Another well educated advocate for health care reform.
Tuesday, July 8, 2008
Health Care for America Now Ad - Magic Eight Ball
watch this video and check the link atthe top of the page to give your support to this cause. The home page to Helath Care for America Now is http://healthcareforamericanow.org/
I hope you will visit and show your support.
Monday, July 7, 2008
Health Care Crisis U.S.A. -- Part 1
These are real people with real problems in America. We should have some compassion for the plight of the poor. Not all people as the corporate machine and capitalist free market supporters would have you believe are lazy and deginerates. We can and should do better.
Go Ahead And Die! (Pirates Of The Health Care-ibean)
a funny spofe on the corporate health care sysytem. The problem is that it's not so far from the truth.
Health Care Burden
This video supports our need for universal health care. The company provided health care system is crushing not only the employee but the employeer. We need a change and we need it now.
Friday, June 27, 2008
My Healthcare reform proposal
My Healthcare Reform
Proposal
I have been a registered nurse for ten years and a person with outspoken opinions for longer than that, so here are my health care reform ideas.
I believe that the infrastructure is one of the only things really worth keeping. I believe the health system in America is in need of total reform for it to serve all in need.
I will use one scenario of a patient type to show how my reforms would work. The ideas I will present will be based on this scenario but will apply to all in one way or another.
My mock patient is a 35 year old man with no health coverage offered at his place of employment, a small 6 person heating and Air Conditioning Company. His yearly income is 30,000 a year. He is married has one child and his wife is a clerk at a local convenience store making 18k a year. He is slightly over weight, eats a diet high in fat and low in fiber, the traditional American diet. He sees a physician only when he is ill and usually at the emergency room when he thinks he just can’t take it anymore. His blood pressure is slightly elevated; he has a family history of diabetes and heart disease.
1. Universal Health Care/ Affordable Insurance: Health insurance for all is where the process starts. It could be a single payer system or a hybrid of our current system. As long as all are covered and that coverage includes all aspects of care to include prescriptions. I believe the employer based health insurance system should be entirely scrapped and the premiums paid for by the states or the federal government. The personal financial responsibility would be based on a persons personal income and those below a certain income would be subsidized or receive free insurance. The premiums normally paid by business would have to be paid into the national health care pool that would provide the base asset pool for the program. Your individual premiums would continue to be removed from your check in the same manner that all other income based taxes are removed. We would all have the same insurance and there would be no difference in the programs for the rich or the poor. This would have to be federal law.
The insurance companies would still be able to make a profit but not what they have become accustom to. They would be required to compete for a given market and would be forced to promote prevention and healthy life style over denial of services to increase their profit margins.
2. Disease prevention: If disease prevention were the focus our healthcare system instead of the treatment of disease and symptom we could prevent many diseases from progressing and contributing to other costly conditions.
Diseases like diabetes and hypertension are chronic conditions that untreated lead to a variety of other costly and often deadly conditions like heart disease, stroke, peripheral vascular diseases, blindness, amputations, renal failure and many more.
We must first begin to promote this with a change in the way we pay our physicians. We should reward our physicians when they keep their patients healthy and for finding problems early when they are less costly to treat. This would require legislation to remove insurance barriers to physicians ordering test for their patients. I am not suggesting a return to fee for service but to a system that values health over short term profits. Our current system does not allow doctors the freedom to treat their patients as they see necessary. After all they are licensed physicians and are supposed to be qualified to make those decisions. I am not advocating for the removal of oversight but do not believe the best person to provide that over sight should be the insurance industry.
Looking at our patient he would have his hypertension treated and that treatment may help prevent his progression to costly treatment of heart, renal and other vascular diseases. The physician would have the tools available to monitor and treat the hypertension with the latest treatments available. The physician also understanding the effects of diabetes and his patients risk factors and could monitor and treat his patient if the disease is present or is found on regular check ups.
If his patient continues to be healthy and meets certain benchmarks then that physician would see and increase in his reimbursement and as a result of his practice would grow.
Many would ask then what will keep practices from refusing patients who are less than healthy and my solution to that issue is to tailor the benchmarks according to the patient’s baseline and accepted theory on disease progression when it is being effectively treated.
Some patients will be non compliant and will continue to work against the goals and measures needed to promote health and those issues would be taken into consideration. You can lead a horse to water but you can’t make it drink. I do not believe in utopia but I do believe that many people are willing to learn a better way and would take advantage of health care if it were available.
3. Inpatient Care: I have been a nurse at the bedside in acute care for ten years now with a brief period of my career as a nurse manager. I believe the greatest reform needs to take place in this arena. There are many issues that the current for profit system cannot solve on its own.
Nurse to patient ratios should be mandated federally and apply to both acute and long term care facilities. There are many ways that this can be done and what ever method is chosen it will require that we deal with increasing the number of nurses willing to work in the inpatient environment.
The studies have been performed and have all come to the conclusion that patients suffer and are more likely to die or end up with costly and debilitating complications due to high nurse to patient ratios. If the ratio of nurse to patients match the reality of the care needed by the patient then we can decrease the days a patient is in the hospital, maximize the patients possibility of return to their baselines and decrease the potential for long and costly treatments as a result of injury due to lack of care. We have failed to keep up with the survival rate of our patient population. Years ago the patient that is now on the medical/surgical floor was in the ICU and those that are now in the ICU were dead. With that said our current for profit system has failed to acknowledge that these patients now require more than they used to and that requires more nurses and fewer patients assigned to each nurse to maximize outcome.
The next issue is the freedom for nurses and other health care providers to report abuse and problems in our system without the threat of termination or reprisal from their employer. Nurses are not allowed to speak freely about the issues that face health care and I have experience the repercussions of speaking out for reform, first hand. Employee’s rights to organize should be strengthened by the formation of a national union for health care workers that promotes fairness in the work place that works for all.
Technology: The use of computerized records should be mandatory. Paper should almost be a thing of the past in a modern health care setting. We spend 40-50% of our time charting and documenting in redundant ways. Technology if used properly could in my opinion reduce that time in half. Physicians placing their orders directly into the patients plan of care instead of having it processed by two or three people would reduce errors in transcription that result in delayed treatment and medication errors that kill thousands of patients every year. Programs have the ability to check the medication against know allergies and to even assist nurses in their recognition of unwanted symptoms and interactions with other medications. We are not taking advantage of what’s available and people are suffering for that. These technologies are expensive but will pay for them selves over time and will decrease the likelihood of costly and potentially deadly errors.
The old timers and the alarmist who are resistant to technology should be helped to get over their fear or be left behind. My health information privacy is important to me and all measures should be taken to protect it. The ability for someone to hack into my information should not keep us from moving forward. I value my life more than I value the information about my life and it is my opinion that the health care system moving into this century out weighs the possible risk to my health information.
