Monday, July 21, 2008

Nurses and The Value of Human Life

When nursing began it was about the promotion of health, prevention of illness and care of the ill, disabled and dying. Nurses became advocates in the promotion of health care and a safe environment. Nurses participated in research as well as the shaping of health policies and systems management within the patient and health business. They developed education for patients, families and other health care providers.

Since the beginning of nationally regulated nurses in New Zealand in the year 1901, nursing has taken on many challenges as well as facelifts. Education for nurses is predominately geared towards the promotion of care and patient advocacy but the real world of nursing exposes nurses and their patients to something very different. Over the years medical care has become more financially profitable for investors than it’s original cause, which was about treating and educating the ill. Profits are obtained by “selling” both health care and education to the ill and their families. Nurses are now severely limited in utilizing their training or desire to practice their professional skills and knowledge as our “Lady with the Lamp,” Florence Nightingale, envisioned. Nursing has evolved into “employment for profits.” Gone are the days of promoting health, prevention of illness and patient advocacy unless there are profits to be made by selling such “merchandise.’’ Acting as a nurse as history established has now created a “nursing shortage.”

With health care “merchandise” resulting quickly and easily in the exchange of 5, 6 and 7 figure charges for a single visit to the hospital, other licensed professionals are now forced to utilize their specialized training and talents in informing you that your insurance is about to run out and there will be no more funds for you to receive their “merchandise.” You will be professionally assisted in reviewing your options to discontinue receiving their “services” and receive “services” from another corporation for a limited period of time or find a way to now take care of yourself at home. While the corporation is carefully working with your insurance company to justify their actions to receive these 5,6 and 7 figures you will probably be convinced that their services and commitment to you are their number one priority. You and your care are very important to them. When they can no longer justify receiving these profits you are professionally informed that you are going to have to find another way to receive the care that you need and that they can no longer extend their wonderful treatment to you. They are, however, very “sorry about your luck.”

Now where do these profits go? While these corporations insist that there is no money in their budget for your direct care such as nursing, they have many other “services” or merchandise to offer you in exchange for profits. They will go so far as to put up new buildings with new décor, new televisions and offer you more treatment options and diagnostic services to get your business. Over the years, the area of direct personal care such as nurses, case managers, social workers, assistive personnel and other departments are working with limited resources including the number of employees needed to assure that you receive the skilled and specialized care that will actually promote a better recovery. They insist that the funds are not available for this “merchandise.”

Statistics have proven that medical errors result in an average of countless thousands of deaths with many of the errors not being reported and that number being hard to determine. It is also proven that the new terminology referred to as “short staffing” has a direct relation to this number of fatal events.

THE TRUTH BEHIND “SHORT STAFFING” AND THE “NURSING SHORTAGE:”

Short staffing is a term used in the field of direct patient care that is deceiving. It leads the public on into believing that corporations are not able to find the correct number of staff to provide one of the most important parts of care that you should receive as a “customer” of their services. That is not the case. Their “staffing models” are set up for profits with your care and safety being at risk. Nurse to patient ratios are at unsafe levels while corporations are raking in the profits for salaries and more “merchandise” to lure you in. Professionals that speak up for your welfare and better working conditions are faced with being slandered and tarnished as “bad employees.” Not only do these corporations have the money to decorate, build and purchase, they have the money to employ large legal firms to protect their actions in proving that these employees were released for justifiable reasons as stories are developed or twisted and supplied within their personal files. The fear of such actions keeps professional caregivers under control to participate in the vicious circle of profits for health care while trying to feed their families and pay their bills.

The terms “short staffing” and “nursing shortage” are used as generic “titles” for this dilemma but in all reality neither of those terms are appropriate because “short staffing” implies that they are actually missing the number of nurses needed to completely staff a unit in order for the appropriate care to be provided and “nursing shortage” implies that we actually have a shortage of nurses in the field. In all reality, “short staffing” is a term that nurses have began using in their every day life of explaining why they have more patients they can handle. The truth of the matter is that the hospitals “staffing model” is typically set up for the nurses to struggle with a set number of patients per shift and that set number is well known throughout the industry to be “too many.” If they work with fewer nurses that number goes up on each assignment. As far as the “nursing shortage” is concerned, there are hundreds of thousands of nurses that are licensed and inactive in practice. Many of those nurses have stated that poor working conditions were the reason for leaving and there are many more that have been unable to find employment because they spoke up about conditions and were terminated and falsely accused of misconduct or inappropriate behavior that has interfered with their ability to find employment.

