Barbara Ficarra recently interviewed Sandy Summers, MSN, MPH, RN, Executive Director of The Center for Nursing Advocacy. Barbara Ficarra and Sandy Summers talk about the image of nurses and why nurses are misrepresented in the media and by Hollywood. Sandy talks about how there is a “denursification” of nurses because of the way nurses are portrayed in the media.

Barbara Ficarra, RN, MPA, Award-Winning Journalist, Executive Producer and Medical Show Host of Health in 30 and Nurses in Motion recently sat down with Bruce Bonanno, MD, and ER Physician to talk about the complex issues surrounding the nursing shortage.

Barbara Ficarra and Dr. Bonanno navigate the viewer through the real ER. They talk about the challenges that face the ER, and the understaffing which leads to stress that many nurses face today. They discuss the vital role of nurses in society and how vital they are to patient quality health care. This only begins to describe the conversation between Barbara and Dr. Bonanno about the real problems facing hospitals and nurses today. Dr. Bonanno also answers viewer’s emails.

Ken Miller, PhD, of The American College of Nurse Practitioners, Julie Stanik-Hutt of Johns Hopkins University, Sandra Ryan, NP, of TakeCare Health Systems, and Bonnie Plion of Vanderbilt University speak at Consumer Health World

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Ken Miller, PhD, of The American College of Nurse Practitioners, Susan Apold of the College of Mount St. Vincent, and Bonnie Plion of Vanderbilt University speak at Consumer Health World

Ken Miller, PhD, of The American College of Nurse Practitioners, and Sandra Ryan, NP, of TakeCare Health Systems speak at Consumer Health World

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Bob Forster, MD of The Little Clinic: Paul Gorman, MD, of QuickHealth: Chris Kersey, MD, of RediClinic: Sandra Ryan, NP, of TakeCare Health Systems

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Barbara Ficarra, RN, Award-Winning Journalist, Executive Producer and Medical Show Host of Health in 30 and Nurses in Motion recently sat down with Fred Pescatore, M.D., NY Times-Best Selling Author and Practicing Family Physician in NY to continue the discussion on the nursing shortage.

The nursing shortage is a global complex issue, and there are no easy answers. Watch uncensored, passionate dialogue unravel; Barbara Ficarra and Dr. Pescatore speak candidly about how the nursing shortage impacts quality patient care, how vital the role of nurses are in society, how nurses are not being compensated for their work as professionals; and how major manufacturers in essence contribute to the nursing shortage.

Fred Pescatore, MD, is a traditionally trained physician practicing nutritional medicine. Dr. Pescatore is the author of the New York Times best selling book, The Hamptons Diet. This lifestyle program focuses on the use of foods of high nutritional quality, does not exclude any food groups, and unravels the mystery of heart-healthy monounsaturated fats. A former Associate Medical Director at the Atkins Center for five years, Dr. Fred’s other titles include, Thin For Good, The Allergy and Asthma Cure and the number 1 best-selling children’s health book, Feed Your Kids Well.

Major television reporters, radio hosts and print journalists call upon him to be the medical expert on nutrition. He has been featured on such shows as, Health in 30 Radio Show with Barbara Ficarra on WRCR, The View, The Today Show, Deborah Norville, The O’Reilly Factor, and Extra. Recent interviews include Washington Post, InStyle, US magazine, First for Women, Women’s Health and Fitness, Let’s Live, The New York Times, The Wall Street Journal, Fortune, Women’s World and more.
Dr. Pescatore lectures across America, and the world; and is actively involved in clinical research.

He is the author of numerous papers and magazine articles. Dr. Fred is a consultant for many firms and is instrumental in developing and clinical testing many of the leading nutritional products. He is the President of the AHCC Research Association, President of the International and American Association of Clinical Nutritionists, member of the National Association of Medical Communicators.

Nurses in Motion Host
Barbara Ficarra RN, BSN, MPA is an award-winning journalist and the medical/health correspondent and executive producer with ScribeMedia. Barbara is the creator/host/executive producer of Health in 30 and Nurses in Motion for Scribe Media. Nurses in Motion delves into the complex ssues surrounding the nursing profession. Barbara is also on-air in Radio.

Barbara is the creator/executive producer/host of Health in 30™ radio show which airs live every Friday from 5:30 p.m. to 6:00 p.m. EST, broadcasts on WRCR-AM 1300 and streams live online at Healthin30.com – click the WRCR logo to listen live! Health in 30™ is a 30-minute show that brings listeners the latest health and medical news and information with leading guest medical experts. Barbara conducts lively and informative discussions with leaders in their fields to provide vital health information on a broad range of topics, while focusing on education and prevention; and listeners will often call-in with questions.

