The Nursing Shortage: Part II - The Dialogue Continues
Barbara Ficarra, RN, BSN, MPA Host/Producer of Health in 30™ continues the series on “The Nursing Shortage: Part II – The Dialogue Continues”. Barbara sat down for a straightforward interview with leading nursing experts. Joining Barbara were Diana Mason, Editor-in-Chief of the American Journal of Nursing and Ruth Amos, a registered nurse at Sharp Mary Birch Hospital in San Diego, California in the Neonatal Intensive Care Unit and medical litigation attorney.
The solution to global nursing shortage seems very simple; we need to hire more nurses. In reality, the issue is far more complex, ranging from the negative portrayal of nurses by the media to the budgetary constraints placed upon our hospitals by a variety of factors such as insurance reimbursement and drug costs. Join Barbara and her distinguished panel of guest experts as they discuss this complex issue.
Diana J. Mason, RN, PhD, FAAN, is editor-in-chief of the American Journal of Nursing, the oldest and largest circulating nursing journal in the world. She is the project director for a print and video series on nursing care of older adults funded by two grants from the Atlantic Philanthropies; a print series on chronic kidney disease funded by the National Kidney Foundation; and series on palliative nursing funded by the Robert Wood Johnson Foundation.
Under her leadership, the journal has received numerous awards including the Clarion Award (Association for Women in Communications) for Best Overall External Magazine (circulation of 100,000 to 500,000) in 2003, Best Regular Editorial for 2003 and 2005, and best feature series for 2006; the 2004 Publication Management Magnum Opus Gold Award and Sigma Theta Tau’s Pinnacle Award (Nursing Print Media) for the Palliative Nursing series; and awards for public dissemination of its work from the American Academy of Nursing and Sigma Theta Tau International Nursing Honorary Society.
Since 1986, she has been one of the producers and moderators of “Healthstyles”, a weekly, live radio program in New York City that focuses on personal health, health care, and health policy. The program has received media awards from the State of New York, Public Health Association of New York City, American Academy of Nursing, and the National Association of Child birthing Centers. She was the project director for the WBAI-Global Kids’ Sound Partners for Community Health Initiative, a program funded by the Benton and Robert Wood Johnson Foundations to train New York City youth in producing radio programs about preventing teen substance abuse.
Dr. Mason is the co-editor of the award-winning book, Policy and Politics in Nursing and Health Care; now in its fourth edition. As a researcher, she published a series of studies about managed care arrangements with nurse practitioners, as well as studies of human rhythms in health and illness.
Dr. Mason is the recipient of numerous awards and honors, including an Honorary Doctorate of Humane Letters from Long Island University; fellowship in the American Academy of Nursing, the New York Academy of Medicine, the West Virginia University Academy of Distinguished Alumni; and the Pioneering Spirit Award from the American Association of Critical Care Nurses. She is a graduate of West Virginia University School of Nursing (BSN, 1970), St. Louis University (MSN, 1977), and New York University (PhD, 1987).
Ruth Amos has significant experience in healthcare, both as a Registered Nurse in Critical Care and as an attorney consulting in complex medical litigation. She has been a nurse for 25 years and an attorney for 15 years.
Ruth completed her nursing degree in Northern California in 1982, and after moving to San Diego in 1985 she was happy to use her fluency in Spanish to translate for patients and their families. However, she saw that Diagnostic Related Groups were taking hold of healthcare and knew she needed legal knowledge in order to make a greater difference.
After graduating law school in 1992 and passing the California Bar Exam, Ruth continued in nursing on a part time basis. She also became involved in political groups in California and Washington D.C. that promised to tackle healthcare issues. Sadly, Managed Care was in charge by then and many proposals challenging that system were defeated in the political arena.
Years later, Ruth traveled the country working in the medical device industry. One summer she was having lunch near her home in La Jolla, California and spotted a familiar face. The man ran to hug her, shouting in Spanish, “Where have you been? My son is back in the hospital, and we have looked for you every day.” Ruth had cared for his son eight years earlier in Pediatric ICU. She was the only nurse in the unit who spoke Spanish and could explain his child’s condition to him.
