Monthly Archive for September, 2009

Nursing Role Extends Beyond Bedside

nursing bedsideThe most important role of the nurse will always be at the bedside. That is, as long as people continue getting sick and needing hands on, direct, skilled, compassionate care.

Since I do not see illness and injury becoming extinct anytime soon, I think it is safe to say that the principles of patient care passed on for generations by the original “lady with the lamp” Florence Nightingale, will continue to remain at the core of nursing education.

The face of health care, however, is changing as the field and everyone in it attempts to accommodate the expanding needs of hospital systems, communities, patient populations such as baby boomers and politicians seeking a solution to allow all their constituents access to care.

Nurses, often seen as central, unifying figures in health care, have more flexibility in their role than ever before.  In addition to their bedside roles, nurses can now seek out opportunities in public health, wellness and preventative medicine, and continuing education among many other areas of health care. As nurses strike out in new and exciting directions, many of their conventional roles are being taken over by LPN’s, certified nurse’s aides and other patient care assistants.

Due to the growing shortage of physicians, nurses may also want to seriously consider furthering their education and becoming nurse practitioners. Physician assistants and nurse practitioners are doing their part to assist with the shortage of doctors. Both PA’s and NP’s can perform nearly all of the primary patient care functions (including prescribing medications) that traditionally required a physician.

To succeed in the rapidly evolving fields of nursing and health care overall, new nurses need to be as educated, multi-faceted and flexible as humanly possible. This is especially true when looking at a national patient population that runs the full spectrum of health care needs.

Some patients place alternative medicine and wellness at the top of their list of health care priorities, while others are adamant about receiving the latest treatments, most high tech diagnostics and best pharmaceuticals that their insurance can buy. Even Florence Nightingale may have found it challenging to keep up with the diverse needs of a diverse patient population.

Nursing Shortage is in the “Eye of the Storm”

nursing shortageIf you have lived in hurricane prone states such as Florida, Louisiana, Texas and similar coastal weather targets, then you are most likely very familiar with the “eye of the storm” warnings reeled off by meteorologists during the fury that is a hurricane.

For those who don’t – this is the point during a hurricane when the sun comes out and the weather goes instantly from pandemonium to picturesque. However, residents are warned not to be fooled by the chirping birds and gentle sunlight.  This is merely the middle of the storm and the gale force winds and sheets of rain will start up again momentarily.

It would appear that the nursing shortage has reached the eye of the storm. Prior to the recently peaked recession, the demand for nurses in hospitals and nursing homes was consistently high. Recruiters could not scoop up nursing school new grads as fast as the schools were graduating them.

With the recession, however, a combination of hospital cutbacks and previously retired nurses returning to the workforce has slightly dampened that need. Stories are now rampant of new grad nurses having trouble finding work. Does this mean that the nursing shortage has passed, problem solved and sunny skies prevail?  Don’t leave your hurricane shelter just yet folks.

According to the Bureau of Health Professions, America’s shortage of nurses is just starting to accelerate. The Bureau reports that the shortage hit double digits at 10 percent in 2008, will double to 20 percent by 2015 and reach 29 percent by 2020. This is largely due to the projected population explosion between now and 2020, especially in the elderly demographic.

The worsening shortage is also a result of the retiring nurses in that demographic.  The effects of such a shortage on the quality of care and patient outcomes are almost too staggering to comprehend. Various studies have shown that as the nurse to patient ratio rises, so does the likelihood that at least one of those patients will die within 30 days*.

If you are considering a career in nursing, do not be deterred by the stories of new grads having trouble finding work. As is true during the eye of a storm – this too will pass and nurses will be needed more than ever before. Nursing remains a recession proof career, even with its current challenges, and it will continue as such indefinitely.

*University of Pennsylvania’s Center for Health Outcomes and Policy Research

Related Topics

Nursing Shortage Crisis

Nursing Students Check Their Biases

Check Your Biases

Nursing school is an excellent time for self-reflection and awareness of your beliefs, fears, prejudices and any other thoughts or behaviors that you may not be aware of now, but have a good chance of rearing their ugly head later in your career when you least expect it.

I know that all nursing students believe they are fair, just, open-minded, nurturing, unbiased, politically correct beacons of humanity. Yet somewhere between graduation day and years into their career, something happens and, in some nurses (not all), the cynicism switch is turned on.

Whether the cause is career burnout, a cutting sense of humor that helps them survive their shift, or they’re just “going along with the crowd,” the once fresh faced, innocent nurse finds herself saying things that would have horrified her in nursing school.  She finds herself labeling patients as “frequent flyers,” “drug seeking,” or sometimes worse depending on what she (or he) has heard from her colleagues.

One of the most common biases in health care is toward the elderly. An article in the Journal of the American Medical Association (JAMA)* stated that “Some studies have indicated that medical students perceive older people as being dull, disagreeable, inactive, and economically burdensome.” Potentially damaging preconceived notions about elderly patients or patients from any specific age group, ethnicity or other demographic, are not confined to medical schools either.

Nurses and nursing students need to examine their own beliefs and notions for potential warning signs.  This is even more true of nurses, since they spend by far the most amount of time in direct contact with patients and also experience a great deal of stress related to heavy workloads. Times of stress have a way of acting like wine, in the sense that “in wine there is truth.”  It is far better to be honest with yourself now and prevent an embarrassing and potentially career threatening situation later.

* “Ageism in the Preclinical Years”; Catherine Caruthers McCray; University of Kansas School of Medicine; JAMA. 1998