Tag: Nursing

Nurseanomics

Apr 22, 2010• 62

By MAGGIE MAHAR

Twenty-eight states are now engaged in a heated debate over the difference between a doctor and a nurse: Legislators in these states are considering whether they should let a nurse practitioner (NP) with an advanced degree provide primary care, without having an M.D. looking over her shoulder. To say that the proposal has upset some physicians would be an understatement. Consider this comment on “Fierce HealthCare”:

“An NP has mostly on the job training…they NEVER went to a formal hard-to-get into school like medical school,” wrote one doctor.

“I have worked with NPs before, and their basic knowledge of medical science is extremely weak. They only have experiential knowledge and very little of the underpinning principles. It would be like allowing flight attendants to land an airplane because pilots are too expensive. HEY NURSIE, IF YOU WANT TO WORK LIKE A DOCTOR…THEN GET YOUR BUTT INTO MEDICAL SCHOOL AND THEN DO RESIDENCY FOR ANOTHER 3-4 YEARS. NO ONE IS PREVENTING YOU IF YOU COULD HACK IT!” [his emphasis]

Fortunately, not all physicians exhibit the same degree of rancor. Some support the movement. Another reader notes the commenter’s emphasis on just how brutal med school can be: “The anger reflected in the previous comments reveals not only the writers’ ignorance of scholastic achievement required of Nurse Practitioners, but mainly their fear that NPs will not be under physicians’ control…Many older doctors’ schooling and experience was conducted in punitive ways, sacrificing self esteem. It seems that anything less, isn’t sufficient.”

Commentology: Dear Mr. Angry

Mar 30, 2010• 2

THCB reader CARISSA PILLOW, an RN, is one of many readers who objected to the tone of the satirical post “Let’s Pay Nurses Minimum Wage.” Carissa writes:

“Dear Mr. Angry, I just wanted to take a moment to express my sincere disappointment. Yep, I’m a nurse. Yep, I got it, you were trying to be funny, with some witty satire. Yep, I see that you were trying to point out how backwards it is to pass legislation “outsourcing” nursing. But, by making a funny funny post, what you did was perpetuate the ongoing misconception of what a nurse does. You describe nurses as a group of butt wiping, overpaid babysitters with skills the equivalent of retail clerks. And while yes, in my 13 years of nursing experience I have done my fair share of butt wiping and babysitting, my daily work involves so very much more than the public understands. So let me clarify my job description for you and for the American public that you have misinformed. In my career I have: Sat by a patient as the only person in the room while they met their maker, and provided dignified post mortem care for them; Given a 40 year old wife the news that her husband had suffered a massive heart attack and was recovering from a cardiac cath procedure that saved his life for the third time; Told a hospitalist the orders that she needed to write for a patient suffering from Diabetic Ketoacidosis; Helped countless doctors sort through the diagnostics on their patients and helped make critical decisions in their patients’ care; Provided critical information to doctors during their patients’ sudden onset of cardiac dysrhythmias; Run countless codes; Prayed with families and patients prior to some very frightening surgeries; Packed countless gaping abdomenal wounds; Given countless doses of Morphine, Zofran and Insulin; Spotted critical errors and omissions in care and brought them to the attention of the doctor responsible for immediate correction; Informed families of impending brain death of their loved ones; Continue reading…

No Country For Young Nurses

Feb 19, 2010• 34

By OLGA KHAZAN

The nursing profession takes a certain dedication to love. After all, most office jobs don’t involve standing for 12 hours at a time, scarfing a bite of lunch between “clients” or handling gallons of bodily fluids on a daily basis. But for years, nursing schools lured students with the promise that they would be snapped up by prestigious hospitals upon graduation, remunerated for their hard work with good pay and enviable job security.

And they were right – until now, that is.

It’s a paradox straight out of “Freakonomics:” Even though California still faces a shortage of nurses, up to 40 percent of nursing school graduates will be unable to find jobs, according to the California Institute for Nursing and Health Care.

The recession set off a domino effect that has caused California hospitals to virtually stop hiring newly-minted nurses. The Institute estimates only half as many nurses will be hired this year as in 2008.

It’s all thanks to Botox, healthcare reform and other people’s husbands.Continue reading…

Nurse Practitioners – Doctors?

