In the aftermath of the tragic earthquake in Haiti, many nurses have responded to calls to volunteer their services. It is commendable that so many thousands of nurses (and doctors and other healthcare workers) are willing to travel to a devastated nation to offer what help they can. On the other hand, many who volunteer on the spur of the moment may need to rethink their plans.

I’ve been reading a few articles about this, and all of the experts agree on one thing–if you want to volunteer, do not do so on your own. Do not get on board a plane and expect that you will be cared for once you hit the ground. This is not the movies or TV. This is real life, and volunteers who arrive without a plan or contacts tend to become part of the problem rather than the solution.

Join a reputable group, such as Medecins san Frontieres (Doctors without Borders), Americares, Partners in Health, etc. National Nurses United is organizing nurses in the U.S. But please, find a group to support you and who will direct you once you arrive.

Next, reevaluate your skills. While all kinds of healthcare workers are needed, right at this moment, the greatest need is for surgeons, surgical nurses, anesthetists, trauma care specialists, post-op nurses–basically, trauma care is the greatest need right now. If you work in psych and have never worked in a surgical setting, now might not be the best time to go. Your skills may be needed later on, after the immediate crisis, but you need to think carefully if you can truly be of help right now.

Third, take a long hard look at the situation. There is nothing romantic about going to a devastated nation, especially one that was already on the edge. Conditions in Haiti were pretty deplorable before the earthquake hit–ravaged by hurricanes and storms over the past few years, civil unrest, abject poverty, poor infrastructure, high rate of infectious disease—well, you get the picture.

Conditions are pretty bad, and as a volunteer, you are not going to be housed at the Ritz Carleton and get catered meals by a fancy French chef. It’s rough going, and you are going to be putting yourself at risk of infection, and injury. In addition, there have been many aftershocks, so the earth has not yet settled down.

Violence and looting have taken hold, so you would also be at risk in that sense.

It will be dirty, with poor to no sanitation. There will be terrible sights to behold–thousands of people with nowhere to go. Injured people unable to get help and living in the streets. Corpses piling up. Unbearable smells.

Many volunteers who do go to war zones and to places where an extreme disaster has occurred experience post traumatic stress syndrome. Yes, it can be as traumatic for the helper as it is for the victim.

Anyway, this is not to discourage anyone from going, but just to go into with your eyes open. The developing world, even in the best of times, can be shocking for Americans who have not done much traveling.

As in the United Arab Emirates. You think we have a nursing shortage here. Well, if it wasn’t for expat nurses, their whole healthcare system would cease to function. It is extremely difficult to get local people to enter nursing.

In an interesting, albeit short, article in Arabian business.com, the nurse-less plight of the part of the world is revealed.

Nursing colleges in the UAE are failing to recruit Emirati nurses, despite government-funded sweeteners including full scholarships, the dean of a prominent nursing school has claimed.

Dr Vijaya Kumaradhas, dean of Ras Al Khaimah College of Nursing, one of the country’s largest nursing schools, has said Emirati students remain significantly under-represented – a fact that is contributing to the country’s nursing shortage.

“There is a definite shortage, but Emiratis will not become nurses. There is a stigma where nursing is concerned. In our college, we don’t have any local student.” she said.

The article doesn’t cite reasons for the lack of interest among Emiratis, but several of those who commented offered their perspective. All of them live or lived in the region, so I imagine that they are speaking from experience. Most agree that it is cultural, and that nursing is not considered a desirable career for a young Emirati woman. And in fact, the attitude is prevalent in many Middle Eastern nations.

There are very few nurses who are natives of the region, and there are many reasons why the profession is shunned. One nurse expat working in the region wrote: It entails touching bodies, much intermingling with males, and for some, would mean that they would leave the profession when married anyway. As long as beliefs remain the same, nothing will change and they will be dependent on expats. They have to buck up and see this for themselves. I’ve worked in the Middle East as a nurse for many years and have yet to see reform on this issue.

Another commenter noted that shift work is unappealing, and goes against local custom; most Emiratis wouldn’t want their daughters/wives to work night shifts. It is against traditional values for the lady to be out of the house at such late hours.

As a profession, nursing is not highly regarded, and parents do not encourage their daughters (and certainly not sons!) to study nursing. Pay is low, hours are poor (sound like a familiar scenario?), and nurses are seen as maids, more or less.