Barbara Ficarra is also the creator and editor-in-chief of the Healthin30.com website. Healthin30.com is dedicated to the responsible sharing of information from leaders in the healthcare industry. On Healthin30.com, readers can get more in-depth information and tips from these same experts. The highlight of the website is the “Speak Out” logo, this is where all medical communicators can go to sign-up to be a guest on the Health in 30™ show and/or write for the website. Nurses are especially encouraged to sign-up and to use their voice to advocate to the pubic that they are medical experts and communicators.

Barbara is a media consultant, medical communicator and media consultant/co-coach with Media Image Coach and is active on the front lines of the healthcare system, she is an administrative head nurse at a level 2 trauma center and she is multifaceted in her clinical experience from oncology to general med/surg.

Barbara Ficarra has been selected by the American College of Emergency Physicians (ACEP) to receive a prestigious Journalism Award of Excellence for Coverage of Emergency Medicine. The program, “Ins and Outs of the ER” covered what to expect in the ER and the challenges of crowding and waiting on the Health in 30 Radio Show.

“Awards are given for outstanding coverage of an emergency medicine issue, in-depth analysis or investigation that brings clarity to a key emergency medicine issue and educates the public and significant impact that motivates positive change or breaks a new story that generates widespread coverage.” Barbara was honored by ACEP at the Leadership and Advocacy Conference on May 1st at the Hyatt Regency in Washington, D.C.

Barbara was selected to teach at the American Medical Association’s Medical Communications Conference in Tampa, Florida on April 12th.

Barbara is in demand to speak at professional conferences, the next conference is scheduled for June 6th where she will be the keynote speaker at the American Association of Critical Care Nurses in Fairfield, NJ. On April 21st Barbara spoke at the Hudson Valley Chapter of the American Society of Ophthalmic Registered Nurses in Mt. Kisco NY, Barbara was the closing keynote speaker on April 27th at the Nursing Spectrum Career Fair in Teaneck, NJ. and presented “Nurses in the Media” during nurses week at a level II trauma center in NJ. Barbara will also be the Keynote Speaker at two Nursing Spectrum Career Fairs in October. Barbara spoke at the National Primary Care Conference in Boston in Nov.

Barbara was recently elected to the Board of the National Association of Medical Communicators and a member of New York Women in Communications. Barbara has media training featuring teleprompter, anchoring, hosting, broadcasting and interviewing; and she is a published author. Barbara serves on the Academy of Judges for the International Health and Medical Media Awards (the FREDDIE Awards).

The United States is facing a major nursing shortage that differs from those of bygone days. This new beast is borne of demographics: as baby-boomers grow older, the nurses at their bedsides are aging alongside them. It’s not only the nurses who are ripening; their teachers are too.

“We’ve had cyclical nursing shortages in this country for some time, but now we have this aging population,” explains Patricia Ford-Roegner, CEO of the American Academy of Nursing. The average age of a nurse is 48 and the average faculty member is pushing mid to late 50s. Meanwhile, “the number of nurses under 30 is extremely low compared to what it used to be.”

There are currently 2.4 million nursing jobs in this country, making nurses the largest population of healthcare workers. The nurse is the patient’s lifeline, administering medication, monitoring vital signs, staying at the bedside through the dark hours of the night. Nurses educate and counsel patients and families about coping with illness. As a patient lies naked in a crepe gown, under the cold fluorescence of an operating table, it is the nurse’s hand he squeezes in fear or pain.

Nurses are invaluable and we don’t have enough of them. Hospitals in this country are short 118,000 nurses, according to a 2006 report by the American Hospital Association, and community health centers are even more drained, says a recent article published by the Journal of the American Medical Association (JAMA).

If the present situation seems dreary, the future is downright dismal. If current trends continue, the nationwide nursing shortage will reach 1 million by 2020, according to the Health Resources and Services Administration (HRSA).

When nurses are scarce, patients suffer. Numerous studies have linked nursing shortages to increased medical errors, patient dissatisfaction, and overall inferior care. Without a sufficient supply of nurses, those who are working are burdened with heavy patient loads, longer hours, and this often means that they are working tired.

Patients are more likely to die when nurses are overworked. A recent study in JAMA found that the odds of mortality for surgical patients increased by 7% for every additional patient in the average nurse’s workload. Another study in Health Affairs estimates that 6,700 patient deaths and 4 million inpatient days could be avoided if hospitals increased their nursing staffs.

