In an article posted in Medpage this week, it was reported: employment projections are estimating that the need for registered nurses (RN) will continue to grow rapidly — at the same time a nurse shortage is expected. The article went on to say that nursing school enrollment is not advancing fast enough to meet the RN demand, and with nurse baby boomers aging there will be fewer nurses available as the health care sector continues to grow. The remainder of the article focused a bit on what employers can do to retain nurses, and included such common sense suggestions as: respect and valuing nurses, providing leadership and mentoring opportunities, and providing adequate tools for success.
Over 30 years ago, and before entering the field of speech-language pathology, I worked as an emergency room nurse. After re-locating to Florida in 1989, I established a Florida nursing license, and each year, fulfill my CE requirements, not willing to relinquish my license, in part, because it was my start in nursing that led to my eventual work as a medical speech-language pathologist. Now, having spent weeks at a time in hospitals as a family caregiver, it is plainly apparent that a nursing shortage is already here.
During a prolonged hospitalization in 2012, when my mother underwent surgery and suffered a stroke, I had my first shock when I realized that no one came into the patient’s room any longer to offer a daily bath, or to help patients brush their teeth, despite increased evidence to support a relationship between poor oral health and bacterial pneumonia. If lucky, physical therapy arrived once a day to walk my mom, with the remainder of her time spent either in bed or in a chair, sometimes for hours at a time. An incentive spirometer sat on her bedside table, and yet, noone ever offered it to her or recommend she use it, despite some potential benefit for maintaining respiratory function. And, despite the fact that she had had a stroke with resultant severe aphasia (unable to speak), no speech therapy was provided or options for non-verbal communication offered until I arrived for a visit with a simple communication board in tow.
In many hospitals now, it is customary for nurses to work 12 hour shifts, and yet, patients may actually see the RN, if lucky, twice a shift, usually for administration of medications, or, when an IV beeping continuously, finally summons someone to the bedside. The remainder of the RN’s time is spent doing data entry on the computer, as the demands for documentation have grown increasingly burdensome. A CNA (certified nursing assistant) usually is the one to help with toileting needs, and relay messages back to the RN, regarding patient complaints such as pain. In the past, LPN (License Practical Nurses) were an intermediary position, working under the supervision of the RN, and often providing direct care at the bedside. While training is not as extensive as for an RN, many LPN had/have skills, including assessment skills, that made them ideally suited to bedside care. As many hospitals have eliminated the LPN position it has no doubt contributed to the nursing shortage increasing demand on the limited number of RN.
For years in hospitals, nurses have had to work over-time if requested, float (work on units other than the primary unit they are trained for), be sent home with hours cut, if the census is low, and at times, withstand verbal abuse from physicians and sometimes patients. Sadly, now, for many, they feel enough is enough. So where does that leave us as potential recipients of healthcare?
While politicians argue about who will pay for “sick” care, we must all be aware that those who chose nursing and related health care fields because they had a desire to serve, are retiring, leaving the field, or choosing other professions leaving family members to fill the roles as the nurse and patient advocate at the bedside. Are you ready?
My MissionTo enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower. Mary Spremulli, MA, CCC-SLP