If just these reforms were made, I believe we would all be better off. I love my profession and my country and wish for the day that I can say as an American and a nurse that we value human life and that when it comes to the health of our citizens we believe all should be treated equally.
Proposal
I have been a registered nurse for ten years and a person with outspoken opinions for longer than that, so here are my health care reform ideas.
I believe that the infrastructure is one of the only things really worth keeping. I believe the health system in America is in need of total reform for it to serve all in need.
I will use one scenario of a patient type to show how my reforms would work. The ideas I will present will be based on this scenario but will apply to all in one way or another.
My mock patient is a 35 year old man with no health coverage offered at his place of employment, a small 6 person heating and Air Conditioning Company. His yearly income is 30,000 a year. He is married has one child and his wife is a clerk at a local convenience store making 18k a year. He is slightly over weight, eats a diet high in fat and low in fiber, the traditional American diet. He sees a physician only when he is ill and usually at the emergency room when he thinks he just can’t take it anymore. His blood pressure is slightly elevated; he has a family history of diabetes and heart disease.
1. Universal Health Care/ Affordable Insurance: Health insurance for all is where the process starts. It could be a single payer system or a hybrid of our current system. As long as all are covered and that coverage includes all aspects of care to include prescriptions. I believe the employer based health insurance system should be entirely scrapped and the premiums paid for by the states or the federal government. The personal financial responsibility would be based on a persons personal income and those below a certain income would be subsidized or receive free insurance. The premiums normally paid by business would have to be paid into the national health care pool that would provide the base asset pool for the program. Your individual premiums would continue to be removed from your check in the same manner that all other income based taxes are removed. We would all have the same insurance and there would be no difference in the programs for the rich or the poor. This would have to be federal law.
The insurance companies would still be able to make a profit but not what they have become accustom to. They would be required to compete for a given market and would be forced to promote prevention and healthy life style over denial of services to increase their profit margins.
2. Disease prevention: If disease prevention were the focus our healthcare system instead of the treatment of disease and symptom we could prevent many diseases from progressing and contributing to other costly conditions.
Diseases like diabetes and hypertension are chronic conditions that untreated lead to a variety of other costly and often deadly conditions like heart disease, stroke, peripheral vascular diseases, blindness, amputations, renal failure and many more.
We must first begin to promote this with a change in the way we pay our physicians. We should reward our physicians when they keep their patients healthy and for finding problems early when they are less costly to treat. This would require legislation to remove insurance barriers to physicians ordering test for their patients. I am not suggesting a return to fee for service but to a system that values health over short term profits. Our current system does not allow doctors the freedom to treat their patients as they see necessary. After all they are licensed physicians and are supposed to be qualified to make those decisions. I am not advocating for the removal of oversight but do not believe the best person to provide that over sight should be the insurance industry.
Looking at our patient he would have his hypertension treated and that treatment may help prevent his progression to costly treatment of heart, renal and other vascular diseases. The physician would have the tools available to monitor and treat the hypertension with the latest treatments available. The physician also understanding the effects of diabetes and his patients risk factors and could monitor and treat his patient if the disease is present or is found on regular check ups.
If his patient continues to be healthy and meets certain benchmarks then that physician would see and increase in his reimbursement and as a result of his practice would grow.
Many would ask then what will keep practices from refusing patients who are less than healthy and my solution to that issue is to tailor the benchmarks according to the patient’s baseline and accepted theory on disease progression when it is being effectively treated.
Some patients will be non compliant and will continue to work against the goals and measures needed to promote health and those issues would be taken into consideration. You can lead a horse to water but you can’t make it drink. I do not believe in utopia but I do believe that many people are willing to learn a better way and would take advantage of health care if it were available.
3. Inpatient Care: I have been a nurse at the bedside in acute care for ten years now with a brief period of my career as a nurse manager. I believe the greatest reform needs to take place in this arena. There are many issues that the current for profit system cannot solve on its own.
Nurse to patient ratios should be mandated federally and apply to both acute and long term care facilities. There are many ways that this can be done and what ever method is chosen it will require that we deal with increasing the number of nurses willing to work in the inpatient environment.
The studies have been performed and have all come to the conclusion that patients suffer and are more likely to die or end up with costly and debilitating complications due to high nurse to patient ratios. If the ratio of nurse to patients match the reality of the care needed by the patient then we can decrease the days a patient is in the hospital, maximize the patients possibility of return to their baselines and decrease the potential for long and costly treatments as a result of injury due to lack of care. We have failed to keep up with the survival rate of our patient population. Years ago the patient that is now on the medical/surgical floor was in the ICU and those that are now in the ICU were dead. With that said our current for profit system has failed to acknowledge that these patients now require more than they used to and that requires more nurses and fewer patients assigned to each nurse to maximize outcome.
The next issue is the freedom for nurses and other health care providers to report abuse and problems in our system without the threat of termination or reprisal from their employer. Nurses are not allowed to speak freely about the issues that face health care and I have experience the repercussions of speaking out for reform, first hand. Employee’s rights to organize should be strengthened by the formation of a national union for health care workers that promotes fairness in the work place that works for all.
Technology: The use of computerized records should be mandatory. Paper should almost be a thing of the past in a modern health care setting. We spend 40-50% of our time charting and documenting in redundant ways. Technology if used properly could in my opinion reduce that time in half. Physicians placing their orders directly into the patients plan of care instead of having it processed by two or three people would reduce errors in transcription that result in delayed treatment and medication errors that kill thousands of patients every year. Programs have the ability to check the medication against know allergies and to even assist nurses in their recognition of unwanted symptoms and interactions with other medications. We are not taking advantage of what’s available and people are suffering for that. These technologies are expensive but will pay for them selves over time and will decrease the likelihood of costly and potentially deadly errors.
The old timers and the alarmist who are resistant to technology should be helped to get over their fear or be left behind. My health information privacy is important to me and all measures should be taken to protect it. The ability for someone to hack into my information should not keep us from moving forward. I value my life more than I value the information about my life and it is my opinion that the health care system moving into this century out weighs the possible risk to my health information.
If just these reforms were made, I believe we would all be better off. I love my profession and my country and wish for the day that I can say as an American and a nurse that we value human life and that when it comes to the health of our citizens we believe all should be treated equally.
Good Advice
This article gives the new grads a great piece of advice. I agree and see the theme of this advice as respect your self, demand respect from others and be proud of what you do.
May 18, 2008
Advice to future nurses: ask questions, be proud
By Kim McAllister
It's that time of year when nursing and medical students shed their label (and protection) of student and head out to the workforce with their new licenses. Over at Emergiblog, veteran emergency room nurse Kim McAllister shared advice with new nursing graduates.
Here are her words of wisdom.