In the past, women in their 20s filled the voids left by retiring nurses, but now career opportunities for women have exploded and they are lured into other professions. Men, comprising a wee 7% of the nursing population, are not compensating for the loss. Minorities are also underrepresented. Although the population of minority nurses tripled from 1980 to 2000, these numbers lagged far behind the growing diversity of the country at large. In 2000, underrepresented minorities constituted 12% of the registered nurse population, less than half of their representation in the general population.

Recruiting youth and diversity is paramount, but simply beefing up the supply side will not heal this problem. What’s ironic about this nursing shortage is that each year, thousands of would-be nursing students are rejected by nursing schools that do not have enough spaces for students. Last year, 32,323 qualified applicants were turned away from entry-level baccalaureate programs in 449 nursing schools across the country, according to preliminary data collected by the American Association of Colleges of Nurses. Bursting at the seams, these nursing programs have reached their carrying capacity. The limiting factor: nursing faculty. No matter how many eager students pound on the doors of admissions offices, there cannot be more nurses unless there are teachers to train them.

It’s not surprising that nurses with advanced degrees don’t jump on teaching positions, because they can earn much more using their degrees in clinical settings. Jean Ann Seago, a PhD with 30 years of experience, earns an annual base salary of $76,800 as an associate professor at the University of California, San Francisco’s School of Nursing. Compare that to a starting six-figure salary for a nurse practitioner in certain clinical settings or $80,000 for a bedside nurse working the night shift.

In addition to the bottleneck created by the shortage of nursing faculty, there is also an issue of retention. Nursing is physically arduous, emotionally and intellectually taxing, and sometimes unrewarding. “The clinical nurse’s job is so demanding,” Ford-Roegner explains, causing feet and back problems for many people. On top of the physical exhaustion from standing on one’s feet for 12 hours, nursing brings plenty of emotional tribulations.

“It’s a very thankless job,” says an emergency room nurse at New York’s Saint Vincent’s Hospital who prefers to remain anonymous. “Sometimes you have these little interns straight out of medical school, and I say ‘Hi, my name is [name],’ and they say ‘Hi, I’m Dr. Smith,’” not even condescending to give a first name. “I’m a professional too.”

“There is a lot of sexism between doctors and nurses” and “it’s not just hitting on, it’s hitting,” Seago says. It’s hard to fathom, but physicians sometimes “abuse nurses, yell at them, throw things.” On top of all these other problems, the whole healthcare system has changed since the mid-90s, when there was a real push to cut cost, she explains. “It really is like an assembly line. It’s not good for nurses, and it’s not good for patients.”

“In the last ten years, it’s become a business, instead of a place where you can take care of people,” the ER nurse says.

Shortages only aggravate the preexisting hardships of the job. When nurse-to-patient ratios are low, nurses are more emotionally exhausted and dissatisfied with their work and thus prone to deserting their careers. A recent JAMA study found that 43% of nurses who say they are burned out and dissatisfied with their jobs intend to leave their current position within the next year. And thus a nasty cycle perpetuates itself. Disenchanted nurses abandon the wards and clinics, and the nursing vacuum enlarges to create more work for the nurses left behind. Those nurses become disenchanted. And the loop of discontent goes on.

Can the cycle be stopped? The state of Michigan has come up with some creative and inspiring plans to solve its nursing woes. Like the rest of the country, Michigan is facing a serious nursing shortage that is only expected to worsen as baby boomers move into old age. The shortage is expected to reach 7,000 nurses by the year 2010 and 18,000 by the year 2015. The state also has an abundant supply of displaced autoworkers: assembly line workers, information technology specialists, engineers, and others. In the past five years, some 90,000 workers have been laid of by the Ford, General Motors, and Chrysler.

And who says autoworkers can’t become nurses?

Michigan educators, politicians, and policy specialists see an opportunity and they are jumping on it, creating programs to help Michigan’s displaced workers launch careers in nursing and other healthcare fields.

Hospitals and universities are launching recruitment programs and are offering free training specifically tailored to the autoworker looking to make a career change. Governor Jennifer Granholm has poured millions of dollars of federal and state funds into an accelerated healthcare training initiative, which provides fast-track professional education programs for displaced workers from the automotive and other industries.

In her recent State of the State Address, Granholm unveiled Michigan’s Nursing Corps initiative, a plan to provide training for 500 additional nursing instructors and graduate more than 3,000 additional nurses over the next three years. As part of this proposal, 200 additional slots in the accelerated nursing degree program are reserved for displaced workers.