So it doesn’t seem that the Emirates are going to be attracting a lot of their own citizens anytime soon, unless they increase the pay, and really make an effort to change the perception of the job. Attracting men into nursing would also help, since that would reduce the intermingling with males.

Either this nurse isn’t too bright, or she’s intentionally malicious. Hard to say from this short news clip from Associated Press:

The police were looking into possible criminal charges against a nurse at a South Florida hospital where officials say she may have exposed some 1,800 patients to H.I.V. and hepatitis by reusing medical supplies. Officials at Broward General Medical Center in Fort Lauderdale said this week that the hospital discovered that the nurse, Qui Lan, 59, was reusing IV tubing and saline bags during cardiac chemical stress tests.

Now is that too cute or what. Apparently Japanese researchers have created a robot nurse that can lift elderly patients from wheelchairs and beds, and rather than make it look like something out of your local sci-fi channel, they decided on cuteness. It looks like a giant teddy bear.

Riba, short for Robot for Interactive Body Assistance, was developed by the state-run Riken research center. Promoters are calling it the world’s first robot to lift people in its arms.

Here’s a comforting note from the National Institute for Occupational Safety and Health :

Occupational disease research and prevention activities represent a significant portion of the NORA Sectors’ program portfolios. The rate of nonfatal occupational illness across all U.S. private industry decreased from 30.7 per 10,000 in 2003 to 21.8 in 2007. The average rate of nonfatal occupational illnesses in the Manufacturing (NAICS 31–33) sector were 2.4-fold greater than U.S. Private industry averages (65.5/10,000 vs. 26.3/10,000). Two other industry sectors reported rates that exceeded the Private industry 2003–2007 average by 50%; Utilities (NAICS 22) and Health Care and Social Assistance (NAICS 62).

They’ve got a cute little graph that shows you where healthcare falls on the scale of non-fatal occupational illnesses (hint–it’s number #3).

Okay, this is a little advertising for the allnurses.com website. But I thought it was a nice video, and I really do think it is a great nursing website. And to answer the next question, no, I have nothing at all to do with the site. I have gotten some great information from there, keeps me up to date on nursing issues, but I am in no way affiliated with the website.

RN Pathways is an interesting venture. I’ve never really looked at it until right now.

This is their description:

RNpathways is the video channel for www.RNpathways.com, the most unique nursing organization in the United States.

At RNpathways, we are passionate about nursing. We’ve created the premiere online destination for nursing career management. On our site, you’ll find comprehensive information about career paths, education, nursing issues and informative industry news. Our goal is to empower nurses and allied healthcare professionals with information to make the right career decisions.

Several other blogs have also reported in on this story, which is really quite remarkable when you think about it. Most times, bureaucrats never get caught with their pants down.

The Wall Street Journal Health Blog has a short story about this, as does The healthcareblog.

But I haven’t seen any feedback yet from the California Nurses Association. I’m curious about their views on this. Can go either way with them!

Well, not in THAT sense. But Governor Arnold has cleaned house at the California Board of Registered Nursing. I can’t say that I have any sad feelings about it. BORNs exist simply to keep themselves in business, and have been a major obstacle to simplifying and improving licensing–like having one database in the US for all registered nurses and one license.

I have fortunately, had to have little dealings with them. But again, they exist to collect money to pay their salaries, and do as little work as possible. For example, in CA, it cost the same extravagant fee to keep a license active or inactive. Really fair, huh.

They have also been known to tack on extra diddies for people applying for CA licenses. A friend of mine who graduated from an accredited nursing school, had an RN license in good standing, and several years experience, was told that they couldn’t issue her a license because she lacked “sociology 101.” Like not having the basic soc course had interfered with her work thus far, and having to return to school to take this basic class was going to benefit California.

Anyway, here’s what the LA Times has to say:

Gov. Arnold Schwarzenegger replaced most members of the state Board of Registered Nursing on Monday, citing the unacceptable time it takes to discipline nurses accused of egregious misconduct.

He fired three of six sitting board members — including President Susanne Phillips — in two-paragraph letters curtly thanking them for their service. Another member resigned Sunday. Late Monday, the governor’s administration released a list of replacements.

The shake-up came a day after The Times and the nonprofit news organization ProPublica published an investigation finding that it takes the board, which oversees 350,000 licensees, an average of three years and five months to investigate and close complaints against nurses.

