I came across this website while just doing a little browsing for any new insights into the nursing shortage–you know, hoping to find an article about how a facility has discontinued canceling nursing shifts when patient census is down, or how they are stocking their place with state of the art technology that will make the lives of nurses easier, or have adopted realistic nurse-patient ratios –you know, stuff that will help keep nurses on the job.

Instead, I found this odd website devoted to the nursing shortage. The title of the website is “Nursing Shortage” and then it has a nice little set of buttons down the side which are supposed to tell you all that you ever wanted to know about the nurse scarcity gripping the nation.

There is no mention of who owns this site, who runs it, or anything–just a half-baked generic email address. And if you actually click on the buttons and read the content…well, with each click, it looks suspiciously more and more like PR double talk.

“Reasons behind the nursing shortage” makes no mention of burn-out or experienced nurses leaving the profession. It only gives the usual, tired, let’s get out the violins excuse of how schools can’t mass produce enough little nurses on the assembly line. And yes, it also squeezes in about the boomers getting old, decrepit, and sickly, and how they will need nurses to change their catheters and bedpans…

And yet, the usual schtick about nurses retiring…

Are we in Kansas yet?

The other sections are no more enlightening. This is from their section on “addressing the shortage:”

When the factors behind the nursing shortage are thoroughly analyzed, it becomes apparent that in order to begin to fix the problem, one of the factors in this cycle needs to be stopped. The cycle is such that there are fewer nurses because many older nurses are retiring. However, there are fewer nursing graduates entering the field because of a lack of funding to nursing schools and programs. How can these younger nurses be expected to enter the field if their educational needs cannot be met? The most important way in which the nursing shortage can be addressed is through this avenue. In order for the shortage to begin to be alleviated, the lack of funding and space in these nursing programs needs to be evaluated. Because of these constraining factors, not enough applicants can be accepted and therefore graduate ready to enter the field –and the shortage continues to grow.

The rest of the section is just as silly. Nothing about improving working conditions, retention of nurses, and so on. The section called “World of Nursing” does mention burn-out, but its entire focus is on long hours–12 hours shifts which many nurses actually prefer working–and on unsafe patient loads. But the way they put it:

Nursing shortages and turnover rates have been reported to be the highest in critical care facilities, in which nurses are worked for long hours and have to care for more patients then they feel they can safely care for.

Uh, what about other areas of the hospital? Unsafe patient loads are not mentioned, like the med/surg nurse assigned 10 patients–6 with IV meds, 4 who can’t get out of bed, 5 with colostomies, 3 with NG tubes, 2 on oxygen…you get the idea.

They also make no mention of mandatory overtime, which is one of the reasons why nurses are working such long hours. Or of the general disrespect that nurses get on the job, or verbal/physical abuse, or hospital PR weenies screaming that the “customer is always right” even if the patient slugs the nurse in the face….and so on.

It’s hard to figure out who put together this brilliant little piece of information. There’s a lot in it about agency nursing and travel nursing, so I’m assuming that a temp agency put it together. If anyone thinks that putting out nonsense like this is “helping” the nursing shortage, they are sadly mistaken. It merely just helps to fuel the myth that hospitals are desperate and willing to do anything to hire and keep their nurses, that workplace abuse just doesn’t exist, and that the primary reason for the shortage is a lack of new nurses.

This is like, getting so old…

This was a record breaker–1067 spams waiting for me. I didn’t check for a day or two, but still, this is ridiculous. I’m hoping that when I upgrade to a newer version of Wordpress, the spam filter will be a little more effective.

I didn’t even stop to read any of the more choice tidbits. Some of them are funny, to say the least. But I won’t miss them when I’m finally able to lock the door to unwanted junk mail.

I’m hoping that sooner rather than later, this website is going to get into shape. Wordpress, the software that this blog runs on, has issued a number of updates, and that is what I’m doing now. After that, then I’m going to change the format and divide up the sections more clearly. I’ve mentioned this before, but since the blog hasn’t changed much, I just wanted to say that the “grand” makeover has not been forgotten.

I’m in Southern California at the moment, and fortunately the heatwave has broken. In fact, today bordered on cool. It was warm in the sun, but the breeze was cool, and it really chilled down as the sun set.

