About 'lpn schools'|... fame or glory for his or her country, school, etc.: he was an honour...thief, rent boy, rusticated LPN, and evangelical Christian." My issue with Whatcott...
This article is the first of a series on the issue of various aspects of medical care today. The majority of this series will focus on your safety in hospital care. It will also offer tips on keeping yourself and loved ones safe while hospitalized. This first article regards the nursing shortage, causes, expectations and effects. Some time back, the nursing shortage was at the top of the news. Suddenly, the subject basically disappeared, leaving many to believe the shortage had ended. While the shortage has become less critical, the shortage does continue to exist. There are many aspects to the nursing shortage, many of which have not been reported in the news media. Part of this is because the issue is a complex one. Another reason is because of misrepresentation by hospitals and other medical facilities on the subject. One reason the subject has stopped gaining as much attention is the fact that the media itself portrayed nursing as an extreme growth field for some time, which led to a sudden boom in admissions to nursing schools. Coupled with delusions formed by watching too many TV dramas, this has led to some problems currently being faced by the medical field. Many new nurses in the field today entered school, even graduated nursing school with visions of sudden wealth and white collar jobs in their minds. The truth dawns too late on many of these new nurses as they become employed and find that, while nursing pays well, one must gain experience to reach the pay levels these new nurses dream of making immediately out of school. They also find that nursing is by no means white collar position until one spends many years in the profession and attains some administrative situation. Only a low percentage of nurses ever attain that situation. No, not many cute doctors are dating nurses they work with. Even if they wanted to, most facilities have protocols against this. Estimates differ on how many nurses are expected to retire or leave nursing in the next few years. Some estimates go as high as 83% of nurses wishing to retire within the next ten years. While the average age of nurses increases year by year, younger nurses are leaving the medical field sooner than previous generations of nurses. This causes a cross between older nurses retiring and younger nurses choosing to change career paths. One study has suggested as many as 1 in 3 nurses under the age of 30 intend to leave nursing as a career within one year from the study date. Other studies have found over 70% of nurses dissatisfied with their current jobs and over 90% experience stress due to inadequate/unsafe staffing levels. It really becomes as simple as taking to the average nurse and finding that nearly every nurse you speak to plans to no longer be actively in nursing within ten years. One issue rarely, if ever, addressed is probably the most important factor in the dissatisfaction of nurses. If a person enters nursing to help people, it generally means having contact with the people they are helping. For many years, I have had the saying that nursing is one third nursing and two thirds paperwork. A nurse may spend an average of 45 minutes of each shift charting on each patient. More patients equals more time charting. If a nurse has 10 patients, just this basic level of charting may require as much as 7.5 hours of the shift. More time than this is required if the same nurse acquires new patients to be admitted. Add in one 30 minute lunch and already the nurse has used 8 hours of a 12 hour shift. With 10 patients, this would leave 24 minutes of 12 hours to spend with each patient. Fine if you like paperwork. Not good if you want to help people. Studies have also shown that charting becomes less accurate as a nurse must care for more patients. One issue clouding the water is stop-gap measures by medical facilities and systems to reduce the need for as many nurses. Hospitals have attempted to consolidate services, closing units or entire hospitals in recent years. There are currently fewer hospital beds and facilities today than there were ten years ago. Nearly every city in the country has seen a decrease in the number of hospital beds available. While having fewer beds available does make it easier to maintain enough nursing staff to care for the patients in those beds, the remaining facilities have still struggled to maintain safe staffing levels. Many hospitals continue to operate at dangerously low levels of staffing. Multiple studies have shown the correlation between lower staffing levels and increased risk of serious medical error or hospital acquired infections. This is at the same time that the danger of acquiring such infections becomes serious, even deadly. These risks caused California to enact legislation which mandates particular staffing levels, ensuring that hospitals must meet for patient safety. Thus far, California has been the only state to pass such legislation, though several other states have investigated enacting similar legislation. Another factor causing the issue to be less clear is a numbers game played by many hospitals. For fear of appearing to staff at unsafe levels, many hospitals inflate the numbers reported regarding nurse/patient ratios. While a hospital may have 1 nurse for every 2 patients in their Intensive Care Unit (ICU), they may have only 1 nurse for 8 patients on the surgical unit. This averages to 1 nurse for every 5 patients, which is what they will advertise and report. Another tactic used is for a hospital to staff 1 nurse for every 4 patients during the day but 1 nurse for every 8-10 patients at night. While enrollment in nursing programs has increased, it has not kept pace with the increased need for new nurses. Many people interested in pursuing nursing as a career choice have changed directions due to long waiting lists to enter nursing schools. Some waiting lists are as long as two years. A potential student cannot place their name on the waiting list until they have met all prerequisites necessary. Many nursing schools are turning away qualified applicants due to shortages in staff, facilities, equipment and funding. While the health of baby boomers is generally better than their elders, the fact remains that the general age of the population is increasing. At the same time, the epidemic of obesity means more people are requiring extensive medical care at a younger age. While the age issue has been addressed in multiple projections regarding the need for more nurses in the future, no major studies have addressed the effect of the obesity rate on nursing as yet. For your own safety, here are some things to consider: If planning to enter the hospital for elective or planned surgery, find out what unit you are expected to remain for most of your stay. Call or visit the unit and ask questions of the charge nurse or nurse manager. Ask what the nurse to patient ratio is for that unit. Then, be sure to ask if the same ratio is maintained both day and night. Also, ask if they normally have enough staff to meet that ratio. A ratio means nothing if it is only on paper. Another question to ask is the percentage of patients on that unit acquire infections while hospitalized. One more question to ask is what the median experience level is of the nurses on that unit. Do not settle for how many RN's they have employed or any other answers offered. Be sure to ask about nurses, not just RN's. Remember that LVN's/LPN's are nurses and many have more experience than RN counterparts. This issue will be addressed in the next article in this series. If you have no immediate plans to enter the hospital, these questions can still be asked. If the hospitals within your insurance plan all have low staffing levels, you may wish to switch plans, if possible. If that's not possible, do several things. One is complain to your insurance company. While one complaint may fall on deaf ears, you have no idea how many other complaints they may receive on the subject. If you find you live in an area where most of the hospitals have low staffing levels, contact your state representatives. Suggest legislation requiring safe levels of staffing in all the hospitals in your state. Encourage your friends and associates to do the same. Write to the local media and suggest an investigative report on the matter. Don't wait until you or a loved one suffers because of poor medical care. Do something about it now. Suggested references: http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm http://www.medicalnewstoday.com/articles/28800.php http://content.healthaffairs.org/cgi/content/full/22/6/40 http://www.nurseweek.com/features/97-10/jobsatis.html http://www.nursingworld.org/ |
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Just what it says--my adventures! (by teenie)
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