During that time, nurses accused of wrongdoing are free to practice — often with spotless records — and move from hospital to hospital. Potential employers are unaware of the risks, and patients have been harmed as a result.

Three and a half years to investigate a complaint? Pray tell, what the hell are they doing all day? There are not all that many complaints, and they have little else to do–in fact, their main reason for being is to investigate complaints and discipline wayward nurses.

Good for you Arnold. Maybe a shake-up might get them off their butts and make the CA BORN a viable institution.

Sounds like some sort of expose. Either that or a made for TV movie.

But that apparently is the new incarnation of the Nurse Advocacy Center, which I blogged about the other day. The Center which closed its door amidst “a great legal crisis,” give or take.

Sandy Summers has now simply reopened the Center under a different name, the Truth About Nursing, but all else appears to be identical. It is run by Sandy and her husband, as was the Advocacy Center, with a small board of directors. I’m assuming that there’s some crossover–that some of the board members have made the switch. I really didn’t have time to check and compare names.

The layout of the website is identical, even down to the color scheme. Much of the archived material, such as movie reviews and profiles of famous nurses, has simply been moved over to the new site.

So for those nurses who mourned the loss of the Advocacy Center, never fear, it is back. Just with a different name.

Since the center is essentially back online, it really makes the explanation given on the old website all the more puzzling. But you know, in the grand scheme of things, it really doesn’t matter.

The Nurse Advocacy Center has a notice on its website that “The Board of Directors of the Center for Nursing Advocacy has decided to close the Center in the near future.” If you click on the link, it gives you a little bit more information about the decision.

The Board of Directors of the Center voted in December 2008 to close the Center. We have posted this information on our Web site. This decision was made after careful consideration of the mission and values of the Center and the ability of the Center to achieve them under its existing operating structure.

It is important for you to know that this decision was a difficult one and was the result of thoughtful deliberation on the part of every Board member. The Center’s records were in disarray, the Center’s taxes had not been paid for years, serious matters had been hidden from the Board of Directors, and the Center was in legal crisis. Indeed, after considering all the options, we felt that we were legally required to dissolve the Center as a corporation.

This is a very strange note to say the least. The Nurse Advocacy Center is a small organization that was started several years ago to serve as a “media watchdog.” Their goal was to try to having nursing shown in a more realistic and positive light in the mass media. While I think their mission was worthwhile, their execution of it was frequently overdone and they didn’t seem to know how to pick their battles.

At any rate, the reasons given here are quite bizarre, considering the size and nature of the organization. Basically, it was run by Sandy Summers and her husband, with a small board of directors. But the language used here is quite provocative–records in disarray, taxes not paid for years, legal crisis, secrets kept from the board. It’s not like this was a huge multinational non-profit, where millions in donations and grants were passing through, and an army of workers was needed to keep track of the paperwork.

However, a short article in the American Journal of Nursing may shed more light on it.

Founder Sandy Summers told AJN by e-mail, “I believe this was the result of my differences with a small faction of the board whose concerns were misplaced or fairly minor, since our records were in order and nonprofit charities like the Center don’t generally pay taxes (I regret that we owed $17 in sales tax).”

It sounds like there may have been some disagreements between Sandy and her board members, and perhaps a little more heated and volatile than she lets on. At any rate, the doors to the Advocacy Center are padlocked, although the website is still up and running.

It’s nice that there is a new TV show out with a nurse in the lead role, but why oh why do they have to pull same old, worn out and tire, dog and pony show? The average medical show (ER, House), has doctors performing deeds that are completely alien to real life. And now, here comes Hawthorne in their footsteps.

Please, a Cheif Nursing Officer (CNO) who steps in and does patient care? A CNO who even leaves her office? A CNO is an administrator, not a clinician. An executive who does not mingle with patients or staff, but instead, attends meetings and does paperwork. Maybe the CNO might put on a pair of scrubs if she worked in a 20 bed rural hospital, but not in a large urban facility. That the CNO is “fighting” for her nurses against the evil establishment is ridiculous, because she is the establishment. Or that she even knows who the nurses are working at the hospital. Even her strutting around in a white coat is ludicrous—CNOs are executives. They wear business suits, no white coats.

