The Measure of a Man

The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.

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Monday, May 19, 2008

Copied Article: Nursing Shortage or Hospitals Short On Nurses?

Nursing Shortage or Hospitals Short on Nurses?Posted by: admin in Laura Gasparis Vonfrolio, RN, PhD, Nurse Staffing Issues
Guest Post by Laura Gasparis Vonfrolio RN, PhD
Let me begin by saying that there is no shortage of nurses. There are over 2.8 million of us. Interesting to note, only 66% are working and 44% are employed full time with 10% of working nurses being “very satisfied” with their jobs. A recent survey found that an astounding 75% of RN’s feel that the quality of nursing care at their facility has declined, with over 68% citing staffing levels as a major contributing factor to this problem.
The statement made by hospitals and administration that there is a nursing shortage, are patently false and evade the real issues of why nurses leave nursing thus contributing to the lack of a sufficient number of nurses at the bedside to meet patient care needs. The term “nursing shortage” becomes a pat excuse for every vacancy that can’t be filled. It is the ultimate answer that absolves the people who are responsible for creating problem – shortage of nurses at the bedside.
There is an annual turnover of approximately 200,000 nurses, which cost the hospital industry a total of nearly 10 billion dollars per year. This staggering cost is the result of the hospitals industry’s failure to retain nurses. If the funds now spent fighting a losing battle to replace disheartened nurses with travel and agency nurses, were instead devoted to improving job conditions, the nursing “shortage” could be largely solved. The Harvard School of Public Health conducted the most comprehensive study linking staffing levels to patient outcomes. The researchers found a strong and consistent relationship between nurse staffing and the outcomes in patients. Higher nurse staffing ratios result in shorter lengths of hospital stay and thus reduce both direct hospital costs of treatment.
Other studies include:
August 2005 – Medical Care“Improving Nurse to Patient Staffing Ratios as a Cost Effective Safety Intervention” Research showed that when nurse staffing is improved, lives are saved in a cost efficient manner.
February 2004 – Medical Care“Nurse Burnout and Satisfaction”Patients were more likely to report high satisfaction with their care and nurses reported less burnout when nurses worked in conditions with adequate staff.
March 2004 – The Agency for Healthcare Research and Quality released its report entitled “Hospital Nurse Staffing And Quality of Care.”Hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as pneumonia, shock, urinary tract infections and cardiac arrest.
January 2003 – Medical Care“Fewer Licensed Nurses Leads To A Greater Number Of Adverse Events”
August 2002 – JCAHO issued a report “Nursing Shortage poses Serious Health Care Risk.”Focuses on the severity of the current and future nursing shortage and its detrimental effects on patients.
May 2002 – New England Journal of Medicine“Nurse Short Staffing Leads To Deadly Complications”Jack Needleman and Peter Buerhaus found that nurses short staffing leads to deadly consequences for patients. Attention nursing administrators – focus on retaining your nurses – improve the staffing levels at the bedside!
A Nurse With a Heart
Laura Gasparis Vonfrolio, RN PhD is one of the most dynamic and entertaining speakers you will have the opportunity to experience. Laura has held CCRN certifications for over 15 years and CEN certifications for 13 years. Laura has helped thousands of nurses over the last sixteen years to prepare for the CCRN and the CEN examinations. She has held positions as staff nurse, Staff Development Instructor and Professor of Nursing.
Dr. Vonfrolio is the proprietor of Education Enterprises and the former publisher of REVOLUTION – The Journal of Nurse Empowerment. Laura has authored numerous articles in Nursing, RN, AJN and co-authored/edited eleven books such as NURSE ABUSE: Impact and Resolution, Critical Care Examination Review and 12 Lead EKG STAT! In addition to being series editor of a six volume State Board Review, Nursetest. Dr. Vonfrolio was the organizer of the Nurses March on Washington DC, March 1995 and May 10, 1996 and has appeared on Good Morning America and Nightline with Ted Koppel (May 1996). You can contact Laura at

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My Story

My Story

I have been a nurse for just over ten years. I earned my degree with the support of my wife and financial assistance for the GI bill. I was drawn to the profession of nursing after a brief exposure to an advanced course in field triage while serving in the army. I find the human body fascinating and am always learning. I also was attracted to the profession for all the usual reasons that bring people to the profession of nursing. I enjoy the reward of giving to my fellow man.

I believe that health care and the advocacy of safe care is the foundation of nursing that was started by our founders like Florence Nightingale. Our practice act calls for our profession to advocate for our patients and against practices that puts their safety in jeopardy.

The healthcare industry has for the last twenty plus years constructed an environment to maximize profits at the expense of patient safety and our profession. We as nurses have stood by fairly quit and allowed for this to happen.