“It does create what we call the perfect storm,” says Jeanette Klemczak, Michigan’s Chief Nursing Executive. “We have all these nursing jobs, if you will, positions that are just waiting, begging for somebody and we have these unemployed displaced workers—autoworkers and others in some other industries.”

But checking vital signs and changing IV’s is quite a switch from working on the assembly line. Les Jenkins, an information technology specialist and Michigan native who has spent his entire career working for Ford and GM, is skeptical.  “I don’t know that you’re suddenly going to have a lot of people putting down their wrenches… and deciding to take up being a nurse.” But Jenkins thinks the transition would be smoother for engineers, IT workers, and administrative assistants cast aside by the auto industry.

Klemczak agrees the autoworker-to-nurse transformation is far from a breeze. Nursing is not for everyone, and many autoworkers, assembly line workers for example, may not have the basic math and science background essential for beginning a nursing training program. However, there is a palpable opportunity for engineers, IT workers, and other employees from the automotive industry who already have college degrees. Some people may be better candidates than others for these accelerated nursing degree programs, but anything is possible, Klemczak says. “We have to start somewhere.”

For those displaced workers who have pursued nursing careers, their stories are inspiring. “The hospitals love them. They are a little bit older, they’re mature workers, they sort of know how to be in the workforce,” Klemczak says.  “The other neat thing about this group is, for some reason, they tend to have a much higher representation of minorities and males. In these special programs, about 18-25% of the participants, the nursing students, are minority or male.” These people “are literally and figuratively changing the face of nursing.”

Other states might take a few tips from Michigan.

Coco Ballantyne is an editorial intern at ScribeMedia.Org and is pursuing her Masters at Columbia University’s Graduate School of Journalism.

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.

This is a legitimate concern.  Non-visible glove failure rates create the risk of cross contamination of blood borne pathogens such as hepatitis or HIV among exposed HCWs or patients. Surgical gloves that are compromised by unnoticed visible defects may also be an indirect cause of surgical wound infection.
 
Our results are consistent with the results of other studies that reported that up to 83% of glove defects go unnoticed to the naked eye. It is important to note that the rate of surgical glove defects was associated with the HCW’s role (surgeon, resident, first assistant, scrub person). Scrub personnel had higher defect rates but
changed their gloves more frequently, whereas surgical residents wore their gloves longer but had the  second highest defect rate.
 
Additionally, the data showed that the majority of the glove defects occurred on the fingers and top of hand, which may be associated  how instruments are passed from one HCW to another.  Additional human factors that contribute to defects include the skill of surgical personnel, operative difficulty, sharp exposure, and types of surgical instruments that require fine hand motor movements.
 
Furthermore, untrained surgical personnel require additional experience to become proficient using protective gear, such as in donning gloves which may have caused scrub and surgical resident personnel to have higher glove defect rates. These findings support those of others who have suggested that the risks associated with one’s role in the operating room may depend on training, acquisition of clinical skills, and years of surgical experience.  Because surgical gloves act as a barrier to infection, frequent changing of gloves and monitoring glove breaches from sharps or surgical instruments is imperative.

Material Type

Non-latex surgical gloves had higher defect rates than latex gloves and defects were consistently higher among specialties such as orthopedic, plastics, and cardiac services.  However, glove type was but one among many factors, and the data are consistent with others who suggest that the type of surgery, duration of operative event, hand dominance, and surgical skill are factors associated with surgical glove defect rate.
 
Based on the results of this study, I recommend the following: (1) surgical gloves, regardless of material (latex or non-latex) should be changed frequently (worn less than 2 hours); (2) HCWs with less surgical experience may be at greater risk for exposure to blood borne pathogens, and specific training in handling procedures may be required or need to be updated; (3) HCWs working in orthopedic, oral, plastics, and cardiac need to adhere to the blood borne pathogen regulations that require HCWs to frequently change their gloves, especially when the barrier becomes compromised; and (4) surgical personnel (surgeons, nurses) responsible for training surgical residents and scrub personnel need to emphasize frequent glove changes, especially among learners.
 
Better equipment decisions will protect worker and patient, and greatly reduce costs of accidents and accidental infection in the OR.  Best of all, glove decisions are ones that HCWs and their managers have control over and so make a positive difference in their work environment.

Denise M. Korniewicz, DNSc, RN, FAAN, is a Professor & Senior Associate Dean for Research, and Interim Assistant Dean of Student Services, Univertity of Miami.