Plus, how difficult is it to come up with a script that doesn’t look like it was written by Mickey Mouse. Would a nurse in 2009 really give a med that he/she knew to be detrimental? No, of course not. If the doctor remained firm, the nurse would take it up with the nurse manager of the unit or supervisor, and hold the dose.

And of course, the primary problem that Hawthorne has to contend with is physicians being mean to nurses. Cruelty to nurses, the ongoing war between the money-hungry and callous MD and the saintly self-sacrificing RN. Yawn….

The show is just a jumble of the worn out and worst of Hollywood cliches of the hospital environment, only now we have nurse Hawthorne instead of Marcus Welby. We have the disgruntled male nurse who would rather be a physician, the newbie who cries because a doctor yells at her (and Hawthorne of course is by her side to wipe the tears), the sexy bimbo nurse (didn’t they disappear circa 1950?), the mean incompetent physicians (all of them on the show), nurses who speak in baby talk and giggle over the cute paramedic…need I do on?

Why not do something innovative, like have the main character as an “ordinary” nurse who is fighting for better working conditions, trying to get the nursing staff to unionize, showing how the hospital deals with uninsured, etc. Or even make her the manager of a single unit, where she would realistically be involved with nurses and could have easier contact with patients.

But no, in all their wisdom, Hollywood chose to give us…it’s a bird, it’s a plane, it’s SUPERNURSE! Making her Chief Nursing Officer means that Ms. Hawthorne can now be responsible for saving the entire hospital, as she appears to be the only one who is competent. And who is always right, and never loses her saintly affect.

Hawthorne’s CNO can do everything and anything, from rushing into the NICU to start an IV, because as we know, the regular nurses working there are just too dumb to perform such a “complicated” procedure, to having time for heart to heart talks with patients and even kissing one on the cheek, to making rounds on the hospital units, sitting in on report…and yet, somehow having time to do her job as CNO.

Here’s a hint for the uninitiated. In a large hospital, most if not all nurses have no idea who the CNO is. They wouldn’t know her by sight, name, and probably don’t even know she exists. Ditto for most doctors. The CNO generally got there because she sticks by rules, doesn’t make waves, and is firmly committed to the status quo. She’s not the renegade who’s out there fighting for truth, justice, and revolution.

I hope this silly show dies a quiet death, before making nurses look even more ridiculous. Or before spreading even more myths and legends about life in the hospital.

Very good review from St. Murse, which outlines the glaring idiocy of this new show.

I haven’t watched the show and don’t intend to (I don’t have Showtime and am not interested enough in the program to try to get it from itunes), but the reviews are slowly coming in. For nurses, what do you think? Do you like it? Find it offensive? See Nurse Jackie as the anti-nurse, the nightmare nurse, doing things you’ve thought about but could never get away with, acting out the frustrations that many nurses feel, or think that she’s just a caricature of the worst possible traits put together?

The AJN has a comment about the show.

Apparently, some nurses were arrested at a Senate Finance Committee meeting on health care reform because they protested the meeting’s lack of representation for those who support a single-payer health care system.

I doubt that they got violent, but maybe they were disruptive enough to end up in the paddy wagon. Or perhaps the arrest was deliberate, in order to bring attention to the single-payer issue, which has been pretty much ignored in the hubris over healthcare reform.

Again, I think that single payer is not as cut and dry as some make it out to be, and certainly, a lot of issues would have to be addressed in order to make that a reality. But I think that single payer advocates should at the very least, be given a seat at the table along with everyone else, and that option should be discussed.

The AJN has a short report on the great nurse arrest of 2009.

Today was the big day, Florence Nightingale’s birthday. And the Daily News in New York has to remind us just how little nursing has advanced. Oh, I’m sure that they meant well, but the headline of the article says it all:

Happy International Nurses Day: Meet New York’s angels of medical mercy

I’m really surprised that no one from the politically correct squad commented on my views about putting 19th caps on 21st century nursing heads.  Nothing about how it will benefit the patient if their nurses resembles Florence Nightingale, or how the cap closely resembles those worn by maids and afterall, that is how nurses should see themselves–selflessly serving the patient.

And really, to tear apart such a heroic effort at improving nursing during National Nurses Week. Well, glad the nurse police aren’t out and about, or at least, maybe attending to real matters, like workplace abuse.

Cam anything be sadder than this story? After nurses have tried heroically to update the profession, to be treated with respect and to maybe look like they belong to the 21st century, a hospital in England is bringing back “Nightingale style caps.” I feel like I’m going to throw up.

The reasoning? Patients like them. Um, I think patients would be happier if you forgot the caps and instead, paid your nurses better, treated them better, so you might be able to attract more people to the profession and thus have decent staffing. Which translates into better care.

Now isn’t that cap cute? Wouldn’t you love to be taken care of by a nurse who looks like she just stepped out of the 19th century with a doily on her head? Doesn’t that just reek of professionalism?

From the Telegraph:

The nurses’ cap has made a come back at Broomfield Hospital in Chelmsford, Essex, to help patients and visitors distinguish between nurses and therapists.

Nurses on Stock Ward are wearing the distinctive white hats for a three-month trial to gauge patients’ reactions before it is decided whether to roll them out across the hospital.

The caps were originally introduced to keep the nurse’s hair neatly in place and it was used by Florence Nightingale in the 1820s.

Not only is the cap a ludicrous idea, but it would certainly help if the journalist who penned this took 3 seconds to look up Florence Nightingale on the Internet.  There is no name on the article, and understandably so. Sorry to shove this into your face, but Nightingale didn’t wear this cap in the 1820s. She was first born in 1820, so maybe she wore some kind of baby cap as an infant and toddler. Her nursing school wasn’t established until 1861.

Now, rather than ask any of the nurses what they think of the caps, or tell the readers if indeed, the nurses are actually going along with this charade, this brilliant journalist just stuffs the story with silly quotes and more inaccuracies over the history of caps. But this quote is priceless.

Mrs Wilson continued: “The nurses with the armed forces still wear hats and look exceedingly smart and professional.

“I have decided that there was a possibility that nurses wearing hats would remind patients of the value and professionalism that nurses bring to their care.”The Mrs. Wilson is this quote is Gwyneth Wilson, director of nursing at Mid Essex Hospitals Trust.

Now, perhaps Mrs. Wilson has not realized that hats are part of all military uniforms, that they match the military uniforms, and are not simply something that a military nurse sticks on her head. The reason that military nurses wear hats is because it is standard part of a military uniform. Notice, military nurses are not being asked to wear 19th century bonnets.

And that last quote–that’s one of the reasons for the sorry state of nursing. Mrs. Wilson thinks that wearing caps is going to remind patients of how valuable and professional nurses are. Maybe she should also dress them in floor length skirts and aprons, so that they can look just like Florence.

If Mrs. Wilson wants professionalism, perhaps she might fight to get nurses paid as professionals and for them to be treated respectfully. And as director of the trust, to improve working conditions, so that they can provide care for their patients. And the journalist who wrote this ridiculous article should have asked her these very questions.

What a combination.

Journalism at its worst, and a nursing director who is infatuated with 19th century head gear.

Hey Barack, pay attention. Nurses can help with healthcare reform in a lot of ways. Tell the doctors not to get their knickers in a twist, we’re not trying to compete with them, but nurse practitioners may well be the people who dare to go “where no doctor has been before.” I’m not talking about outer space, but into rural areas, inner cities, etc, the places that are suffering the most from shortages of primary care clinicians.

Anyway, if you’re interested, tune in on May 8 to the news conference. Details below:

Whether Dealing with Pandemic or Acute Shortage of Physicians, Nurse-Managed Health Centers Seen As A Key Solution to Health Care Crisis

WASHINGTON, D.C. May 8, 2009–Health care reform is going to mean that nurse practitioners will play a more front-and-center role in treating patients, especially the more than 46 million Americans who currently lack health care insurance and are underserved by today’s health care system. Whether treating patients with the H1N1 swine flu virus or other illnesses, nurse-managed health centers – an innovative delivery model for primary and preventive care, especially for low-income and vulnerable populations – should expand significantly to increase the capacity of the nation’s over-strained health care delivery system.

That will be the message of speakers at the phone-based news conference to be held Friday (May 8, 2009) at 10:30 a.m. EDT by the American Academy of Nursing (AAN) and its “Raise the Voice” (RTV) campaign.