To the new nursing classes of 2008:
Your first year will be the most difficult as you acclimate to your new role as a professional nurse. Hang in there! Keep your focus on why you went into nursing to begin with.
Keep your eyes and ears open. Watch the nurses around you. You will be surrounded by role models. Take the best of what you see and incorporate it into your own practice. It may be hard to believe, but by the time the next class enters the profession YOU will be the role model they look up to.
Ask questions. Ask a lot of them. Keep asking “why?” This will keep you learning every day. I still do it after 30 years. Don’t take symptoms or lab values or behavior at face value. Find out why.
Don’t let yourself get cynical or burnt out. Don’t work so much that you are exhausted on your days off. Work what you need to work to get by - keep overtime to a minimum. Yes, the money is nice but so is your mental health. Nursing is hard, demanding work. You need your downtime to recharge.
Speaking of cynical or burnt out, you will work with nurses who suffer from both. Don’t let their attitude bring you down. (And I hereby apologize to all those nurses who had to work with me when I was suffering from both those maladies). You will feel the same on occasion, but keep in mind that “this, too, shall pass”. It does.
You are professional nurses! Don’t let anyone treat you like a housemaid, a slave, an underling, or anything other than the educated, professional people that you are. Don’t accept the status quo. Don’t accept that things “have always been done this way.” Don’t accept stupid water bottles with hospital logos on them.
Please, please remember that you practice nursing and not medicine. The professions are complimentary, not identical. Should a patient refer to you as “Doctor”, let them know you are a registered nurse. Act like the consummate professional, and you will find that the doctors will treat you accordingly. Those who don’t have a problem. You do not.
Tell everyone what you do! Promote the profession! Encourage young people to consider nursing. Explain the difference between nursing and medicine to those who are confused.
And finally, there will be days when you leave work exhausted, emotionally drained and aching from head to toe, wondering “What the hell was I thinking?”
On those days remember that you made a difference in someone’s life.
Because you are a nurse.
Congratulations to the Nursing Class of 2008! I’m proud to call you colleague.
May 18, 2008 in Nursing
May 18, 2008
Advice to future nurses: ask questions, be proud
By Kim McAllister
It's that time of year when nursing and medical students shed their label (and protection) of student and head out to the workforce with their new licenses. Over at Emergiblog, veteran emergency room nurse Kim McAllister shared advice with new nursing graduates.
Here are her words of wisdom.
To the new nursing classes of 2008:
Your first year will be the most difficult as you acclimate to your new role as a professional nurse. Hang in there! Keep your focus on why you went into nursing to begin with.
Keep your eyes and ears open. Watch the nurses around you. You will be surrounded by role models. Take the best of what you see and incorporate it into your own practice. It may be hard to believe, but by the time the next class enters the profession YOU will be the role model they look up to.
Ask questions. Ask a lot of them. Keep asking “why?” This will keep you learning every day. I still do it after 30 years. Don’t take symptoms or lab values or behavior at face value. Find out why.
Don’t let yourself get cynical or burnt out. Don’t work so much that you are exhausted on your days off. Work what you need to work to get by - keep overtime to a minimum. Yes, the money is nice but so is your mental health. Nursing is hard, demanding work. You need your downtime to recharge.
Speaking of cynical or burnt out, you will work with nurses who suffer from both. Don’t let their attitude bring you down. (And I hereby apologize to all those nurses who had to work with me when I was suffering from both those maladies). You will feel the same on occasion, but keep in mind that “this, too, shall pass”. It does.
You are professional nurses! Don’t let anyone treat you like a housemaid, a slave, an underling, or anything other than the educated, professional people that you are. Don’t accept the status quo. Don’t accept that things “have always been done this way.” Don’t accept stupid water bottles with hospital logos on them.
Please, please remember that you practice nursing and not medicine. The professions are complimentary, not identical. Should a patient refer to you as “Doctor”, let them know you are a registered nurse. Act like the consummate professional, and you will find that the doctors will treat you accordingly. Those who don’t have a problem. You do not.
Tell everyone what you do! Promote the profession! Encourage young people to consider nursing. Explain the difference between nursing and medicine to those who are confused.
And finally, there will be days when you leave work exhausted, emotionally drained and aching from head to toe, wondering “What the hell was I thinking?”
On those days remember that you made a difference in someone’s life.
Because you are a nurse.
Congratulations to the Nursing Class of 2008! I’m proud to call you colleague.
May 18, 2008 in Nursing
Benign Neglect and the Nursing Shortage - Brian Klepper
I sit on the Dean's Advisory Councils of the Colleges of Health at two public universities in Florida. Both Colleges are led by extremely capable PhD nurses, and have a variety of programs that train students to be health professionals, including nurses.
A few months ago, I was startled when one of the Deans mentioned that her Nursing program had 500 qualified applicants for 132 student slots. In other words, at a time when the market wants her to gear up, she turns away 3 qualified applicants for each one she accepts. As it turns out, it's a national problem. In 2006, Colleges of Nursing turned away 43,000 qualified applicants.
It's not news that health care institutions face a critical nursing shortage. An April 2006 AHA report estimated that American hospitals currently need 118,000 RNs to fill vacancies. That number is expected to triple by 2020, to 340,000 vacancies.
What is less clear to most of us is exactly why the shortage exists. Most of the facts in this piece were drawn from an excellent presentation by Geraldine Polly Bednash, PhD RN. Dr. Bednash is the Executive Director of the American Association of Colleges of Nursing (AACN). AACN's site has a wealth of data on the problem, and the distinguished members of that association draw a VERY compelling picture of benign neglect of the training process by the sector it serves.
To read the full article click on this link. http://www.thehealthcareblog.com/the_health_care_blog/2007/08/why-do-we-have-.html
The comment below is posted by Nurse Advocate
Pay attention to the comments made at the bottom of the article. There are many good ideas posted there.
I believe that if all hospitals in a state or a group of states would work towards subsidizing the pay differential for nursing professors with the idea that a partnership would be formed between the universities and colleges the shortage could be solved or at very least improved. This however will require a commitment of money and it is my opinion that most hospitals are not interested in redesigning their staffing matrix to fit the higher acuity of our current patient type because it will decrease the all mighty profit margin associated with each patient or unit of service.
Think about it; If you increase the number of nurses you employ and reduce the ratios because you now have an adequate pool of nurses for the higher acuity patients, your profits fall!!
This is not in the best interest of the current for profit system of health care in America. We must mandate ratios according to acuity or a flat nurse to patient ratio plan. I believe that most bedside nurses and the unit level nurse managers want and do give the best care they can but they are not in control of the purse strings and those at the top owe their loyalty to the stockholders and the profit GOD. Don't be fooled into believing that greed and general business practices are not the dominating force of health care as it is in any other for profit industry.