At the present time it appears as if the average age of leaving nursing tends to be people in their 40’s. Many of those nurses have suffered physical damage due to the heavy lifting and harsh physical demands. Others have been forced out for either speaking up about unsafe conditions or just simply replaced by younger cheaper nurses. Look around and you will notice more young and new nurses as the primary population on many hospital units. You will also see these young and new nurses training newer nurses when they have had minimal experience in the field. Nursing is a profession that requires actual experiences to perform tasks with skill. New and inexperienced nurses are at risk for inaccurately dosing medications they are not familiar with, not having the experience to handle a code situation in order to save a life and many other things that come from “exposure.” Yet these nurses are now training the new graduates in the field. Experienced and seasoned nurses are found in smaller and smaller numbers throughout hospitals. There is a surprising number of nurses that would either return to the field to work if the conditions were more manageable or if previous employers were controlled from tarnishing their personnel files with slanderous allegations of misconduct after speaking up about conditions. This, alone, would resolve retention issues as well as make the field more desirable to qualified people who have avoided nursing as a career because they are fully aware of the conditions.

The sad truth is that the administrators within the corporations are fully aware of all of these facts but deny their validity to the public as well as those around them. Many nurses within management have either NEVER experienced actual floor nursing or have spent very little time as a floor nurse. It is not uncommon to find a nurse in a supervisor position who either never worked as a floor nurse or couldn’t handle the demands of floor nursing. In order to secure their position and salary they are more than willing to enforce “staffing models” otherwise known as “short staffing” where nurses are forced to work under unsafe conditions. Unlike history’s role models Ellen Dougherty and Florence Nightingale, these managers have lost the vision of “advocates in the promotion of health care and a safe environment” and are more concerned with budget restraints and their own income. Often times the staff employed under their management are dissatisfied with them but are afraid to speak up for fear of losing their jobs.

SO WHAT DOES ALL THIS MEAN?

I ask you… what is the value of human life? What is the value of your life and the lives of your loved ones? Do you turn the other cheek when your care is barely managed by a nurse with 8 patients and she is too busy to see that you are not able to breath and too weak to call for help? Or do you throw such a fuss that the care you receive is adequate but the other 7 patients are now neglected? People have begun to recognize this problem and speak up and so far the only changes that have been made is that the corporations and accrediting organizations have come up with more work for the nurses to cover up this problem. They have been given more documentation and more tasks to address the fact that people are stating that they see that nurses do not have time to spend with patients. They still have more patients than they can safely handle but now they have documentation and tasks to prove to their employer and the public that they CAN handle the assignments. Obviously, speaking up has not cured this problem.

So what do we do?

For one, there are many (too many to be exact) organizations that are promoting changes in the medical field to address the “short staffing” problem as well as “whistle blowing” which is unreasonable reprimand or consequences for speaking up. These organizations have already put together petitions and are working to change the problems that exist. You can sign their petitions, join as members, assist them with their mission and even make cash donations to support them.

So, what can we do while we are waiting for things to change?

KNOW YOUR MEDICAL PROVIDER! Ask hospital administrators how many patients that their nurses are responsible for on each shift. Ask them how they handle “short staffing” concerns. Tell them that you know that 8 – 10 or more patients is unsafe. Tell them that you do not agree with their staffing model and that you are aware that the risk of medical errors goes up with the number of patients there staff is responsible for. Tell them that you refuse to believe when staff is forced to tell you that they have the time to take care of you and that you don’t approve of them covering things up with lies. Tell them that you don’t agree with risking patients’ lives by refusing to staff with numbers that allow for safe patient handling and care.

Another deceiving concept is something called “Magnet Status.” With this “title” hospitals strive to convince the public that their employees are happy to work there and that safe conditions exist. Again, take a look around. How many experienced seasoned nurses do you see? If the majority of the population is young and new graduates, then why has there been such a turn around in employees? How many supplemental staff are on the floor? Chances are many seasoned nurses were pushed out, fired or chased off. The present staff is encouraged to prove their loyalty by acting out in a way to help the hospital obtain “Magnet Status.” As far as I am concerned, Magnet Status would be the hospitals with the least amount of turnover, the least amount of terminated employees and the least amount of employees that have left due to dissatisfaction. There isn’t anything in the process of achieving “Magnet Status” that addresses that. Achieving “Magnet Status” comes from current employees who may not have even been there long and all they have to do is fill out surveys. I believe “Magnet Status” should be a concept that tells the public that they reviewed their “human resources” files and they publicly post….

1) The number of employees terminated for negative reasons,
2) The number of employees that left voluntarily for negative reasons,
3) The number of employees that left satisfied but to pursue other options,
4) The number of patients that nurses are responsible for on each unit and each shift.

Those are the facts that speak for themselves.

Read more about Magnet Status:
http://www.nursingadvocacy.org/faq/magnet.html

See the actual survey for nurses:
http://nursecredentialing.inquisiteasp.com/cgi-bin/qwebcorporate.dll?WSEVF5
Fill in the information with something and go read the survey for yourself.

The questions in the survey do not address the most important issues that result in SAFE PATIENT CARE.

BE INFORMED!
SPEAK UP!


Don’t waste your breath telling them that you felt the nurses were too busy and didn’t have time. Tell them what you know. Tell them that you know 8 patients and more is unsafe. Tell them that forcing employees to repeat scripts telling you that they have time is an insult to your intelligence. It’s your life and your health…. what is it worth to you to turn the other cheek until some medical error causes a tragedy in YOUR family.