Involving more than 1,500 professionals and organizations, the nationwide RTV campaign is designed to harness the power of nurses, nurse practitioners and other professionals to provide needed primary health care, health promotion and disease prevention through “disruptive solutions” such as community-based care. That is, care delivered by advanced nurse practitioners and related professionals in a holistic, patient-centered way. The goal of a national network of 200 Nurse-Managed Health Centers (NMHCs) nationwide, many of them associated with schools of nursing, is consistent with the call from President Obama to double the number of community health care centers. The American Academy of Nursing’s “Raise the Voice” campaign receives support from the Robert Wood Johnson Foundation; the news conference is supported in part by the Independence Foundation.

News event speakers will be:

* University of Miami President Donna E. Shalala, former Secretary of the U.S. Department of Health and Human Services (HHS) and Chair of the Advisory Committee of the “Raise the Voice” campaign of the American Academy of Nursing;

* Pennsylvania Governor Edward G. Rendell;

* National Nursing Centers Consortium Executive Director Tine Hansen-Turton; and

* Independence Foundation President Susan E. Sherman.

TO PARTICIPATE: You can join this live, phone-based news conference (with full, two-way Q&A) at 10:30 a.m. ET on May 8, 2009 by dialing 1 (800) 860-2442. Ask for the “nurses/health care reform” news event. Copies of speaker slides are available on http://www.aannet.org.

CAN’T PARTICIPATE?: A streaming audio recording of the news event will be available on the Web as of 3 p.m. EDT on May 8, 2009 at http://wwww.aannet.org.

CONTACT: Robin Strongin, (202) 263-2917 or rstrongin@amplifypublicaffairs.net.

Many nurses served in Vietnam, and it is important to note that Vietnam was the first war in which MEN were allowed to nurse. Ironic, isn’t it, to think of how reverse discrimination resulted in hundreds of male nurses (I’m assuming hundreds rather than thousands, since not that many men were nurses during WWII and Korea) could not work as nurses. Even though the need was dire for trained healers, and even though there was an abundant supply of men who could serve as soldiers, male nurses were not permitted to work as such until Vietnam. Talk about stupidity and idiocy.

In fact, there was an episode on the popular TV show MASH, where the subject came up. It wasn’t the main storyline, but there was a male soldier who said he was a nurse, but couldn’t work as one in the army. The military instead, forced him to pick up a gun and learn to kill, rather than allowing him to be at the bedside of the injured and sick, and save lives.

So this little background scenario brings me to the subject at hand. The American Journal of Nursing has a nice story in this month’s issue about Vietnam Women’s Memorial. It’s been a long time in coming, but is finally here.

According to the Vietnam Women’s Memorial Foundation (www.vietnamwomensmemorial.org), more than 265,000 women-almost 90% of them nurses-volunteered for service in the U.S. military during the Vietnam War era. About 11,000 of these women were stationed in Vietnam. The average army nurse serving in Vietnam was under the age of 24, and 65% had less than two years of nursing experience. They found that their own fear of being in a war zone was quickly replaced by the need and desire to care for others.

Kettlewell, like many nurses who served in Vietnam, faced overwhelming trauma and danger and witnessed a great deal of death. Most nurses were young and inexperienced-unprepared for seemingly endless pain and tragedy. And unknown numbers returned with PTSD and painful memories of caregiving situations. This past year, the 15-year anniversary of the Vietnam Women’s Memorial recognized the heroism and sacrifices of these women with a candlelight ceremony, storytelling, a reading of the names of those who died in Vietnam, and other events.

If you go to the article, you can also click on icons for images and podcasts. Nice story, AJN!

Apparently, in spite of all the dire reports of a sudden drying up of nursing  jobs in choice spots like NY, Boston and San Francisco, Texas apparently needs nurses. Of course, this can be due to the fact that nurses are not well paid, well treated, non-unionized, etc. I don’t know. There are several very prestigious medical centers throughout Texas, so perhaps the prestige doesn’t spill over to either attracting or keeping nurses on the job.

But at any rate, the shortage is alive and well according to the Houston Chronicle:

Texas nursing’s in a fine fix. The statewide shortage of nurses moved beyond industry standards for “critical” several years ago, says veteran University of Texas School of Nursing Dean Patricia Starck . These days, it’s acute. In her 25 years in nursing education, Starck says she’s never seen anything like today’s situation. Job openings are going begging because we don’t have enough nursing educators. That is mostly because the high salaries offered to nurses in the workplace are luring away those who might otherwise opt to teach. To their credit, hospital administrators here are allowing nurses to take time away from the job with pay to fill teaching slots and ease the shortage.