I sit on the Dean's Advisory Councils of the Colleges of Health at two public universities in Florida. Both Colleges are led by extremely capable PhD nurses, and have a variety of programs that train students to be health professionals, including nurses.
A few months ago, I was startled when one of the Deans mentioned that her Nursing program had 500 qualified applicants for 132 student slots. In other words, at a time when the market wants her to gear up, she turns away 3 qualified applicants for each one she accepts. As it turns out, it's a national problem. In 2006, Colleges of Nursing turned away 43,000 qualified applicants.
It's not news that health care institutions face a critical nursing shortage. An April 2006 AHA report estimated that American hospitals currently need 118,000 RNs to fill vacancies. That number is expected to triple by 2020, to 340,000 vacancies.
What is less clear to most of us is exactly why the shortage exists. Most of the facts in this piece were drawn from an excellent presentation by Geraldine Polly Bednash, PhD RN. Dr. Bednash is the Executive Director of the American Association of Colleges of Nursing (AACN). AACN's site has a wealth of data on the problem, and the distinguished members of that association draw a VERY compelling picture of benign neglect of the training process by the sector it serves.
To read the full article click on this link. http://www.thehealthcareblog.com/the_health_care_blog/2007/08/why-do-we-have-.html
The comment below is posted by Nurse Advocate
Pay attention to the comments made at the bottom of the article. There are many good ideas posted there.
I believe that if all hospitals in a state or a group of states would work towards subsidizing the pay differential for nursing professors with the idea that a partnership would be formed between the universities and colleges the shortage could be solved or at very least improved. This however will require a commitment of money and it is my opinion that most hospitals are not interested in redesigning their staffing matrix to fit the higher acuity of our current patient type because it will decrease the all mighty profit margin associated with each patient or unit of service.
Think about it; If you increase the number of nurses you employ and reduce the ratios because you now have an adequate pool of nurses for the higher acuity patients, your profits fall!!
This is not in the best interest of the current for profit system of health care in America. We must mandate ratios according to acuity or a flat nurse to patient ratio plan. I believe that most bedside nurses and the unit level nurse managers want and do give the best care they can but they are not in control of the purse strings and those at the top owe their loyalty to the stockholders and the profit GOD. Don't be fooled into believing that greed and general business practices are not the dominating force of health care as it is in any other for profit industry.
Sunday, June 22, 2008
Lets Talk About Your Right To Talk.
This post is a plea to all who read it to consider the state of health care and our society at this time in our history and ask how we got here. Even if you believe that all is good and there is no need for reform, you should never stop exploring new ideas.
It is my opinion that the climate in our corporate culture has been very harsh to those that voice opposition to their position on a subject. Even if we disagree on the solutions to staffing issues, how continuing education for nurses should be handled, unions and the right to organize, floating, pay and benefits, overtime, and the way out of the nursing shortage aren't we better off by communicating on these issues than by creating an environment that fosters silence. When as Americans did we give up our rights to free speech and allow our employer to dictate what we think, who we speak to and ultimately what we believe.
This culture of suppression is an epidemic in health care across the nation and if things are to be improved it needs to be changed. We can never get to reform and solutions if nurses as the frontline providers of acute care services are denied their rights to advocate for needed reform. We are in the trenches every day and see first hand the failings of our current system and approach to the problems I identified in the first paragraph. What are the administrators afraid of? Give the public the respect to figure out the truth of the situation based on a free exchange of ideas and assessments from both sides of the issues.I believe that when you support a free exchange of ideas, even those that are different to your own, you promote positive change and empower people to work towards the betterment of our profession and we all win.
When you suppress information and discussion that is not in agreement with your own you create a breeding ground for discontent, frustration and ultimately we all lose. This method is not democratic is not fair and denies Americans of the basics of civil liberties as established by our Constitution. I believe our founding fathers recognized that if one side is able to dominate the discussion and the voice of dissent is silenced then we all suffer and that true progress is the victim.Please stand up and voice your concerns and opinions to your administrators, congressman, senators and the public as they have a right to know there is a problem. I am not alone in recognizing that there are many areas of health care that are broken. You have a responsibility to voice your concerns. Those that attempt to keep you silent will only be stopped when enough of us say enough.
It is my opinion that the climate in our corporate culture has been very harsh to those that voice opposition to their position on a subject. Even if we disagree on the solutions to staffing issues, how continuing education for nurses should be handled, unions and the right to organize, floating, pay and benefits, overtime, and the way out of the nursing shortage aren't we better off by communicating on these issues than by creating an environment that fosters silence. When as Americans did we give up our rights to free speech and allow our employer to dictate what we think, who we speak to and ultimately what we believe.
This culture of suppression is an epidemic in health care across the nation and if things are to be improved it needs to be changed. We can never get to reform and solutions if nurses as the frontline providers of acute care services are denied their rights to advocate for needed reform. We are in the trenches every day and see first hand the failings of our current system and approach to the problems I identified in the first paragraph. What are the administrators afraid of? Give the public the respect to figure out the truth of the situation based on a free exchange of ideas and assessments from both sides of the issues.I believe that when you support a free exchange of ideas, even those that are different to your own, you promote positive change and empower people to work towards the betterment of our profession and we all win.
When you suppress information and discussion that is not in agreement with your own you create a breeding ground for discontent, frustration and ultimately we all lose. This method is not democratic is not fair and denies Americans of the basics of civil liberties as established by our Constitution. I believe our founding fathers recognized that if one side is able to dominate the discussion and the voice of dissent is silenced then we all suffer and that true progress is the victim.Please stand up and voice your concerns and opinions to your administrators, congressman, senators and the public as they have a right to know there is a problem. I am not alone in recognizing that there are many areas of health care that are broken. You have a responsibility to voice your concerns. Those that attempt to keep you silent will only be stopped when enough of us say enough.
Friday, June 20, 2008
SUPERVISORS IN NAME ONLY
The Oakwood Decision and Labor Rights
Lewis Maltby
Linda Bennett never realized she was a manager. As a nurse in Oakwood Heritage Hospital in Taylor, Michigan, she had no ability to hire, fire, promote, or discipline other nurses. But because she was a “charge nurse”, who divided up the work that needed to be done on her shift, the National Labor Relations Board recently held that she was a “supervisor” and did not have the right to join the nurses’ union at her facility. She cannot negotiate collectively with other nurses over her pay and benefits, but must accept whatever management offers or quit. She won’t be protected from arbitrary termination; management can fire her at any time on a whim.
Bennett isn’t alone. Millions of other rank and file workers lost the right to join unions on October 3 when the National Labor Relations Board issued three decisions that classified them as supervisors. These decisions hold that any employee who is responsible for the work of another employee is a supervisor, and not protected by the National Relations Act, unless the work is completely routine. By this definition, every teacher with an aide, carpenter or welder with an apprentice, and executive secretary with an assistant in America is a supervisor. The Economic Policy Institute estimates that up to eight million Americans will lose the right to join a union under these decisions.
