Nursing in crisis: Shortage couldn't come at worse time
Across Pennsylvania and the nation, America is confronting its worst and most dangerous shortage of nurses in decades.
It is an urgent and growing crisis. There simply are far too few nurses for the vacancies in our hospitals, clinics, nursing homes and the rapidly expanding field of home health care.
With baby boomers getting older and fears now of bioterrorism, the shortage comes at a terrible time. It threatens our nation's public health and puts every one of us at risk when we become a patient at today's too-often-understaffed medical facilities.
What is causing the nursing shortage? How urgent is it? What is driving young people away from nursing as a career and causing veteran RNs to abandon their profession in record numbers?
To find the answers, the Pennsylvania Association of Staff Nurses and Allied Professionals recently mailed a 26-question survey to more than 50,000 Registered Nurses across Pennsylvania. More than 6,000 nurses responded, making this survey one of the largest ever conducted.
We made the results public this month and, for Pennsylvania's health-care providers, policymakers and patients, the findings are deeply unsettling if not outright alarming.
For example 56 percent of RNs practicing in the commonwealth -- a clear majority -- say they never would enter the profession if they had it to do over again. Only one-half of working nurses report that they plan to stay in the profession, and nearly 25 percent say they are leaving nursing immediately or within the next one to five years.
Nearly three-fourths of Pennsylvania nurses cite deteriorating working conditions, such as chronic understaffing, as the chief cause of nurses leaving the field.
Seven out of every 10 nurses say their facility is short-staffed "most of the time" or "all of the time," and 58 percent say staffs have been reduced in their workplace in the last few years because of management-imposed budget cuts.
Meanwhile, 61 percent warn that low pay and benefits also are discouraging young people from becoming nurses.
Regrettably, the current shortage was predictable and avoidable. Nursing traditionally has gone through cyclical but manageable shortages; however, the hospital and management care industry in the 1990s turned a normal shortage into a national crisis.
Goaded by business consultants peddling a fixation on the bottom line, the industry laid off nurses by the tens of thousands and then tried to transfer the science-based and professionally licensed work of the registered nurse to well-meaning but inadequately prepared and unlicensed personnel.
The nurses still on staff after consultants such as the Hunter Group and KPMG departed town were now given more and sicker patients for whom to care. As staffing levels deteriorated, and the pressure of bigger patient caseloads mounted, many RNs left for safer and less stressful work. Hospitals responded by systematically forcing overtime on the remaining RNs to plug the holes, speeding up even faster the exodus from the profession.
Perversely, the same forces that conspired to create today's nursing crisis are now busy promoting supposed solutions. Many hospitals are pushing large sign-on bonuses for RNs (such as the $25,000 recently offered by the Jefferson Health System's Main Line Health Division). They're also paying exorbitant fees to temporary staffing agencies and seeking government help with nursing school loan forgiveness and tuition reimbursement.
Those tactics, however, don't fix the structural problems behind the shortage. Sign-on bonuses simply increase the competition for a dwindling supply of nurses. Temporary staffing agencies sap hospital resources while becoming extremely wealthy in the process. And school financial incentives may get more students for the moment into nursing, but the new nurse on the job still confronts the intolerable working conditions that are driving older colleagues out of the profession.
Our lawmakers are going to have to step in with government-enforced standards before we further endanger our families and the public health. A formula for the safe number of nurses per patients should be imposed. Mandatory overtime should be eliminated except in cases of declared emergency. Medicare, Medicaid and HMO reimbursements must use their funding authority to require improved nurse staffing levels for the sake of patient care.
Nurses have always been the backbone of America's health system. They are needed now more than ever as our parents and grandparents age and the country faces these uncertain times of terrorist threats.
Fixing the nursing shortage could mean the difference between life and death in the years ahead. It's past time we got on with the job.
Bill Cruice is director of the Pennsylvania Association of Staff Nurses and Allied Professionals, a statewide union with 5,000 members based in Conshohocken, Montgomery County.
