The Fall and Decline of the Nursing Profession
Nurses seen as the "bad guys"
Media headlines report murder, theft, abuse, drug dealings and forgery at the hands of a nurse. Other headlines report breakdowns in negotiations between unions and health organizations, with threats of strike action. These are the types of stories most people read about nurses, painting a tainted view of nurses as cruel, indifferent, greedy, lazy and power hungry human beings.
Nurses are the largest body of health care professionals in North America, and in most other countries as well. They are the backbone of every health care system, gluing all other parts together, providing support and strength in the care of the sick, injured, and healthy. Such news stories however create a very ugly picture of the profession. Though of the on- line comments to these stories which are harsh, but justified, most reporters rarely present all sides of the story, just those that seem most "news worthy"; Controversy makes for great headlines.
The temptations within the profession of nursing are very real, but that is no excuse for any nurse to misuse their position of trust. Some of the stories are reported are only half truths mainly because most nurses will not speak up on their own behalf to clarify the situations that have occurred. So are the public’s perception of nurses, the misunderstanding, are own fault?
Rarely has this author read any in-depth reporting on the difficulties and realities today's nurse’s face. According to a study, and book, written by Bernice Buresh and Suzanne Gordon (206), the media’s interest and attempts at trying to understand the profession better are too often met with silence. In their book, “From Silence to Voice: What Nurses Know and Need to Communicate to the Public” these studies were shared, in an attempt to help nurses learn to communicate more clearly, the realities and needs of the profession. The book suggests that nurses are still too quiet, too passive (and maybe even spineless), preferring to suffer in silence. Many governments still do not understand; they continue to cut staffing and in the same breath make promises to the public that cannot be kept.
So what is the rest of the story? Who are nurses? What kinds of people are they and why have these situations occurred?
The Truth About Nurses
With the North American population of baby boomer's hitting sixty, the astronomical numbers of people living with AIDS, obesity and diabetes epidemic in many countries, and the constant threat of new disease, the existing global nursing shortage makes the delivery of health care difficult at best. Add to these facts that health care consumers have become highly educated around health, and demanding as well, is it any wonder nurses are short tempered and burnt out. Still, it is no excuse for bad behavior. The world is in desperate need of more nurses, yet stories about nurses who kill or hurt their patients make the profession seem less attractive to younger generations seeking a profession.
Nurses are not what they seem; certainly not what the media often present them to be. There is so much more to the profession than any government, or member of the general public realizes. It is almost certain that most, if not all, people around the world are aware of the nursing shortage. Governments continue to fund and report their studies, yet the results seem to lead only to more studies.
Political groups continue to use the health care crisis in their election promises but sorry little is really done after an election. Policies to decrease wait times, opening more hospital beds, even building new hospitals, seem ridiculous and unproductive strategies toward any real solutions. Increased spending of money for the recruitment and retention of nurses is not providing any real long term solutions; provinces, states, and countries are simply fighting for the same few nurses.
Aside from the bad reputation that the profession is dealing with there are many interested, and qualified, individuals who desire to become a nurse yet schools regularly turn away hundreds, if not thousands, of applicants each year. There is not enough money to hire qualified instructors to teach, and often the salaries offered are not as much as a nurse could make working in another healthcare setting.
Overworked and Burnt Out
Are the stresses of too few nurses and too much work causing nurses to turn bad?
In 2005 Statistics Canada published a survey, "The National Nursing Work and Health Survey". The survey examined the work environment of nurses and the links to their state of health. It addressed some very serious questions about the state of physical and mental health of nurses, as well as how nurses perceived the quality of patient care they were able to give. The results showed thirty, to nearly 50% of nurses worked overtime, paid or unpaid. Twenty-seven percent of nurses reported deterioration in nursing quality, risks and workload pressures. More than a quarter of respondents who provided direct hands on care reported being physically assaulted, and 44% reported being emotionally abused by patients. The report noted that in 2005 the average age of nurses was 44.3 years. Rates of obesity among nurses were similar to all working Canadians. More than one third of nurses reported under staffing, especially working in hospital or long-term care settings. Over fifty percent reported coming to work early, staying late or even missing breaks in order to keep up with the work load.
But what do these numbers mean?
So what now?
You could probably ask any nurse currently working under today’s conditions (under staffing, heavy workloads, poor pay,) and get real and timely answers. But few strategists seem to listen to the front line workers. Committees and study participants are made up of politicians and high end management, none of whom have spent any time, recently, at the bed side. When nurses do make suggestions their ideas and suggestions must first be taken to a committee, or studied more, by upper management. Real concrete actions should have started years ago. Nurses have the answers but no one is listening.
With the constant emergence of new diseases, an aging population that is also living longer, and too few nursing professionals to care for people, hospitalization or nursing home placement seems like a death sentence.
Patients and care home residents to not get the care they need because nurses are stretched too thin. Hospital acquired infections and medication errors continue to cause thousands of deaths each year, mostly due to a lack of a simple procedure nurses find little time for; Hand washing, and cleansing of stethoscopes between patients rarely occurs, not because of a nurse’s lack of understanding of infection control, but because of time constraints. And what about medication errors? Patients receive wrong medications, wrong doses of medications, even missed medications because nurses are rushed. Things that should be done, that really must be done, are not happening, because nurses are pushed to the limits of getting tasks done within certain time frames and without the proper manpower and physical resources to do it.
In Canada the theme for Nurse's Week 2016 is "Nurses: With you every step of the way". The ANA (American Nurses Association) theme is "Culture of Safety...It starts with you" Nurses know about the themes each year but does the general public? North America has yearly themes that try and put the nursing profession in the spotlight for a time, but how many other countries do the same?
Nursing is a powerful yet highly misunderstood, and trod upon, health care profession. This body of professionals do far more than give medications, dress wounds, immunize your children, or hold a dying patient’s hand. Nurses are inventors, political activists influencing government policy, authors, and selfless human beings with a passion to help complete strangers.
Without more nurses new equipment will stand idle, new beds will only gather dust. Physicians, surgeons and specialists cannot provide the best care for their patients without nurses to follow through on care plans on a 24 hour basis.
Nurses are also made of the same flesh and blood as the people they care for, prone to the same illness, needs, and vulnerabilities. The work carries many inherent hazards and the chances of becoming ill or injured on the job are far greater than the general public may realize. It is a truly dangerous profession.
.Public awareness and action have always been great motivators for change in government views and practice. The nursing profession needs this public action and support.