Jan 14, 2010• 518

By Barbara Ficarra, RN, BSN, MPA

Doctors like to assert, maintain control and continuously patrol over their territories; at least some do. In a recent post on THCB, “Nurseanomics” by Maggie Mahar addresses the heated debate over the difference between a doctor and a nurse. Mahar takles the question that Legislators in twenty-eight states are dealing with. Should a nurse practitioner (NP) with an advanced degree provide primary care, without an M.D. being in charge? But another pressing question that needs to be addressed is: Should nurse practitioners be called doctors (DNP)? (DNP is a Doctor of Nursing Practice.) That is the question that I will address here. I reached out to the medical community to get their reaction. It’s not surprising that the immediate response of some doctors when asked if nurse practitioners should be called doctors (DNP) is “No!” evidenced by Dr. Stangl’s comment.

“NO! Nurse practitioners should NOT be called “doctors” because they are NOT! While many NPs do an excellent job of handling certain types of problems in certain settings, they do not have near the depth or length of education that physicians do and should be credited for what they Do have, which is their nursing background and expertise.” Susan Stangl, MD

Take a look at this comment that appears in THCB:

“An NP has mostly on the job training…they NEVER went to a formal hard-to-get into school like medical school,” wrote one doctor. “I have worked with NPs before, and their basic knowledge of medical science is extremely weak. They only have experiential knowledge and very little of the underpinning principles. It would be like allowing flight attendants to land an airplane because pilots are too expensive. HEY NURSIE, IF YOU WANT TO WORK LIKE A DOCTOR…THEN GET YOUR BUTT INTO MEDICAL SCHOOL AND THEN DO RESIDENCY FOR ANOTHER 3-4 YEARS. NO ONE IS PREVENTING YOU IF YOU COULD HACK IT![his emphasis]”

Continue reading…

Welcoming immigrants and robots to fill the nursing shortage

Dec 30, 2009• 36

By DAVID E. WILLIAMS

David E Williams

In a report this week, Nursing crisis looms as baby boomers age, CNN Money repeats a well-known story: there are unlikely to be enough nurses to take care of people as they age. Nursing schools can’t keep up with the demand and trouble awaits. We’ll face a shortage of 260,000 RNs by 2025, we’re told.

I don’t really believe it’s such a big deal.

There are two good solutions to the problem, and they aren’t mutually exclusive:

Increase the recruitment of nurses from abroad
Substitute technology for laborContinue reading…

After Nurses Investigation, Scrutiny Turns to Other California Health Boards

Jul 24, 2009• 4

By ALEXANDRA ANDREWS Nurse_computer_flickr_20090721

Earlier this month, ProPublica and the Los Angeles Times published an investigation detailing the failure of the California Board of Registered Nursing to investigate and discipline nurses accused of misconduct in a timely manner. An examination of all disciplinary cases from 2002 to 2008 found that the board took an average of more than three years to investigate and close them — while the nurses accused of wrongdoing continued to practice without restriction. The day after the story was published, Gov. Arnold Schwarzenegger replaced most members of the board, and its longtime executive officer resigned the day after that.

The fallout has continued. There have been a slew of follow-up editorials and articles in California newspapers. One, in the Los Angeles Times, said of the governor's response: "This time, he acted to protect patients, but where was the gubernatorial outrage when the state Board of Chiropractic Examiners, which included several of Schwarzenegger's friends, was accused in a state audit of similar failures to put consumers first?"

Another, in the San Francisco Chronicle, suggested that "Schwarzenegger shares a measure of blame too: his imposed work furloughs will slow investigations, and his administration should have been on the problem earlier."

Schwarzenegger replaces most of state nursing board

Jul 14, 2009• 5

By TRACY WEBER AND CHARLES ORNSTEIN

Gov. Arnold Schwarzenegger replaced most members of the California
Board of Registered Nursing on Monday, citing the unacceptable time it takes to discipline nurses accused of egregious
misconduct.

He fired three of six sitting board members – including President
Susanne Phillips – in two-paragraph letters curtly thanking them for
their service. Another member resigned Sunday. Late Monday, the governor's
administration released a list of replacements.

