June 18, 2012

Nursing Shortages – Oh Really?

Nursing shortage seems like another myth. In some areas of the USA, this is true. In other areas, there is an honest shortage, but it may not last long. What are some of the factors affecting the field of nursing? There are some obvious answers and some almost obscure answers.

Two of the most telling answers are one; older nurses are not retiring because of the economy and may well have a spouse without a job. The second and more frightening answer is hospitals are just not replacing nurses as they leave. Why you might ask? The reduction in profits is largely to blame and increases in hospital administrator salaries are adding to this pressure.

Although many hospitals have positions for nurse aids, more hospitals are adding them in place of nurses. This will increase the workload for remaining nurses, but the hospitals are striving to keep profits increasing. How are the hospitals determining this? They have people patrolling the floors of the hospitals, counting patients, watching nurse activities and other variables. These people report to the administration about their observations.

This may sound cruel, but many nurses have brought this on themselves by their actions or maybe I should say lack of doing their duties. I have been in a few hospitals and actually seen this and wondered how the hospital could make money with the nurses sitting around the nursing station. In one visit to a friend, the five hours I was there they sat and never made rounds. Call buzzers would go off and still they did not move. They would send an aid to check and only leave the nurse's station if it was something urgent. The patient I was visiting needed a shot every four hours, but while I was visiting, no shots were given.

Even a trip to the nurse station did not get a shot. In this case, I called the doctor and explained what had happened. The doctor said he would be there in a few minutes and he was. He came in an entrance away from the nurse's station and came directly to the room. He checked the chart and asked how long I had been there. Next, he headed to the dispensary to get the medication for the shot and the syringe. He asked why his patient had not been given a shot on time. The answer was it was not listed on the patient file. He came to the room, gave the shot, and then went back to the station with the patients chart in his hand.

I don't know more as visiting hours were over and the nurses were checking every room and making sure all visitors were leaving. The whole time I had been there, no rounds had been made by the nurses, but the aids had come and gone rather regularly. From what I observed, the five nurses had a gab fest the whole time and I don't think four had gone anywhere except to use the ladies' room and one to the cafeteria to bring back food for all.

In another hospital, I knew there were very few patients on that level, but the nurses were constantly checking rooms and I very seldom heard a call bell (or buzzer) sounding. About every 15 to 20 minutes, a nurse would be in to check on my wife, checking pulse and blood pressure and moistening her lips with water on a cloth. When shift time came, one of the day nurses stayed and two others reported in plus a couple of aids. Even they were making rounds and checking on the few patients. A very clear contrast when compared to my visit to a friend.

From the second article, this seems to be the case I have described above and varies from hospital to hospital. Some nurses are extremely busy and at some hospitals, it is difficult to see nurses at work. Even patients are complaining at these hospitals. Although this is seldom talked about, hospitals that have strong unions are where the most complaints originate. Others say it depends on the strength of the director of nursing. And, it may be a combination of these.

Either way there are several scenarios that may play out in the next few years. I disagree with the scenarios discussed in this blog, but he may be right as he is an insider and I am a patient. I suspect there will not be an oversupply of nurses because many will leave for employment that is more lucrative. Hospitals will work diligently to reduce the nursing staff and replace many with nurse aids to reduce labor costs and at the same time bring in pharmacists to administer medications and manage inhouse pharmacies. Unions will be either forced out or greatly weakened all as a means of increasing profits.

No comments: