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.

You just gotta love healthcare. I thought I’d seen and heard almost everything, but this really racks up as one of the best moments in the annals of moronic managers and dim-witted organizations

A managed at the Dean Health System in Madison, WI, laid off a nurse who was in the middle of a surgical procedure.Yes, she was in the middle of surgery and a manager pulled her out of the procedure and told her to pack up her stuff. Did you ever?

From the LaCrosse Tribune:

The abrupt removal, which spokesman Paul Pitas said posed no danger to the patient, came after the Madison-based health-care provider announced Wednesday it planned to “immediately” lay off 90 employees.
Pitas, director of corporate communications, labeled the action “clearly … an error in judgment on the part of the manager conducting the layoff.” He declined to name the manager but described her as “an otherwise good employe with more than 30 years of nursing experience who made a regrettable decision.”

“This person is very upset and is extremely remorseful over this,” Pitas said, adding that the layoffs created “extraordinary circumstances.”

Yeah, I’m sure that the person is “extremely remorseful” over the incident. What about using basic common sense in the first place? Would someone with 30 years of nursing experience go and pull a nurse out of surgery to lay her off? And even if her boss told her to do it, she should have stood her ground–another hour or so is not going to make or break the hospital.

If the manager took it upon herself (or himself) to interpret immediately as meaning to pull people away from doing essential jobs, then this person should have been booted out the door. Really, would she/he pull a nurse away from starting an IV, or who was changing a dressing, or helping a patient get out of bed? Just drop the patient and get out.

Of course, what makes it worse is the equally dim-witted sound-bytes from the spin doctors about this.

Pitas said Dean plans to pursue the matter, but he declined to say what the possible outcomes could be.

“Dean will continue to reiterate to its staff the importance of following all patient-care policies,” he said. “Out of respect for the (manager), we cannot discuss specifics. However, we can tell you we are looking into this and appropriate action will be taken.”

That’s reassuring, isn’t it. That comment sounds like it came from Sarah Palin–incoherent and pointless. And the bottom line is that they will do nothing. Just shrug and pat their pet manager on the head for good behavior. Because you know, a manager who does something this dumb must have been doing equally dumb things all along. This type of stupidity just doesn’t spring up out of nowhere.

A nursing student was expelled for posting evil things on MySpace.  My first reaction was that the school was being really anal and trying to relive the myth of nursing students being angels-of-mercy-in-training. You know, they don’t do bad things like MySpace or post about subjects that might indicate a lack of celibacy.

But it seems that this nursing student is missing several screws. She posted about her patients on MySpace, apparently under her real name, and named her school. She can blog all she wants, but she is violating patient privacy even without specifically naming the patient. It can be easy to trace it back to who she is referring to. And I have to say, if she is being this dumb now, what is she going to do once she becomes a nurse? Blog about her employer, give the name of the hospital and discuss the patients she takes care of (let’s hear all about Mr. G’s incontinence).

This has nothingto do with freedom of speech but with patient privacy issues. If she blogged, for instance, about her patients but didn’t name the school she goes to and disguised the incidents and didn’t mention where they took place, then that would be one thing. Or if she blogged under a pseudonym, as a lot of nurses do. But this is different, sorry to say.

This is just an addendum to my posting the other day about the perils of the breast pump. Well, I should say the tie in to the NY Times article about the breast pump. But I found one of the comments rather provacative, and really, it says it all.  The breast feeding wars–like what is that about?  How truly inane are we becoming?

A lot of ideological wars going on around birthing and motherhood give me as much a feeling of freedom as being told to wear a burka. Exclusive breast-feeding for a year or more is one of them. The women who insist that we cannot be good mothers if we do not follow this edict are as repressive as the men who said women should not be in a boardroom or in combat positions.

I couldn’t have said it better. There is so much more to raising a happy, healthy, well-adjusted child who will hopefully become a productive and law abiding member of society than the amount of time you breastfeed, if you breastfeed exclusively for one year, or if you breastfeed at all.

Nurses should definitely try to guide new moms in their decision making, but it is not the nurse’s place to attempt to force an opinion, or try to make a new mom feel guilty or like she’s failing her baby if she doesn’t breast feed (yes, I’ve seen some of those). There’s more to it than just a breast and a baby.

There was an interesting article that was just published in New York Magazine about Cara Mulhaln, the midwife to end all midwives. In a nutshell, she does homebirths and home birth only, and judging from this article, seems a little on the fanatic side. To the point of being dangerous.

Again, I know nothing about this woman, other than the article, but several readers posted personal experiences with this woman–some good and some bad–very bad. And even in the article, the author describes a case where the woman was in labor for 72 hours, was not progressing, but Mulhaln thought that was okay.  She told the couple that the body knows what its doing, or some nonsense like that. But this woman was not dilating, and her water broke, making her vulnerable to an infection. The couple intelligently decided to go to the hospital, where Mom soon spiked a high fever (indicating an infection). She ultimately had a section and baby ended up in the NICU. And Mulhaln still didn’t think she did anything wrong.

“How do you feel about having a C-section?” Muhlhahn asked the couple at a follow-up appointment to discuss what had happened. It was the first they’d spoken to her since she’d dropped them off at the hospital. Garcia felt the question was barbed with the implication that if she’d only had more patience—tried harder—she could have had a vaginal birth. “I had a plan the whole time,” Muhlhahn told them, “and you just didn’t trust me.”

Is this woman playing with a full deck or what? Didn’t trust her? And she had a “plan” the whole time? What, to wait until Mom and baby had overwhelming sepsis?

The scary thing about Mulhaln is that she doesn’t seem to have a back-up. Midwives delivering at home will generally have a physician as back up in case something goes wrong, or have an agreement with a hospital. Something, anything. But Mulhaln has nothing. She doesn’t have a signed practice agreement with a physician, which she is required by NY State law to have (where she practices). She also doesn’t carry malpractice insurance.  And judging from these stories, she also delivers high risk pregnancies at home, and doesn’t seem to have good judgment when to quit and get help. I wonder what kind of equipment she has with her–does she have sufficient tools to resusciate a baby? Does she know what she’s doing?

I have nothing against home births, but the midwife delivering should have a back-up, should always err on the side of caution, and should be adept at handling an emergency.

What do you all think of home births?

Not my words.  It’s the headline of a news story, and we know how that often goes.

This headline appears jumbled together with news stories about how dire the nursing shortage is, another about how there are less jobs for nurses at Massachusetts General Hospital but still 400 available (the spokesperson didn’t specify if they would hire new grads or why there are so many jobs open considering the trouble that Boston area nurses are having in finding a job), and some of the usual press release-ish stories about shortages of nursing teachers and if only we can just mass produce nurses everything will be peachy and sweet in healthcare.

Now, the article at hand. This one is a mix and match of quotes and stats, but doesn’t seem to have a direction. In other words, is it talking about a nursing shortage, nurses having trouble finding a job, Obama’s healthcare plan, or what? And some newspapers are wondering why they fail to meet the needs of the public, and why no one with a working brain wants to read them.

From the Daily Pennsylvanian:

If the Obama administration succeeds in extending health care to all U.S. citizens, the system will be under enormous strain, said Nursing professor Matthew McHugh, whose research focuses on nursing workforce policy and the current deficit of nurses in particular.

There “simply won’t be enough” infrastructure to care for the newly insured, he said. “We need to make sure we have a health care workforce that is able to meet the demands of a reformed health care system.”

True, I have to agree. More insured people mean that more wil probably seek medical care. That means more workers needed.

McHugh predicts a shortfall of 300,000 to 800,000 nurses by 2020, but he said, “there hasn’t been significant focus by the administration … on the infrastructure problem of providing a nursing workforce.”

For nursing students, the shortage would seem to be beneficial.

“The nursing shortage makes nursing students at Penn feel more secure,” said Nursing senior Katie Heaberlin.

“The combination of a good school and there being a shortage makes me confident that I’m going to get a job.”

Now these three paragraphs, basically one sentence quotes, tell us nothing. First, the usual quotes about the shortage. But what does he mean that there hasn’t been enough focus on the infastructure problem. Perhaps the article might have concentrated on that one area, and explained it. What should the administration be doing? What should they be focusing on? That might have made a good article.

But no, as usual, it skips over to some silly meaningless comment from a nursing student. Yes, we’re all glad that you feel secure and hope you get a great job. But what has that got to do with an important issue that was just raised.

Now it gets even dumber. We move to student #2, who feels less secure and is worried about a job despite the so-called shortage.

Nursing senior Alexa Nickeson, has found the job market much more challenging in this economy, the shortage notwithstanding. She said hospitals are delaying start dates, and there are fewer positions available this year.

“Research shows a correlation between a higher nurse-to-patient ratio and higher patient mortality,” she said.

Even with the clear benefits of an increased number of nurses, hospitals are still hiring less this year, a number of nursing students said.

So now Alexa says its harder to find a job. Another mixed opportunity–the article could have discussed the difficulty nurses are having in finding a job, despite the dire predictions of a shortage. But it gives no reason why jobs are tighter, what percentage of nurses can’t find jobs, if it is national or just in this state or metro areas, etc.

Instead, they some mumbo jumbo quote about the benefits of smaller nurse to patient ratio, and that this still hasn’t convinced hospitas to hire more nurses. Well, are the hospitals that aren’t hiring working very short staffed? Is the situation dangerous? Are they not hiring because they’re using the economy as an excuse? Are they purposely working short staffed even though they can afford more nurses or at least, temps?

Of course, no info whatsoever. Another lost opportunity.

The last part of the article is something about socialized medicine…I can’t even go there. Is it asking too much for decent reporting, for a news story that has a focus and gives the reader actual information?

But where is it going? And how beneficial is it going to be for nurses in general?

Those are my questions, Barack. Do tell.

A Reuters article that I found the other day (I don’t know what I did with the link–but I had copied it to send to my editor), says that:

“The economic stimulus bill Obama signed last month included $500 million to address shortages of health workers. About $100 million of this could go to tackling the nursing shortage. There are about 2.5 million working U.S. registered nurses.”

So what does this mean, exactly? How do “we tackle” the shortage of healthcare workers without addressing the root causes of shortages in the first place. Yeah, I know, get out the violins and let’s here that the nursing shortage is caused by not enough schools or teachers, and has absolutely nothing to do with working conditions, or the fact that there are more desirable jobs out there. There are certainly a lot desirable jobs in healthcare than being a nurse. I think even scrub techs get more respect, or radiology techs.

What is the money going to be spent on? More studies to tell us that we have a shortage of healthcare workers, which is tempered a little now due to economic conditions, but which will flare up as soon as the economy starts pumping away again? More studies to look at the causes of the nursing shortage?

“Separately, Senator Dick Durbin and Representative Nita Lowey, both Democrats, have introduced a measure to increase federal grants to help nursing colleges.” Now, what is a “nursing college?” I don’t know of any college that specializes in nursing, do you? Do they mean nursing programs? And how is the money going to help? Are nursing instructors going to get more money than instructors in other subject areas–that will go over real well, I’m sure.

I can’t stand these vague statements which are nothing more than gobbly-gook. A good reporter, like in the olden days, would actually inquire what they plan on spending the money on, and how they assume it will help the shortage. The whole article is just sound bytes from experts, and doesn’t touch on where the money will be siphoned.

You know what? I am going to write to the White House. Barack says he wants to hear from us? Well, he will hear from me.

Is the nursing shortage suddenly over? Have RNs clutching their newly minted licenses overrun the healthcare system to such a degree that no one is hiring anymore? Have we reached the point where it is no longer politically correct to say to nurses and would-be nurses, “You’ll always have a job?”

But there’s been a lot of chitchat that new grads are having trouble finding work, especially in northern California, NYC, Boston, and New Jersey. There have been scattered news stories about layoffs in Tuscon, AZ and the Philly area. Some new nurses have reported that not only can’t they find a job, but they can’t even get an interview. Many have been searching for several months.

Is this an instant replay of the early-mid 1990s?

I’ve written about the “service with a smile” previously, and about how hospital administrators (the ones who never got close enough to a patient to see the blood and poop) think that they are running a 5 star resort. Nurses are a combination concierge, housekeeper, cook, and slave, and administrators make sure that their customers (aka patients) are aware of that.

Even if it kills the patient.

And from what I’ve been reading, it seems that nurse managers and supervisors are also so busy brown nosing administration, that they too, forget that patient care and safety is the first priority. This is a story (which I have condensed and paraphrased) that a nurse posted on allnurses.com. It is really scary.

A child was admitted with a viral illness and febrile seizures, and the mother was a local physician’s secretary (uh-oh). The mother wrote a formal complaint to the hospital management about the nurse, because she committed the crime of checking the baby’s temperature every 4 hours. Now, if a baby is admitted with seizures due to fever, I would certainly hope that he was being monitored closely. In fact, I would expect temps to be taken every two hours. The baby also had an IV in, which does need to be checked–make sure it hasn’t infiltrated, flowing properly, sufficient fluid in the bag, etc.

But this parent said that the nurse “compromised the sleep of her baby and her” by coming into the room and checking the temp, and that the nurse’s actions were “insensitive to her needs” and that basically, the nurse should have just said “night, night,” and closed the door behind her, and left them alone for the shift. Unless, of course, mom wanted room service at 2am, or eggs benedict at 7am with a mocha latte (hold the foam).

I don’t know if the mother complained to the nurse or not, or if anything transpired between them–ie, mom telling the nurse not to disturb them, etc. If so, I would have told the mother that she is in the hospital for a reason (or did she think she was at Disneyworld?) and that her child needs to be closely monitored. This is the standard of care at this facility, these are the physician’s orders, and that we can’t care for her child if we are unable to look at him and assess him. If that speech failed, I would have phoned the physician and the nursing supervisor, and dumped it into their laps. Bottom line–you want a peaceful night of sleep without a pesky nurse trying to take your baby’s temp–then don’t come to a hospital. Or check out AMA.

Most shocking was the reaction of the nurse manager, in response to the complaint. It goes to show that a working brain is not required for the job. The manager told the nurse that in the future, she should check with families if it is “okay” to disturb them at night for vital signs and assessments. The nurse then asked her manager if she would be held responsible for a dead or seriously ill baby, should the family refuse to be disturbed during the night. The manager hesitated and said she wasn’t sure.

Double, triple and quadruple..DUH!

The poster doesn’t say how she responded to the manager, but again, her reaction to the complaint is so inappropriate–she should have her license revoked. The manager should have supported the nurse without question, and told the recipient of the complaint that this was unit policy, physician’s orders, and it was for the safety and well being of the patient. Throw in the word malpractice a few times, and lawsuit, and they start to get the message.

And her response that she wasn’t sure if the nurse would be held responsible? How about she take the responsibility instead? If a family again decides that they are at a poshy resort and don’t want their sick baby disturbed at night, the nurse calls the manager and lets her make the decision–and then charts it? For further back-up, the nurse should also call the physician and the nursing supervisor–and let everyone know that this family has come to the hospital to sleep, and not get their baby treated.

The customer service bandwagon is galloping out of control, but I’m sure that the weenies who came up with this bright idea never imagined the worst case scenario–that disgruntled customers, like the family whose baby dies from neglect because of their stupidity, are going to the sue the hospital and not the nurse. They are going to head for the big pockets.