The Oakwood decision comes on the heels of other Board rulings that are divorced from reality. In a case involving Brown University, the Board held that graduate students who are paid for teaching college courses are not employees of the university. In other cases, it held that disabled workers who receive counseling as part of their compensation and models at art schools are not employees.
This isn’t fair and is not what Congress intended when it passed the National Labor Relations Act. As the Supreme Count stated in the Bell Aerospace case, Congress intended to distinguish between “real supervisors who have genuine management prerogatives” who are considered part of management and “minor supervisors” who are still workers themselves and are to be covered by the Act. The current National Relations Board, led by a majority of Bush Administration appointees, has forgotten this important mandate.
These rulings couldn’t have come at a worse time. Americans have watched their take home pay (adjusted for inflation) shrink for over a decade, despite soaring productivity and record corporate profits. Employers are also cutting back on medical benefits and eliminating pension plans. Employees with unions, while not immune to these problems, do far better. The average union member makes 20% more than employees with comparable jobs that don’t belong to a union. Union members are also far more likely to have employer-paid medical care and retirement plans. Taking away the right to organize denies workers their best opportunity to maintain a decent standard of living.
The Board needs to rethink its rulings in light of the Act’s fundamental objectives. If it can’t, or won’t, Congress needs to amend the National Labor Relations Act to correct these mistakes. At a time when real wages are declining and job security is becoming a thing of the past, the last thing the country needs are misguided rulings that deny employees the right to join a union.
The Oakwood Decision and Labor Rights
Lewis Maltby
Linda Bennett never realized she was a manager. As a nurse in Oakwood Heritage Hospital in Taylor, Michigan, she had no ability to hire, fire, promote, or discipline other nurses. But because she was a “charge nurse”, who divided up the work that needed to be done on her shift, the National Labor Relations Board recently held that she was a “supervisor” and did not have the right to join the nurses’ union at her facility. She cannot negotiate collectively with other nurses over her pay and benefits, but must accept whatever management offers or quit. She won’t be protected from arbitrary termination; management can fire her at any time on a whim.
Bennett isn’t alone. Millions of other rank and file workers lost the right to join unions on October 3 when the National Labor Relations Board issued three decisions that classified them as supervisors. These decisions hold that any employee who is responsible for the work of another employee is a supervisor, and not protected by the National Relations Act, unless the work is completely routine. By this definition, every teacher with an aide, carpenter or welder with an apprentice, and executive secretary with an assistant in America is a supervisor. The Economic Policy Institute estimates that up to eight million Americans will lose the right to join a union under these decisions.
The Oakwood decision comes on the heels of other Board rulings that are divorced from reality. In a case involving Brown University, the Board held that graduate students who are paid for teaching college courses are not employees of the university. In other cases, it held that disabled workers who receive counseling as part of their compensation and models at art schools are not employees.
This isn’t fair and is not what Congress intended when it passed the National Labor Relations Act. As the Supreme Count stated in the Bell Aerospace case, Congress intended to distinguish between “real supervisors who have genuine management prerogatives” who are considered part of management and “minor supervisors” who are still workers themselves and are to be covered by the Act. The current National Relations Board, led by a majority of Bush Administration appointees, has forgotten this important mandate.
These rulings couldn’t have come at a worse time. Americans have watched their take home pay (adjusted for inflation) shrink for over a decade, despite soaring productivity and record corporate profits. Employers are also cutting back on medical benefits and eliminating pension plans. Employees with unions, while not immune to these problems, do far better. The average union member makes 20% more than employees with comparable jobs that don’t belong to a union. Union members are also far more likely to have employer-paid medical care and retirement plans. Taking away the right to organize denies workers their best opportunity to maintain a decent standard of living.
The Board needs to rethink its rulings in light of the Act’s fundamental objectives. If it can’t, or won’t, Congress needs to amend the National Labor Relations Act to correct these mistakes. At a time when real wages are declining and job security is becoming a thing of the past, the last thing the country needs are misguided rulings that deny employees the right to join a union.
Friday, June 13, 2008
Depressed
There was a great presentation on the Bill Moyer Journal tonight that examined the demise of the middle class and the obscene growth of the wealthy. I have posted the link to his blog that in a day or two will feature the entire video as presented tonight. http://www.pbs.org/moyers/journal/index-flash.html
I titled the post depressed because the subject matter is down right depressing. When you think that so many hard working Americans will never reach the American dream and so many others will have it snatched out from under them due to the rising cost and inequalities of health care and the economy in general and the stagnation of wages.
Our government, our corporations and our leaders are letting us all down. We need to take control back. Please vote your conscious this election year. Get involved!!!
I titled the post depressed because the subject matter is down right depressing. When you think that so many hard working Americans will never reach the American dream and so many others will have it snatched out from under them due to the rising cost and inequalities of health care and the economy in general and the stagnation of wages.
Our government, our corporations and our leaders are letting us all down. We need to take control back. Please vote your conscious this election year. Get involved!!!
Tuesday, June 3, 2008
The Health Care Crisis, Part I
This video presentation by The Pinky Show does an excellant job of presenting the facts about our managed care system and the need for reform. Please view this video and forward it on to your friends and fellow nurses. I will post the second part when it becomes available. I will also post a link to the pinky show web site on our links to the right of this post.
Monday, June 2, 2008
MSN Story on how to fix health care.
Take a look at this story and videos by MSN on health care. The proposals made are moderate and would go a long way to improving our current health care system. Here is the link http://articles.moneycentral.msn.com/Investing/HomeMortgageSavings/HowToFixHealthCare.aspx
Thursday, May 29, 2008
The U.S. compared to other nations health care systems
This is a copied article from Nurse Connect by Jennifer Decker Arevalo.
I found this to be very balanced in it's presentation and facts. I believe it better to show the article in its entirety rather than excerpts.
This article supports my position that we are in need of reform in the US. The money we spend is not providing the care we deserve or have paid for. We are getting ripped off and should demand more. The world has provided us templets to adopt and creat a fair and effective health care system. Get away from the idea of adopting one system from another nation but the idea that we can take the best pieces from the other nations of the world to provide our citizens the best in the world. We must however take profit out of the equation our we will fail. Our goal should be to be fiscaly balanced and to provide the best care.
I hope you read the entire article below and think about why we rank so poorly when compared to other nations despite the fact that we pay twice as much per patient as any other country.
Review by Nurse Advocate.
Article by:
Jennifer Decker Arevalo, MA, contributor
When it comes to issues, such as affordability, access, care coordination and patient safety how does the U.S. stack up against other countries? Not so good, according to the Commonwealth Fund's 10th International Health Policy Survey released in October 2007.