Copyright ©1997-2001 PG Publishing Co., Inc. All Rights Reserved
Biz Bytes: A no-holds-barred look at the week's business news
<http://www.post-gazette.com/businessnews/20011118revue1118fnp5.asp>
by Steve Massey, Pittsburgh Post-Gazette Staff, November 18, 2001
... NOT TO CAST ASPERSIONS, 2
Nearly half of some 6,000 registered nurses answering a poll about job conditions said they are so disgusted and disgruntled that they intended to quit in the next five years. (It should be noted that the survey was given to 60,000 but only 6,000 responded.) The Call: Not to cast aspersions or to undermine the disgruntled nurses' sincerity, but IT'S A JOB AND YOU'RE PAID TO DO IT. If you don't like it, do something else. ...
Pressure mounts on health sector
<http://onenews.nzoom.com/news_detail/0,1227,69584-1-6,00.html>
ONE News sourced from TVNZ, RNZ, Reuters, Dec 03, 2001
As the government signals it will put more money into health in the next budget, industrial pressure on cash-strapped health boards is increasing.
Radiation therapists in three North Island centres walked off the job on Monday as Canterbury health workers entered day two of their strike which has emptied Christchurch hospitals.
Four striking nurses, on stand-by for an emergency, had to leave the picket line to help treat the victim of a machete attack on Monday morning.
Denise McGurk from the Nurse Emergency Response Team said they knew resources were stretched and if the call was made they had to go and help.
Emergency Specialist Professor Mike Ardagh said the team responded quickly and handled the situation well.
But as the strike wears on, so do the hours clocked up by staff left to hold the fort. Many are working 17 hour shifts and sleeping on site.
However, health workers are holding firm and hundreds are manning the pickets. And their call is now becoming louder for government intervention.
Health Minister Annette King says she is not permitted to get involved in local decision-making or industrial disputes, but the Prime Minister offered a pre-Budget glimmer of hope for health boards struggling with huge debts.
Canterbury District Health Board spokeswoman Jean O'Callaghan says the government appears to be recognising the pressure on health and they may get a three year plan instead of only being able to plan on an annual basis.
But it is the immediate future that weary Christchurch doctors are concerned about.
Ardagh said he and his colleagues may be less enthusiastic to work so hard to hold it together next time.
OSH bill campaign - CTU
<http://www.union.org.nz/osh/campaign.htm>
Nurses' negotiations - TV3, 26 November 2001
<http://www.tv3.co.nz/news/news_info.cfm?news_id=9087&news_category_id=1>
Christchurch nurses strike - TV3, 3 December 2001
<http://www.tv3.co.nz/news/news_info.cfm?news_id=9270&news_category_id=1>
Funding Package No Magic Recipe To Resolving Nurses' Pay Disputes - New Zealand Nurses Organisation, 10th December 2001
<http://www.newsroom.co.nz/story/77535-99999.html>
Multi-employer Health Agreement Is 'Best of The Best' - New Zealand Council of Trade Unions, 14th December 2001
<http://www.newsroom.co.nz/story/78314-99999.html>
Multi-employer Health Agreement Is 'Best of The Best': South Island Nurses And Midwives Join Historic, Multi-Employer Agreement - New Zealand Nurses Organisation, 14th December 2001
<http://www.newsroom.co.nz/story/78307-99999.html>
3,500 Civilians Killed in Afghanistan by US Bombs
DURHAM, NEW HAMPSHIRE - December 10 - More than 3,500 civilians have been killed in Afghanistan by US bombs, according to a study to be released December 10 by Marc W. Herold, Professor of Economics, International Relations, and Women's Studies at the University of New Hampshire. Professor Herold will announce his findings on Monday, December 10 in a discussion with award-winning journalist, Amy Goodman of Democracy Now! in Exile's War and Peace Report <http://www.democracynow.org>. Professor Herold has been gathering data on civilian casualties since October 7 by culling information from news agencies, major newspapers, and first-hand accounts. "I decided to do the study because I suspected that the modern weaponry was not what it was advertised to be. I was concerned that there would be significant civilian casualties caused by the bombing, and I was able to find some mention of casualties in the foreign press but almost nothing in the US press," said Herold. Herold's data will be available at <http://pubpages.unh.edu/~mwherold>. ...