And here I thought I was up on everything to do with nursing. Apparently, there is a movement to create an Office of the National Nurse–and have it be on the same par as the Surgeon General. According to the supporters, this is what the Office of National Nurse would be/would do:

* Elevate the Chief Nurse Officer (CNO) of the US Public Health Service to full time status within the Office of the Surgeon General to become the National Nurse to enhance prevention efforts in all communities.
* Complement the work of the US Surgeon General.
* Promote involvement in the Medical Reserve Corps to improve the health and safety of the community.
* Incorporate proven evidence-based public health education when delivering prevention.

HR 4903 was introduced into the 109th Congress, to make this a reality.

Laura Stokowski MSN, RN testified before the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020, on the behalf of creating the Office of the National Nurse. She closed her statement with this:

We believe that creating an Office of the National Nurse is a way to bring attention to nursing, to instill pride and to recruit new nurses. But most importantly, it is a way to achieve better health for the citizens of this country by effectively utilizing nurses to improve health outcomes.”

I really haven’t thought too much about this issue, and don’t really have an opinion on it. But realistically, is the ONN really going to make that much of a difference in the health of Americans? That is, is the ONN really going to go to bat and fight the huge agribusinesses that promote junk food, factory farming, and the mass industrial complex that producing food has become? The industrial complex that doesn’t want to hear about the detrimental effects that its products are having not only on health, but on the environment and the degradation of prime farmland?

Is the ONN going to work on exposing the shenanigans that go on behind the scenes, between the FDA and big pharma? Or how the FDA is still working hard to undermine the alternative health community, the availability of supplements, or allowing any sort of health information (notice the word information, not claims to cure diseases) of some of these products?

Is the ONN going to help people get health insurance–for a price they can afford and that provides decent coverage?

Is the ONN going to stop Congress from cutting Medicaid and Medicare payments to practitioners–and this includes advance nurse practitioners as well? Hint–lower payments to clinicians means that fewer and fewer are going to accept patients on Medicaid and Medicare.

Is creating an ONN really going to help nurse recruit? What about nurse retention? Is the ONN really going to do anything about working environments, pay, schedules, abuse, and all the other negatives that nurses in hospitals have to deal with it?

These are issues to think about it, before making sweeping statements about what this position is going to do. Many of the surgeon generals find their hands tied, and do little to nothing by the time their tenure is over. And if a president doesn’t like them, they get the boot.

C. Everett Koop was perhaps the Surgeon General who made the greatest impact, in that he bucked the Reagan administration and attacked the AIDS epidemic head-on. I think Reagan was torn between staying the darling of conservatives and his Hollywood friends dying of AIDS–so closing his eyes and allowing Koop to take the heat was a nice compromise. But aside from Koop, I think most Americans would have a hard time recalling the name of any of the Surgeon Generals, or tying their names with a major inroad in the health of our nation.

Anyway, if you want to read more about the National Nurse:

http://nationalnurse.org/

It seems that our neighbors north of the border are also having a little crisis in healthcare. Canada’s healthcare system is remarkably different from ours, but it seems that they are plagued with the same problems when it comes to staffing shortages. And according to this article from the National Post, it seems that they are taking the same dumb-assed approach to solving a physician shortage (which was artificially created in the first place) that we are taking to solve the nursing shortage here (also artificially created).

The country [Canada] has approximately 15,000 too few doctors, a figure roughly double the total number of students in all years of study at our 17 medical schools combined. At a doctor-patient ratio of just 2.3 per 1,000 population, we are 24th on the list of 28 industrialized countries. Approximately 1.5 million Canadians cannot find a family physician as a result.

No, it isn’t the climate that is causing the shortage in Canada. The problem is multifaceted and complex, just like the nursing shortage here. It was created artificially, and the brilliant idea to solve it is to shorten medical training.

Yep, you heard right. Shave off a year of medical school, from 4 years to 3. And voila, all the issues that caused the shortage in the first place will disappear. Surely, whoever dreamed up this idiocy must have been receiving intel from the same idiot who decided that shortening nursing education in the US was the key to solving the shortage. Some brilliant minds at work no doubt. Just mass produce them puppies, and all troubles will melt like lemon drops.

The writer of this editorial agrees with me, and thinks that the idea is insane. Just like putting a bandaid on a head injury where your brains are oozing out of the skull.