Results from a Harris Interactive survey of 12,000 adults in Australia, Canada, Germany, New Zealand, the United Kingdom, the United States and for the first time, the Netherlands, were published as a Health Affairs Web Exclusive, entitled Toward Higher-Performance Health Systems: Adults’ Health Care Experiences in Seven Countries.
Thirty-four percent of American adults indicated that the U.S. health care system needed to be rebuilt completely; this rate was higher than in any of the other six countries. Although there is no perfect health care system, much can be learned from the innovations and strengths of other countries and then considered for transferability to the U.S.
Affordability
According to senior vice president for Research and Evaluation and study co-author, Cathy Schoen, in the Commonwealth Fund’s website presentation, “U.S. adults are the most likely to go without care because of costs.”
Thirty-seven percent reported that they skipped medications, did not visit a doctor when they got sick or did not get recommended care because of financial reasons, compared to people from Canada, the Netherlands and the U.K., who were the least likely to skip care because they could not afford it. This may directly correlate to the 47 million Americans who lack health insurance coverage, unlike citizens of the other six countries who have some type of universal health coverage.
“In the U.S., both the insured and uninsured population reported out-of-pocket medical costs as high as $1,000,” said Schoen in the web cast. “Such high out-of-pocket expenses were rare in other countries.”
Only five and four percent of adults in the Netherlands and the U.K., respectively, paid over $1,000 in the past year compared to 30 percent of Americans, 19 percent of Australians and 12 percent of Canadians.
Nearly one-fifth (19 percent) of U.S. adults had trouble paying medical bills; this was more than double the rate of the next highest country.
Access
Schoen also stated in the website presentation that, “US and Canadian adults were the least likely to report rapid access to seeing a doctor in their community when they got sick.”
For same day appointments, 30 percent of Americans and 22 percent of Canadians had quick access, compared to 50 percent or more of Germans, Dutch and New Zealanders. In the U.S., Canada and Australia, over two-thirds of those surveyed reported difficulty getting care on nights, weekends or holidays.
“The Netherlands reported the least difficulty in getting after hours care,” added Schoen, most probably due to nurses and physicians who staff phone banks to provide assistance.
Care Coordination
Across all seven countries, only 50 to 60 percent of adults had access to a “medical home,” as determined by the following criteria: the physicians and staff knew a patient’s medical history, were available by phone during office hours and coordinated a patient’s care with other providers.
“The vast majority reported having a regular doctor and source of primary care where the staff knew information about their medical history,” said Schoen. “However, this percentage dropped off and varied by country when asked about access, that is how easy and quickly it was to get in. It dropped off even more when asked about coordination of care.”
“In all of the countries, patients with a medical home were the least likely to report problems with coordination of care and the most likely to report that information had flowed well and that their primary care physician had helped them to find the right specialist,” continued Schoen in the web cast.
However, for patients without medical homes, 23 percent of U.S. adults stated that either test results were unavailable at the appointment time or doctors ordered duplicate tests; 19 percent of Germans and 18 percent of Australians reported similar problems.
Across all seven countries, patients in medical homes had more: positive care experiences, time spent with their doctor, and involvement in their care decision.
Patient-centered care is a key element of medical homes. “Across all countries, three out of four patients with a medical home said their doctor provided these key elements of patient-centered care,” said vice president and director of International Program in Health Policy and Practice and study co-author, Robin Osborn, during the website presentation. “This was 20 to 30 percent higher than for those without a medical home.”
“It is critical for patients with chronic medical conditions to have a medical home, as they see multiple providers, take multiple medications, are at higher risk for hospital or emergency room admissions and are at greatest risk for poor handoffs between providers and settings of care,” continued Osborn. “This is the most vulnerable population in the health care system; vulnerable to system shortfalls in coordination of care.”
Patients with medical homes were less likely to report medical errors and the study authors believe that regardless of the type of health system patients have, medical homes improve patient safety and satisfaction, as well as efficiency and care coordination.
Patient Safety
Out of all seven countries, adults in the U.S. reported the highest rates of lab test errors and some of the highest rates of medical or medication errors. Patients with multiple doctors or chronic illnesses experienced most of the reported errors, across the board.
“Combining medical and medication errors, as well as diagnostic test errors, one in five patients in Australia and the U.S. experienced an adverse event,” said Osborn. “This is stunning given that it was a general population sample. As you might expect, the rates went up dramatically with patients’ medical complexity.”
Thirty-two percent of U.S. patients with two or more chronic conditions reported a medical, medication or lab test error in the past two years, compared with 28 percent of patients in Canada, 26 percent in Australia and fewer patients in the other countries. Among adults with multiple chronic conditions, error rates were lowest in Germany, at 16 percent, according to the study authors.
“Country patterns reflect striking differences in policy,” summarized Osborn. “Universal coverage matters for access, quality and equity, as does benefit design. Across all seven countries, the survey underscored the pressing need to develop more system integration. Most compelling, there was overwhelmingly strong public support for designing the health care system around the medical home.”
I found this to be very balanced in it's presentation and facts. I believe it better to show the article in its entirety rather than excerpts.
This article supports my position that we are in need of reform in the US. The money we spend is not providing the care we deserve or have paid for. We are getting ripped off and should demand more. The world has provided us templets to adopt and creat a fair and effective health care system. Get away from the idea of adopting one system from another nation but the idea that we can take the best pieces from the other nations of the world to provide our citizens the best in the world. We must however take profit out of the equation our we will fail. Our goal should be to be fiscaly balanced and to provide the best care.
I hope you read the entire article below and think about why we rank so poorly when compared to other nations despite the fact that we pay twice as much per patient as any other country.
Review by Nurse Advocate.
Article by:
Jennifer Decker Arevalo, MA, contributor
When it comes to issues, such as affordability, access, care coordination and patient safety how does the U.S. stack up against other countries? Not so good, according to the Commonwealth Fund's 10th International Health Policy Survey released in October 2007.
Results from a Harris Interactive survey of 12,000 adults in Australia, Canada, Germany, New Zealand, the United Kingdom, the United States and for the first time, the Netherlands, were published as a Health Affairs Web Exclusive, entitled Toward Higher-Performance Health Systems: Adults’ Health Care Experiences in Seven Countries.
Thirty-four percent of American adults indicated that the U.S. health care system needed to be rebuilt completely; this rate was higher than in any of the other six countries. Although there is no perfect health care system, much can be learned from the innovations and strengths of other countries and then considered for transferability to the U.S.
Affordability
According to senior vice president for Research and Evaluation and study co-author, Cathy Schoen, in the Commonwealth Fund’s website presentation, “U.S. adults are the most likely to go without care because of costs.”