Who Will Count the Dead? US Media Fail to Report Civilian Casualties in Afghanistan - Marc W. Herold, Media Alliance, Volume 20 # 5, December 2001
<http://www.media-alliance.org/mediafile/20-5/index.html>
Health study new blow to veterans:A Chatham Marine who served in Kuwait says he'll cope with the news that he has a higher risk of developing ALS - Robin Lord, Cape Cod Times, December 15, 2001
<http://www.capecodonline.com/cctimes/archives/2001/dec/15/healthstudy15.htm>
Gay-rights activists drop protest notes in Salvation Army kettles - The Associated Press, December 15, 2001
<http://www.capecodonline.com/cctimes/archives/2001/dec/15/gayrights15.htm>
Indian mascot issue resurfaces
by Mia Taylor, The Patriot Ledger, December 15, 2001
QUINCY - Yakoo is under investigation.
State officials have decided to investigate whether North Quincy High School's mascot, a caricature of a white person dressed like a Native American, is a racial stereotype.
The investigation is being conducted by the Massachusetts Commission Against Discrimination, which received a complaint about the Yakoo from a Quincy teacher earlier this year.
An MCAD spokeswoman confirmed this week that the Yakoo case has been "authorized for investigation."
But because it's an active case, MCAD communications director JeLesa Jones said, she could not provide any further details. She wouldn't comment on what specifically led to the agency's decision to proceed with an investigation or what concerns the agency might have about the mascot.
Contacted this week, school officials said they had not been notified of the MCAD investigation.
"As soon as the MCAD informs us of that, we will be working with them to listen and to hear what they have to say," School Superintendent Richard DeCristofaro said. "But we haven't heard anything yet. As soon as we do, we will deal with it."
Ed Grogran, a teacher in the Quincy public schools for about 30 years, filed the complaint with the MCAD in February.
In doing so, Grogan resurrected a highly charged debate of a decade ago.
The Yakoo was created in the late 1950s by a student who drew the profile of Allan Yacubian, a member of the North Quincy Class of 1958. The mascot sports war paint, a feathered headband, a Mohawk haircut and a fierce scowl. Yacubian now is a well-known Wollaston dentist.
During the early 1990s, Grogan raised objections about the Yakoo that culminated with a protest demonstration by Native Americans outside North Quincy High School, court battles and a storm of public criticism from Yakoo supporters.
Quincy school officials and Yakoo supporters argued then and maintain today that the Yakoo is not a Native American image but rather a drawing of a student dressed as a Native American.
The battle appeared resolved after the U.S. Department of Education ruled the image does not violate the U.S. Civil Rights Act. A 1995 decision put forth by the department's Boston regional office called the tomahawk-wielding figure offensive, but said it does not create a racially hostile environment at the school.
Grogan, the teacher, disagrees with that ruling.
A series of events during the past year or so prompted Grogan to renew his efforts. One was the mock scalping of a stuffed dummy at a rally before the Quincy-North Quincy Thanksgiving Day football game last year.
Grogan says he was also inspired by an opinion issued earlier this year by the U.S. Civil Rights Commission, which called for an end to the use of Native American mascots.
Also, last April, the New York State Board of Education ordered all schools in that state to phase out such mascots.
"I believe there should be no mascot of any ethnic, racial or cultural group in a public school," Grogan's MCAD complaint says. "No other ethnic group would be depicted in such a manner. I believe the mascot is offensive to the Native American culture."
In the complaint, Grogan lists himself as the party who was discriminated against.
Grogan said this week that the commission rejected his personal complaint of discrimination because he's not Native American, and therefore cannot be an aggrieved party.