If this scarcity can be alleviated, even in part, by shortening the duration of doctor training, it might be worth a look, provided Canadians can also be reassured the change will not dull the skill of the country’s new doctors. However, it doesn’t go to the twin hearts of the problem: socialized medicine and centralized planning of health care. Graduating more doctors sooner won’t cure the underlying condition. Rather, it is more like treating a wound on the left hand by suturing the right one.

The doctor shortage began in the mid-1980s — not coincidentally, at the same time the last Trudeau government passed the Canada Health Act, which forbade user fees, balanced billing by doctors and private clinics and hospitals. Immediately, doctors began moving to the United States by the hundreds every year. The effects of this exodus were compounded in the early 1990s when provincial health ministers consciously decided to limit enrolments in their medical schools. Doctors, they reasoned, were the enemies of health budgets; limit the number of doctors and there would be fewer tests ordered, fewer hospital beds filled, fewer surgeries performed and lower costs to their department’s budget. (By this thinking, eliminating doctors altogether would really bring provincial cost into line.)

And here I thought that the Canadians had more sense when it came to healthcare. Guess I was wrong.

Yes it’s true, nurses are packing it in and moving on. Moving on from hospitals, that is. As working conditions within hospitals continue to deteriorate, and opportunities outside the hospital continue to proliferate, what do you think the outcome will be? Will nurses remain angels of mercy or martyrs, or will they get out of Dodge while they’re still in one piece?

From Modern Healthcare:

If hospital administrators think they face a nursing shortage now, they have more than another thing coming.

That’s because the looming problem has many parts to it, experts say. First, there continues to be great demand for Nursing care outside the hospital setting, a need that will persist as the baby boomer generation ages and seeks care at home, in skilled-nursing facilities, and in outpatient clinics. At the same time, the average age of nurses who work outside hospitals is older than the age of those who work in acute-care settings. So as they retire, these other facilities will look to hospitals to replenish their workforce. And data from the National League for Nursing just compound the problem. The league estimates that 3,500 nursing faculty will retire in 2009, with that number growing steadily to 11,500 in 2013 and just under 28,000 in 2023.

“We are not replacing the nurses in retirement as fast as they are aging,” says Mary Jean Schumann, director of nursing practice and policy at the American Nurses Association. “And the ones that we are putting out are not your 19- to 22-year-old nurses; they’re older. It’s a problem that self-perpetuates.”

Peter Buerhaus is the director of the Center for Interdisciplinary Health Workforce Studies at Vanderbilt University Medical Center in Nashville, Tenn. He notes that 73% of registered nurses worked in hospitals and 27% served in other settings in 1983, compared with 60% of nurses who worked in hospitals and 40% who worked in nonacute-care settings in 2006. As the population ages, Buerhaus says, there will continue to be a demand for healthcare services, and many baby boomer patients will be unwilling or uninterested in receiving care within hospitals. In addition, the nursing workforce is also aging, according to Buerhaus….

Of course, this article is the usual regurgitated pablum, in that it ignores the fact that nurses are leaving hospitals because working conditions suck. And no, most are not going to work in long term care or skilled nursing facilities–those places have even worse staffing problems than hospitals. But then, Modern Healthcare isn’t going to say anything negative about hospitals. The reason I quoted this was just for the stats. Compares with 20 years ago, the number of nurses working in hospitals has dropped dramatically. And will continue to drop, and mass producing nurses on the assembly line isn’t going to change that trend.

I’ve been away for a change of pace, covering the American Society of Clinical Oncologists annual meeting. I was frantically busy there, scurrying through a convention center that is larger than some cities, attending sessions and writing up reports. Once home, then I had to continue writing up reports. Now I’m off again to another conference, but by mid-week, I should be back and then be able to get into a normal blogging mode again. Plus, I will be revamping this site, and that is also taking some work behind the scenes.

Oh, and by the way, did you know that there’s a nursing shortage? And did you know that everyone is still spewing out their conjectures as to the cause of it? And as I write, some poor nurse is getting whacked in the face by a patient, and the hospital is telling her to “just forget it” because its bad for PR. And in another hospital, nurses are being told that housekeeping services are being curtailed and that they have to pick up the slack (grab that mop, baby!). And in another facility, the union busters are gloating and patting themselves on the back.

And so it goes. Can’t figure out why anyone wants to leave hospital nursing.