Thirty-seven percent reported that they skipped medications, did not visit a doctor when they got sick or did not get recommended care because of financial reasons, compared to people from Canada, the Netherlands and the U.K., who were the least likely to skip care because they could not afford it. This may directly correlate to the 47 million Americans who lack health insurance coverage, unlike citizens of the other six countries who have some type of universal health coverage.
“In the U.S., both the insured and uninsured population reported out-of-pocket medical costs as high as $1,000,” said Schoen in the web cast. “Such high out-of-pocket expenses were rare in other countries.”
Only five and four percent of adults in the Netherlands and the U.K., respectively, paid over $1,000 in the past year compared to 30 percent of Americans, 19 percent of Australians and 12 percent of Canadians.
Nearly one-fifth (19 percent) of U.S. adults had trouble paying medical bills; this was more than double the rate of the next highest country.
Access
Schoen also stated in the website presentation that, “US and Canadian adults were the least likely to report rapid access to seeing a doctor in their community when they got sick.”
For same day appointments, 30 percent of Americans and 22 percent of Canadians had quick access, compared to 50 percent or more of Germans, Dutch and New Zealanders. In the U.S., Canada and Australia, over two-thirds of those surveyed reported difficulty getting care on nights, weekends or holidays.
“The Netherlands reported the least difficulty in getting after hours care,” added Schoen, most probably due to nurses and physicians who staff phone banks to provide assistance.
Care Coordination
Across all seven countries, only 50 to 60 percent of adults had access to a “medical home,” as determined by the following criteria: the physicians and staff knew a patient’s medical history, were available by phone during office hours and coordinated a patient’s care with other providers.
“The vast majority reported having a regular doctor and source of primary care where the staff knew information about their medical history,” said Schoen. “However, this percentage dropped off and varied by country when asked about access, that is how easy and quickly it was to get in. It dropped off even more when asked about coordination of care.”
“In all of the countries, patients with a medical home were the least likely to report problems with coordination of care and the most likely to report that information had flowed well and that their primary care physician had helped them to find the right specialist,” continued Schoen in the web cast.
However, for patients without medical homes, 23 percent of U.S. adults stated that either test results were unavailable at the appointment time or doctors ordered duplicate tests; 19 percent of Germans and 18 percent of Australians reported similar problems.
Across all seven countries, patients in medical homes had more: positive care experiences, time spent with their doctor, and involvement in their care decision.
Patient-centered care is a key element of medical homes. “Across all countries, three out of four patients with a medical home said their doctor provided these key elements of patient-centered care,” said vice president and director of International Program in Health Policy and Practice and study co-author, Robin Osborn, during the website presentation. “This was 20 to 30 percent higher than for those without a medical home.”
“It is critical for patients with chronic medical conditions to have a medical home, as they see multiple providers, take multiple medications, are at higher risk for hospital or emergency room admissions and are at greatest risk for poor handoffs between providers and settings of care,” continued Osborn. “This is the most vulnerable population in the health care system; vulnerable to system shortfalls in coordination of care.”
Patients with medical homes were less likely to report medical errors and the study authors believe that regardless of the type of health system patients have, medical homes improve patient safety and satisfaction, as well as efficiency and care coordination.
Patient Safety
Out of all seven countries, adults in the U.S. reported the highest rates of lab test errors and some of the highest rates of medical or medication errors. Patients with multiple doctors or chronic illnesses experienced most of the reported errors, across the board.
“Combining medical and medication errors, as well as diagnostic test errors, one in five patients in Australia and the U.S. experienced an adverse event,” said Osborn. “This is stunning given that it was a general population sample. As you might expect, the rates went up dramatically with patients’ medical complexity.”
Thirty-two percent of U.S. patients with two or more chronic conditions reported a medical, medication or lab test error in the past two years, compared with 28 percent of patients in Canada, 26 percent in Australia and fewer patients in the other countries. Among adults with multiple chronic conditions, error rates were lowest in Germany, at 16 percent, according to the study authors.
“Country patterns reflect striking differences in policy,” summarized Osborn. “Universal coverage matters for access, quality and equity, as does benefit design. Across all seven countries, the survey underscored the pressing need to develop more system integration. Most compelling, there was overwhelmingly strong public support for designing the health care system around the medical home.”
Thursday, May 22, 2008
The Status Quo
Recently I was having a conversation with a nurse on my unit about Ted Kennedy and his diagnosis of brain cancer. The comment I made was that when they thought he had a stroke he was air lifted to the best hospital in Massachusetts. I commented that we all deserve that level of response and care when or if we ever have an event like that. I went on to state that there should not be class care in this country and that we all deserve to be treated with the best available care.
She responded that I needed to accept that there is a class system and it exist every where and that it will never change. I accept the statement as fact but reject the notion that I should accept it as ethical or moral practice. Furthermore I believe that my professional ethics require me to fight against class care and demand that all patients and people regardless of their circumstances or economic or social position in life places them. With that said we won't change the minds of the world that some are entitled to more because of the size of their wallets or the family to which they were born but we can work on changing the minds of nurses that this concept should not apply to health care.
What is the value of human life. Are you more or less valuable than Kennedy or me or anyone for that matter? Should your ability to pay be part of the treatment process?
Please think about those you have seen in your careers that have lived and died and ask if there have ever been patients who might have survived if they had the money to afford better care. The question is not meant to imply that your facility or you made the choice to give bad care or neglect the patient but would more options have been pursued if the money for those treatments had been available. With that said, health care is one area where we should not have a first class and coach.
I hope you will comment on this post and share your comments about this subject.
She responded that I needed to accept that there is a class system and it exist every where and that it will never change. I accept the statement as fact but reject the notion that I should accept it as ethical or moral practice. Furthermore I believe that my professional ethics require me to fight against class care and demand that all patients and people regardless of their circumstances or economic or social position in life places them. With that said we won't change the minds of the world that some are entitled to more because of the size of their wallets or the family to which they were born but we can work on changing the minds of nurses that this concept should not apply to health care.
What is the value of human life. Are you more or less valuable than Kennedy or me or anyone for that matter? Should your ability to pay be part of the treatment process?
Please think about those you have seen in your careers that have lived and died and ask if there have ever been patients who might have survived if they had the money to afford better care. The question is not meant to imply that your facility or you made the choice to give bad care or neglect the patient but would more options have been pursued if the money for those treatments had been available. With that said, health care is one area where we should not have a first class and coach.
I hope you will comment on this post and share your comments about this subject.
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
greatnurses.com
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 afeduprn@aol.com.
Guest Post by Laura Gasparis Vonfrolio RN, PhD
greatnurses.com
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 afeduprn@aol.com.
Wednesday, May 14, 2008
Another nurse week has come and gone.