The shake-up came a day after the Los Angeles Times and ProPublica published an investigation finding that it takes the board, which oversees 350,000 licensees, an average
of three years and five months to investigate and close complaints against
nurses.

During that time, nurses accused of wrongdoing are free to
practice – often with spotless records – and move from hospital to
hospital. Potential employers are unaware of the risks, and patients have been
harmed as a result.

Head of Investigations Unit Resigns

Jul 10, 2009

Dca-logo BY TRACY WEBER

The head of investigations for California’s Department of Consumer Affairs has resigned, continuing the fallout from a Los Angeles Times – Propublica investigation into lengthy delays in disciplining nurses accused of egregious misconduct.

According to a spokeswoman for the California State and Consumer Service Agency, the decision by Lynda Swenson to quit was tied to revelations by The Los Angeles Times and ProPublica about problems at the Board of Registered Nursing. Most investigations of errant nurses are handled by the Division of Investigation, which Swenson headed.

Op-Ed: No Need for Alarm Over Need for Foreign Nurses

Apr 9, 2009• 22

By MICK WHITLEY

Recent news coverage (“Amid Nation’s Recession,
More Than 200,000 Nursing Jobs Go Unfilled,” Reuters, March 8th) validly
and vividly calls attention to a nursing shortage in the U.S. healthcare system that
“threatens the quality of patient care even as tens of thousands of
people are turned away from nursing schools, according to experts.”

That article adds, “The shortage has drawn the
attention of President Barack Obama. During a White House meeting on Thursday
to promote his promised healthcare system overhaul, Obama expressed alarm over
the notion that the United States
might have to import trained foreign nurses because so many U.S. nursing jobs are
unfilled.”

Importing internationally-trained nurses is no cause for
alarm. The fact is, at least in the short term, the U.S.does have to
import these nurses, and plenty more of them, if we are to meet our rapidly
growing healthcare needs. Don’t understand why? Consider the
following:

Op-Ed: Let’s Pay Nurses Minimum Wage!!

Apr 5, 2009• 114

By ANGRY AMERICAN

Every morning I wake up and thank God that we still have some Republicans in Congress. Representative John Shadegg (R) from Arizona, is one of those blessings. He has introduced a bill in Congress called the Nursing Reform Act of 2009. The bill calls for increasing work visas for foreign nurses (and their spouses). When passed, it will eliminate the nursing shortage!

This bill is great on so many levels. For one, everyone knows that healthcare is costing us an arm and a leg (pun intended). The biggest causes are obviously nurses and nursing unions. Nurses are way overpaid, but unfortunately the healthcare corporations have not been able to break the nursing unions because of the shortage of nurses. By bringing in lots of foreigners, they can flood the market with labor, break the unions, and get nursing salaries down to where they belong — somewhere around what retail pays. If only there weren’t that law capping the number of foreign nurses we allow in the country… As a side benefit, the bill allows for nurses’ spouses to get unrestricted work visas as well, so it will help bring down salaries in all sorts of other industries as well!

The true brilliance of this bill (thank you Mr. Shadegg!) is in the way it is written. It doesn’t bring them all in at once. It starts out with 50,000 new visas the first year, which is a low enough number that people will “buy it” and the bill can get passed. Supporters of the bill have had to go to great lengths to say that nursing salaries will be unchanged, which of course will be true at first. However, the genius in the bill (evil grin) is that the number of allowable visas automatically goes up 20% per year, so it will be 60,000 visas in year two, 72,000 visas in year three, 86,400 visas by year four, 103,680 by year five, and a whopping 124,416 by year six! The bill states that “According to the Department of Labor, the current national nursing shortage exceeds 126,000.” Therefore, the nursing shortage will be solved in about six short years, and healthcare companies can get back to earning the kind of money they deserve! Incidentally, this is just the approach that was so successful in cutting the salaries earned by information technology workers about 10 years ago. Corporate profits were getting impacted by high IT costs, so our brilliant Congress increased the number of H1-B visas, and companies were able to hire cheap workers from India and other places. Thank you, Congress! Later, many of these foreign workers returned to their homelands and brought the work with them. Now, corporate America doesn’t have to pay high salaries, and they don’t even have to look at the foreigners anymore — they can just write a little check to India. Bravo! Fortunately, information technology salaries have never rebounded to the levels where they were.