But he says agency officials told him they had decided to pursue the case on their own. Jones, the MCAD spokeswoman who confirmed that an investigation is under way, would not confirm Grogan's comments.
Whatever the case, Grogan remains optimistic.
"I'm just happy they're not closing the door," he said. "But they didn't give me any promises."
At the same time the MCAD confirmed its decision, the state Commission on Indian Affairs came forward to lend its support to Grogan's battle.
In a letter to The Patriot Ledger, the commission's executive director, John Peters, called the mascot "demeaning" and an "insult" to Native Americans.
Peters also condemned the symbolic bloody scalping of a stuffed dummy before the Thanksgiving Day football game last year.
"I am outraged that racially hostile, horrific pranks are allowed and sanctioned by this school system," Peters wrote. "The portrayal of an Indian scalping someone in a public forum to incite students to confront their opponents in a like manner is a horrifying act and falsely associated with native people."
The letter echoes comments Peters said he made on the issue at a Massachusetts Commission Against Discrimination hearing recently.
In October, the state Commission on Indian Affairs voted unanimously that mascots such as the Yakoo should be should be done away with.
The commission, however, has no enforcement authority or power to bring a lawsuit on the issue, Peters said.
Peters is a Wampanoag Indian from Mashpee. His father was the commission's executive director before him. And it was John Peters Sr. who spoke out against the Yakoo during the early 1990s hearings in Quincy.
John Peters Jr. said he remembers his father returning from those hearings amazed at the way he was heckled and laughed at by the crowds. So it doesn't surprise him that Grogan is still fighting.
Quincy, he said, is one of a handful of communities in the state still working through such a debate.
"The battle still goes on," he said. "It's still with us."
Copyright The Patriot Ledger
International Affairs Committee Drafting Resolution to Authorize Bombing of Iraq
Rep. Ron Paul Circulating Congressional Letter in Opposition
Friends - As many of you know, there has been immense pressure building recently within the Bush Administration, and the media, to make Iraq the next target in our unending war against terrorism. Now a number of members of Congress have written a letter urging President Bush to do just that, and this coming Tuesday the House International Relations Committee will be drafting a resolution to authorize attacks on Iraq. (Much greater attacks than what we have been doing already, aimed at overthrowing Saddam Hussein.) It will, among other things, stipulate that any refusal of Iraq to grant access to UN inspectors to any site in Iraq will be considered an "act of aggression against the United States."
Con. Ron Paul of Texas is circulating a letter opposing any attacks on Iraq. While not a pacifist letter, it does clearly state that there will be massive loss of life if we do this, that pretty much the rest of the world opposes us doing this, that even our allies freely acknowledge that there is no evidence that Iraq had anything to do with the September 11 bombing, and that taking military action against them would thus go well beyond the original resolution authorizing use of force in Afghanistan. Please circulate this message to all your group and personal email listserves, and urge your group members, colleagues or friends to call their Represenatives immediately (as in Monday and Tuesday) to speak against the bombing of Iraq, and to urge them to sign on to Rep. Paul's letter. While all members of Congress are important, the members of the House International Relations Committee are particularly so, and they are listed below.
