Sick Around the World

This news article, by FrontLine and Washington Post foreign correspondent T.R. Reid compares the American Healthcare system with 5 other democratic countries. I very worthwhile, and eye opening report. There are some great systems out there that greatly benefit health care consumers.

I would love to see this report expanded on to delve more in to how these systems affect nurses' quality of workplace as well as lifestyle. Do they pay enough? It was obvious that in most systems doctors can not "get rich" like in North America, but they do manage a descent living (I believe). But do nurses?

If you have not seen this program yet, aired on PBS this month, I strongly recommend you take 30 minutes and have a listen

Sick around the World>

Nurse to Patient ratios in long-term care

Acute care settings are starting to get serious about safe staffing ratios, with some push from registering bodies. But my concern is that extended / long term care residents are not getting the same consideration and care...and that is dangerous. Not everyone in these facilities is set to pass from this world in the near future. Many still have quite a few years left to live. See, long term care facilities are not just for older folk. Accident victims who end up paraplegic, perhaps even requiring a ventilator to assist breathing, can spend 5, 10 or more years in long term care.
I have worked in several nursing homes/extended care facilities and it seems (at present) that the normal staffing ratio is one (1) licensed nurse (RN or LPN) for 30 or more residents. That one licensed nurse is responsible for medications and treatments for all those residents. I have also worked with ventilated patients/residents where nurse/patient ratios seem to show that the lives of those in long term care are not as sacred as those in an acute care setting. In hospital, each nurse has no more than 2 ventilated patients. In long term care, on night shifts particularly, each licensed nurse has 3, and far to often 5, residents to themselves PLUS another 10 (or more) non-ventilated residents.
I said earlier this is dangerous and I stand by that. Dangerous for the lives and quality of life for the residents as well as the professional and personal life of the nurse.

Licensure costs

Every year when I renew, or apply for license in a new province, I am astounded at the amount of money I must put out. A yearly subscription to the federal magazine can't cost that much to create surely. And does having someone look up your previous information in the computer, fill in a form and place a stamp on the envelop really equal the cost of verifications or reinstatements? I have had to nearly turn down job offers because I could not find these funds (my husband came through with a credit card, but should that be so necessary?).
More recently I faced a different cost put out by a provincial licensing body. I am supposed to trust and pit faith in my professional nursing bodies, I follow their guidelines and rules for being licensed so I do not practice nursing without a license. And I have done so in the past. Recently however, after having sent in all appropriate documents and fees I made a simple phone call to my registering body to find out why I had not yet (after 3 weeks) received my certificate in the mail. The person at the registers office looked up my information on their computer and merely said..."oh". I'm too scared to ask what that meant exactly. She then put me on hold and later came back with "we'll mail that out right away". Three days later I still can't log in the their member page on the web site...it does not recognize my registration number.....Now what?

Horizontal violence

A fancy name given an on going problem, that of nurse to nurse violence. I have been reading a lot of stories lately in chat rooms about other nurses stories, stories of verbal abuse from coworkers, all too often coming from managers. The consequence of course is an added burden to the nursing shortage as nurses leave the profession because nothing is being done. And I mean nothing. Fancy articles published in journals by those holding PHDs about how we need to pull together, methods we could use for handling stress in our lives and what managers should do to increase mentorships, nurse to nurse. Reality check here...it is not being done and we continue to lose good nurses.
Let's cut to the chase shall we. There are far too many crappy (and cranky) managers, whose own managers are probably just as bad if not altogether blind. I'm tired of reading pretty theories, it is time for real action. Nursing is a powerful profession but we are using this power wrong. Put in to the hands of professionals with real vision nursing can become a vibrant and caring strong hold that nurtures its' own. It can be seen as a profession that many will want to embrace because of what we can accomplish for the health and well being of the world. That is not a load of crap! Think about this for a moment...if health care systems around the world lost nurses the entire health system would crumble. It would become nothing more than a hit and miss entity when sought out by the sick or injured. Nursing holds it all together. FACT!
There is no excuse for abusing and mistreatment of coworkers by coworkers, management or governing bodies. It must stop now! We are well educated and well practiced and we are necessary. If you want a strong future for nursing we must all find the strength to stand up and say STOP, and we must do it now. The only consequence you need to worry about is that if this horizontal violence continues you will have no one to blame but yourself.

Nursing still viewed as lowly work

As I was researching nursing life in other countries I turned up some disturbing facts. Countries such as India and Indonesia still view nurses as nothing more than hand maidens of doctors. Training is not comparable to North American standards (and I'm comparing here because this is where i was trained) and more highly educated nurses are not entirely welcome by upper management of hospitals. Letters to newspaper editors in these countries often state how poor people can not afford health care (in some instances must show up with own chemo drugs for treatment) and are treated coldly by nursing staff.
Here we are in 2007 and depending upon what country you are in women...nurses...are treated poorly, as is the profession overall. The profession has much work to do indeed, to increase government and overall understanding and respect for what we do, who we are.

If nursing were run like a business

I know I have mentioned in the past that part of the current problems with nursing and the health care system might be attributed to management treating health care more like a business. I was at first upset by having to refer to patients as clients and taking customer service courses. Now I think health care organizations may have better luck retaining nurses (and others) if they treated them as well as many larger retail chains treated their employees. I have spent a little time in the retail industry during these last 11 years of nursing and have been left impressed with how managers encourage sales associates to grow through performance incentives and employee discounts. The hours of work may be long, the days very busy, but I have always found more enjoyment in my work (in retail) because of these factors.

Poorly paid nursing faculty adds to nursing shortage

In researching the part of my book dealing with the question "is there really a nursing shortage" I found information regarding the pay scales for nursing faculty. Now, one of the reasons nursing schools turn away prospective students is because of lack of faculty. And it seems that this lack of faculty may have everything to do with poor pay. Most faculty members are prepared at the Masters level (at the very least), yet they are paid (in the USA) at 39% LESS than a Nurse Anesthetist.
Underpaying nurses for their skills and knowledge is, in my eyes,a show of disrespect for the profession.