Recently, I and others voiced concerns related to patient safety and working conditions at Summit Hospital a hospital owned by Healthcare Corporation of America. Our issues included the working of nurse with approximately six month of experience for more than twenty four hours straight. This particular nurse did volunteer to work these hours but in my opinion should not have been ask to do so. She is a great nurse for her limited experience but put her license and the safety of her patients at risk that night. The manager of the unit failed her and the patients in her charge. Study after study has shown that the error rate goes off the chart after twelve hours. I and fifteen other nurses also expressed to management our concerns over the floating policies that were sending unqualified nurses to our unit. We noted several instances were these nurse made errors that put the patient in potential jeopardy. We also expressed our concerns over ratios of 3 to 1 becoming the norm in the unit when 2 to 1 is considered the norm in intensive care across most of the country.

We submitted these concerns in writing and signed by sixteen nurses from our unit. Management responded by holding meetings with a group of employees that they chose and their representatives which included the director of HR, our unit manager and the director of nursing. The meetings at their start gave us some hope that our issues might be taken seriously and dealt with. It was soon apparent that would not be the case and these meetings quickly moved away from our issues to their issues. They would agree that their were problems but would not put any solutions into writing, stating that they needed to be able to remain flexible and made statements like we will try instead of we will.

At around this same time I was informed of an organization called the NNOC or National Nurses Organizing Committee, that was holding meetings in the Nashville area to organize nurses to advocate for patients and against many of the problems that I expressed above. I met with their organizer and felt that their movement was something that I could support. I became a member of the NNOC and began attending meetings on a regular basis. I also began placing invitations to attend meetings in the break room of my unit and speaking with interested coworkers, while on break, about the need to organize and advocate for our patients and our profession.

After a short period of time I was ask by my manager about my involvement with the NNOC and my desire to form a union at Summit Hospital. I did not deny my association and did not hide my opinion as to why I felt that organizing was needed. I also informed them that I had the right as outlined in the National Labor Relation Act. The nursing staff at Summit was then subjected to mandatory anti union meetings and letter sent to our homes and to our email accounts at work. I was required to attend meetings with the hospital attorney and informed that because I was a charge nurse I was considered management and could not associate with the NNOC. I contested that I was a member of management but submitted to their demands to end my association with the NNOC. I never attended another meeting or recruited for the cause after that meeting. I did however continue to operate a blog, , that advocated for reform of the healthcare system and employee rights to organize. I did not use computers at work for this endeavor and did not use my real name on the blog or use any other names that would tell a reader where I worked or who I worked for.

I was ultimately terminated from Summit Medical Center on June 11th, 2008 for what I was told was the operation of a blog. I was given no specifics of what about the blog was grounds for my termination despite my asking. I appealed my termination through the hospitals employment dispute resolution process, attempting to get clarification as to what about my blog was cause for my termination. The peer panel dispute process was a sham. The panel as outlined by the hospitals policy was to be made up of my peers, who were “not familiar with the problem or have a close relationship with any of the parties involved”. The panel was anything but and was made up of persons who had expressed an open hostility to my rights to organize and to freely associate with the NNOC in the past. Two of the panel members were charge nurses from the ER also under the supervision of my manager, who had terminated me. These two persons were also at the meeting with the hospitals attorney and expressed anti union sentiment. Another panel member was a person who was well aware of my personal views related to unions and the right to organize and had been present at private settings outside the hospital were I had expressed my opinions related to the issues that started all this. This puts three of the five panel members in clear violation of the policy. I then was refused the right to seek any clarification as to what about the blog was grounds for my termination despite that being the stated reason for the panel. I was not given the right to hear the reasons as stated by my manager and the director of HR.

I am writing this because I believe that my fundamental right to due process has been violated. This is a right to work state and right or wrong that gives Summit the right to do as the please when it comes to hiring and firing of employees but most people believe and Summit attempts to mislead their employees that they are fair and just when it comes to matters of employee issues.

If Summit is allowed to get away with this and is not challenged then patients are at risk. Health care workers need to be free to advocate for safety for their patients and if they are scared into submission then patients will suffer.

Join me in fighting for our rights to free association and to advocate for our patients as our practice act requires. Support the employee free choice act, and send a message to Summit and other corporate bullies that feel you are entitled to the rights they give you and nothing more.
Also visit sited like Leap for Safety and support petitions to mandate stronger legislation that will ensure a safer environment. Visit to get involved.

I truly believe that our healthcare system is in dire trouble and we as nurses have a responsibility to get involved. Please join the fight. Your family may one day depend on what we do today.

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