Wound Care Nursing, I have chosen to board dogs at my home. The pay is more, the stress is much less, and the rewards are even greater! Can you blame me?
In closing I will say it was a pleasure reading your article. Keep up the good work!
We need people like you!
The Irish Sitter
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Jan 09 '01
9:30 am PST
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Re: RN (Reply to this comment)
by SurgRN911
Well, it has gotten to epidemic levels. You as all nurses MUST regardless of the working conditions REMEMBER...the patient comes first, and continue to give good quality care. Bottom line if it takes you four hours to do 2 hours worth of work take that time...
Thanks for commenting. Hang in there.
Di
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Nov 16 '00
4:26 am PST
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RN (Reply to this comment)
by pensiveRN
i have only been in the nursing profession for eight months. i graduated from an BSN program that i felt did not prepare me for the realities of nursing. i have been trained as a med-surg telemetry staff nurse at a mid size hospitial. i read a opinion that stated in esence that todays nurse is faced with longer hours, increased patient load who the majority require assistance with basic ADLs, complex technology all with constant harrassment to do more with less by the management who are only concerned with the almighty dollar. i have seen all this to be true am i have only been in the field for eight months or so. It feels at times like i am tossing meds at my patients and hoping that by the end of my shift that no one is worse for the wear simply from lack of time. i honestly feel as if sometime my patients are suffering from lack of care because i am simple unable to do the basics like effective staffing. i did not realize how much nursing has changed until my mother in law made a statement about how she always in the past looked foreward to being hosptialzed for tests. she said that she always rested. imagine a patient who is in for minore test and rest for a week!!
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Nov 15 '00
9:43 am PST
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Re: Excellent, Surg! (Reply to this comment)
by SurgRN911
Well thank God for many of us people are still mote important, than the dollar.
Thanks for your comment.
Di
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Nov 10 '00
1:58 am PST
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Excellent, Surg! (Reply to this comment)
by kanike2000
You said it extremely well. I see it in the nurses at our nursing home, too. Especially in the face of my friend, the Director of Nurses. She's there 10 or more hours a day, has stacks of paperwork to take home after hours, fights battles with insurance companies who want to discharge patients before they should be, and has to deal with staffing problems endlessly----meaning if someone calls off and they can't find a replacement, she does it herself. A dedicated nurse is worth her weight in gold. Sometimes I don't know what keeps you all going except that you CARE. kanike
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Nov 09 '00
9:08 pm PST
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Re: You Are Preaching To The Choir Here! (Reply to this comment)
by SurgRN911
Casey, thanks and by your profession I know you know exactly what I mean? Thanks for the comment......Here's hoping for better days.
Di
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Nov 09 '00
5:59 pm PST
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You Are Preaching To The Choir Here! (Reply to this comment)
by kcfoxy
But it is a wonderful sermon anyway! Thanks very much for telling it like it is...and isn't.
Casey Stewart
Triage RN
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Nov 09 '00
5:46 pm PST
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Re: There isn't a nurse I know that doesn't feel like this! (Reply to this comment)
by SurgRN911
Thanks for your lovely comment. I think for the most part nurses do still care, it is sad what "business" has done to the medical field.
Di
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Nov 09 '00
1:50 pm PST
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There isn't a nurse I know that doesn't feel like this! (Reply to this comment)
by Mrsfitts
What a great tribute to an honorable profession. The nurses are usually the first and last people a patient sees in the hospital. And they are all -without exception- way overworked. Too many demands on their time put on by the money grabbers.
Thank you for letting people know about the abuses in our medical system -THE NURSES ARE TRYING TO DO THEIR BEST DESPITE THE RESTRICTIONS PUT ON THEM!
Mrsfitts
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Nov 09 '00
8:51 am PST
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Re: I think nursing.... (Reply to this comment)
by SurgRN911
Thank you I try all any of us can do. Thank you for the kind comments.
Di
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Nov 07 '00
5:01 pm PST
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I think nursing.... (Reply to this comment)
by miridunn
like only a FEW other occupations (religious/ teaching) is a CALLING --- not just a professional. I bet you are WONDERFUL at your calling!
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Nov 07 '00
2:38 pm PST
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