PLEASE TAKE ACTION NOW TO PREVENT THIS WAR FROM SPREADING EVEN FURTHER
Members of the House International Relations Committee:
Henry J. Hyde, Chairman (R-IL) (202) 225-4561
Benjamin A. Gilman, New York (202) 225-3776
Tom Lantos (Ranking Member), California (202) 225-3531
James A. Leach, Iowa (202) 225-6576
Howard L. Berman, California (202) 225-4695
Doug Bereuter, Nebraska (202) 225-4806
Gary L. Ackerman, New York (202) 225-2601
Christopher H. Smith, New Jersey (202) 225-376
Eni F. H. Faleomavaega, American Samoa (202) 225-8577
Dan Burton, Indiana (202) 225-2276
Donald M. Payne, New Jersey (202) 225-3436
Elton Gallegly, California (202) 225-5811
Robert Menendez, New Jersey (202) 225-7919
Ileana Ros-Lehtinen, Florida (202) 225-3931
Sherrod Brown, Ohio (202) 225-3401
Cass Ballenger, North Carolina (202) 225-2576
Cynthia A. McKinney, Georgia (202)225-1605
Dana Rohrabacher, California (202)225-2415
Earl F. Hilliard, Alabama (202)225-2665
Edward R. Royce, California (202)225-4111
Brad Sherman, California (202) 225-5911
Peter T. King, New York (202) 225-7896
Robert Wexler, Florida (202)225-3001
Steve Chabot, Ohio (202) 225-2216
Jim Davis, Florida (202) 225-3376
Amo Houghton, New York (202) 225-3161
Eliot L. Engel, New York (202)225-2464
John M. McHugh, New York : (202)225-4611
William D. Delahunt, Massachusetts (202) 225-3111
Richard Burr, North Carolina (202) 225-2071
Gregory W. Meeks, New York (202)225-3461
John Cooksey, Louisiana (202)225-8490
Barbara Lee, California (202)225-2661 (THE WOMAN!!)
Thomas G. Tancredo, Colorado (202)225-7882
Joseph Crowley, New York (202)225-3965
Ron Paul, Texas (202) 225-2831 (big cheer to Ron Paul!)
Joseph M. Hoeffel, Pennsylvania (202) 225-6111
Nick Smith, Michigan (202) 225-6276
Earl Blumenauer, Oregon (202)225-4811
Joseph R. Pitts, Pennsylvania (202)225-2411
Shelley Berkley, Nevada (202)225-5965
Darrell E. Issa, California (202)225-3906
Grace Napolitano, California (202) 225-5256
Eric Cantor, Virginia (202) 225-2815
Adam B. Schiff, California (202)225-4176
Jeff Flake, Arizona (202) 225-2635
Diane E. Watson, California (202)225-7084
Brian D. Kerns, Indiana (202)225-5805
US targets three more countries - James Clark, Nick Fielding & Tony Allen-Mills, The Times (London), November 25, 2001
<http://www.sunday-times.co.uk/article/0,,9002-2001544397,00.html>
This war is not just - James Carroll, Boston Globe, November 27, 2001
<http://www.boston.com/dailyglobe2/331/oped/This_war_is_not_just+.shtml>
Alliance accused of brutality in capture of Kunduz: Wounded prisoners shot and left to die - Rory McCarthy & Nicholas Watt, Manchester Guardian, November 27, 2001
<http://www.guardian.co.uk/Archive/Article/0,4273,4308059,00.html>
Amnesty demands inquiry as hundreds die in fort siege - Simon Jeffery, Guardian Unlimited, November 28, 2001
<http://www.guardian.co.uk/Archive/Article/0,4273,4309310,00.html>
Tories want war on terror to target Saddam - Andrew Grice, Independent Digital (UK) Ltd, 28 November 2001
<http://news.independent.co.uk/uk/politics/story.jsp?story=107172>
Is this Self-Defense Forces' loyalty toward US Forces? - Akahata editorial, November 29, 2001
<http://www.japan-press.co.jp/2263/is.html>
Fast Track "win" could haunt Bush administration -- and Democrats who sided with it - The Nation, December 6, 2001
<http://www.thenation.com/thebeat>
Boondocks Cartoon Censored - Frances M. Beal, The Black World Today, December 7, 2001
<http://www.tbwt.com/views/feat/feat8010.asp>
Pontiff reiterates his call for peace, Reportedly fears extension of war - Crispian Balmer, Reuters, December 10, 2001
<http://www.boston.com/dailyglobe2/344/nation/Pontiff_reiterates_his_call_for_peace+.shtml>
Vicious circle of terrorism and revenge must end - Akahata
<http://www.japan-press.co.jp/2264/vicious.html>