That encounter rekindled in Ruth the importance of bedside nursing. She decided to return to the bedside in order to affect change.
Currently, Ruth works as a staff nurse in Neonatal ICU at Sharp Mary Birch Hospital in San Diego, California. She also consults in high profile medical litigation and is a certified arbitrator. Her goal is to influence healthcare in the most meaningful way possible: by encouraging nurses who work at the bedside where it all happens.
Excellent discussion of critical issues. Ms. Mason and Ms. Amos are both articulate nursing advocates who address the nursing shortage with intelligence and wit. The interview provides great insight into the problem and offers achievable solutions. All nurses should tune in.
Sharp HealthCare nurses, who are negotiating a new labor contract with the nonprofit hospital operator, have filed a 140-page complaint with the state Department of Health Services alleging hundreds of regulatory violations at Sharp’s seven hospitals.
Members of United Nurses Association of California/Union of Health Care Professionals said they will discuss the complaint today during an 11 a.m. news conference outside Sharp Mary Birch Hospital for Women in San Diego.
Union officials said many of the allegations involve issues of understaffing that, at times, have left patients not monitored and rooms improperly cleaned. The complaint was derived from testimonials given by nurses to union officials describing work conditions.
Dan Gross, executive vice president of hospital operations for Sharp, said nurses had not put forward their concerns through the company’s formal complaint channels. “Sharp has always been and will continue to be committed to the highest quality of care that can be delivered to patients,” Gross said.
– K.D.
In response to KD’s comments, I have kept a close personal eye on the issues and allegations against the Sharp Healthcare System by the nurses union, UNAC.
Unfortunately, many of the allegations of understaffing at Sharp can happen to all units at one point or another despite all efforts by management, simply because of the nursing shortage. The DHS (Department of Health Services) has already begun investigation of these allegations.
I spoke with the Nurse Manager of the Neonatal ICU at Sharp Mary Birch Hospital today about this situation and feel confident that there is a tremendous commitment to quality care and staffing in our unit. As a staff RN who works in the NICU at the bedside, I am an eyewitness to staffing conditions and am very proud of the efforts by the managers to keep safe staffing levels at all times.
As to the allegations against the entire Sharp system, this investigation will bear out one of two things: either enough of the allegations will prove true, providing opportunity for positive change; or, the allegations will prove largely unfounded and nurses will need to decide whether or not UNAC is accurately representing their best interests.
If Sharp Healthcare, having won many local and national awards for Nursing Excellence, is being placed under the spotlight, then all others are subject to scrutiny-and soon.
This widespread scrutiny may be a good thing, if it means that more public attention will eventually be placed on the REAL issues about the nursing shortage, instead of solely blaming management for not being able to manufacture nurses out of thin air.
Sincerely,
Ruth Amos
Barbara, I just finished listening to Part II of the Nursing Shortage — very well done! I think, though, that we need to be more sensitive to the global shortage. It’s not just us. In fact, with a global perspective, it’s not us at all. There is a global shortage of health workers. The US carries 10% of the global burden of illness, but has 37% of the global health workers. We are siphoning off desperately needed nurses from developing nations — most of which would kill to have our staffing rations. There are places in Sub-Saharan Africa that have only a handful of nurses per 100,000 population. As one of my students suggested, as a matter of equity, we should be offering incentives to American nurses to go there! Burt
For the past two months, Sharp Healthcare and the Nurses Union (UNAC) have been at loggerheads over labor contract provisions and 9 days ago nurses in the Union voted to strike.
I am happy to report that as of 10:30pm last night, Sharp Healthcare and UNAC have reached a tentative agreement and the strike has been averted. Details of the agreement are not yet available, but I am encouraged that both sides were willing to go back to the table and continue to work out their differences.
In the current healthcare climate, I strongly believe that the problems go further than staffing issues and labor contracts. This is the time for leadership on all levels to address fundamental stumblingblocks and remove them from the path to safe patient care.
Thank you to both Sharp Healthcare and UNAC for your willingness to work out differences and reach an agreement. These are difficult times and I applaud any and all efforts to keep coming to the table.