Another nurses week has come and gone and we are still looking at the same problems that faced our profession last year and the year before that. Things are better these days at my particular facility but will it last? If the past holds any prediction for the future I would say no. Once budgets are analyzed and the meetings are held things will creep back to the norm of short staffing with high ratios and unsafe conditions. I at the moment am fortunate but have not forgotten that there are real problems that are facing our profession and that for the most part are not being delt with by our trusted administrators, universities and goverment.
I titled this post nurses week to expose the bribe, although admittedly a small one, that the trinkets, bobbles and food they give us in the name of celebrating our profession and work is meerly a distraction and a bribe. They are avoiding the hard and expensive solution to the real problems that face our profession and the health care industry as a whole. I see thier hallow actions as an insult and do not participate in the game.
If the moneys from all the little parties and socials that were held all over the country this last week were pooled and used for scholarships or for the building of a new nursing program at a university or the hiring of an additional nurse educator or more ancillary staff to assist with patient care then you could say your work was being respected. These measures would take commitment and a larger acknowledgment that their is a problem. But pizza, ice cream, cookies and other door prizes are cheap and fun and isn't that what we are really all about!
We are a caring profession but more accurately we are a highly skilled analytical profession that save peoples lives on a regular basis. Until we accept that and demand the respect we are entitled to we will not get it from our administrators or politicians. Show me you respect me with better working conditions, better equipment to aid me in my care, better pay, better benefits and education and keep your door prizes and cake and ice cream.
Join me in the future by asking your leaders and administrators to keep their parties and the trinkets and bobbles and to create a scholarship or put that money into something constructive and lasting for our profession.
I titled this post nurses week to expose the bribe, although admittedly a small one, that the trinkets, bobbles and food they give us in the name of celebrating our profession and work is meerly a distraction and a bribe. They are avoiding the hard and expensive solution to the real problems that face our profession and the health care industry as a whole. I see thier hallow actions as an insult and do not participate in the game.
If the moneys from all the little parties and socials that were held all over the country this last week were pooled and used for scholarships or for the building of a new nursing program at a university or the hiring of an additional nurse educator or more ancillary staff to assist with patient care then you could say your work was being respected. These measures would take commitment and a larger acknowledgment that their is a problem. But pizza, ice cream, cookies and other door prizes are cheap and fun and isn't that what we are really all about!
We are a caring profession but more accurately we are a highly skilled analytical profession that save peoples lives on a regular basis. Until we accept that and demand the respect we are entitled to we will not get it from our administrators or politicians. Show me you respect me with better working conditions, better equipment to aid me in my care, better pay, better benefits and education and keep your door prizes and cake and ice cream.
Join me in the future by asking your leaders and administrators to keep their parties and the trinkets and bobbles and to create a scholarship or put that money into something constructive and lasting for our profession.
Saturday, May 10, 2008
A look at health care by Bill Moyer of PBS
This video is a must see. http://www.pbs.org/moyers/journal/05092008/watch.html The evidence is clear and supported by facts that our current health care system is broken. This video looks at the CNA and their efforts to reform our health care system. The argument is that all Americans are entitled, (yes I said it entitled), to quality health care.
I believe that health care is a basic human right and that the basis of this countries morals and ethics are based on helping those less fortunate than ourselves without regard to their beliefs. I also believe that in order for our country and economy to be strong we have to be healthy as a people.
The act of providing emergency care when people are at their most critical but not the care to avoid getting to deaths door is negligent and inefficient. The sysytem cost the American people Millions of dollars every day. Every time a person due to lack of insurance or the funds to afford medications or routine medical care ends up in our ER's or ICU or the floors for that matter cost every person in the form of higher insurance premiums, more expensive cost of services, higher drug cost ect. The hospitals, insurance companies, drug companies all document millions in charity care however they also regularly increase the cost of their services to recover the losses they incure with that charity care. So I ask you is it really charity? I say yes but we are the ones providing it. So with that said I think it would be much more efficiant and cost effective to cut out the middle man and provide universal single payer coverage to all Americans. We are paying for it any way.
My premiums that I currently pay to Aetna along with your premiums and the premiums paid by the employeers would go to providing coverage for all. The sysytem in the end would cost us all less. Do your reserch and look at the cost of our system compared to that of other nations. We are not getting our moneys worth in our current system and we all need to become better consumers and demand that profit be removed from health care and that we get what we are all paying for.
Do your own research and examine the profits posted by the big insurance companies and health care corporations. Look at the salaries of the CEO's who run those companies and remember that they earn their money by increasing profit for the company which means denial of claims and services. Trimming the "fat" which in most instances is the lay off of staff that provide care is another way profits are increased. Nurses demands for safe ratios are fought because the more patients each nurse provides care for at one time increases profit by reducing the staffing budget. Don't be fooled, profit is king and you and I are only valued as long as we are making that profit. But don't forget that they can not operate without us. We hold all the power to influence change as long as we act toghter. Join me in this cause and take some kind of action now.
I believe that health care is a basic human right and that the basis of this countries morals and ethics are based on helping those less fortunate than ourselves without regard to their beliefs. I also believe that in order for our country and economy to be strong we have to be healthy as a people.
The act of providing emergency care when people are at their most critical but not the care to avoid getting to deaths door is negligent and inefficient. The sysytem cost the American people Millions of dollars every day. Every time a person due to lack of insurance or the funds to afford medications or routine medical care ends up in our ER's or ICU or the floors for that matter cost every person in the form of higher insurance premiums, more expensive cost of services, higher drug cost ect. The hospitals, insurance companies, drug companies all document millions in charity care however they also regularly increase the cost of their services to recover the losses they incure with that charity care. So I ask you is it really charity? I say yes but we are the ones providing it. So with that said I think it would be much more efficiant and cost effective to cut out the middle man and provide universal single payer coverage to all Americans. We are paying for it any way.
My premiums that I currently pay to Aetna along with your premiums and the premiums paid by the employeers would go to providing coverage for all. The sysytem in the end would cost us all less. Do your reserch and look at the cost of our system compared to that of other nations. We are not getting our moneys worth in our current system and we all need to become better consumers and demand that profit be removed from health care and that we get what we are all paying for.
Do your own research and examine the profits posted by the big insurance companies and health care corporations. Look at the salaries of the CEO's who run those companies and remember that they earn their money by increasing profit for the company which means denial of claims and services. Trimming the "fat" which in most instances is the lay off of staff that provide care is another way profits are increased. Nurses demands for safe ratios are fought because the more patients each nurse provides care for at one time increases profit by reducing the staffing budget. Don't be fooled, profit is king and you and I are only valued as long as we are making that profit. But don't forget that they can not operate without us. We hold all the power to influence change as long as we act toghter. Join me in this cause and take some kind of action now.
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