Our Nurses: The Workers Point Of View

CounterPunch
March 14, 2005

The Workers' View
Nursing Against the Odds
By DAVID SWANSON

"Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care,"
by Suzanne Gordon
Cornell University Press, 450 pages.

What nurses actually do is invisible to us, even to patients, even to nurses themselves. We think in terms of 19th century stereotypes. We picture nurses in hats that no living nurse has worn. We imagine them as the unskilled humanizing assistants to doctors who do all the scientific thinking. We imagine that only women can be nurses -- and only women who lack intelligence and ambition. Being a nurse, like being a teacher, is a second-best career perhaps because its aim is not the advancement of scientific knowledge. Never mind that nurses contribute as much as doctors to medical knowledge or that there are purposes more noble in life than the accumulation of knowledge.

Gordon's book is a masterful depiction and analysis of a career we generally fail to understand, and which health care corporations have clearly failed to come to terms with. In this country, nurses do much of the work done by doctors in some countries. They are constantly observing and diagnosing. They often speak in terms that give doctors credit for their work, but if nurses always waited for doctors to analyze the raw data they collect, many lives would be lost. Entering a hospital that really functioned like that would carry a greater risk to patients than entering a war zone.

How ever skilled your doctor may be, a stay in a hospital without nurses competent in the fields relevant to your illness means a serious risk to your health. So does a stay in a hospital in which doctors will not condescend to listen to nurses. The stories Gordon tells of nurses' warnings being ignored, and needless deaths resulting, are heartbreaking and frustrating. Surely we should be beyond such petty egotism and class distinctions in a profession as long established as health care. Apparently we are not. Gordon devotes much of the first 150 pages of her book to the dysfunctional relationships in our hospitals.

Gordon encourages nurses to play a more outspoken role in the public debate over single-payer and other health care questions. But this book is not just for nurses. Every profession should have a book like this one. And every one of us should read each of those books. Working class solidarity is built by understanding the work our brothers and sisters do, and this book is a wonderful contribution toward that end.

http://www.counterpunch.org/swanson03142005.html

The motherfucking administration won't fucking help them in their goddamn shitty plight.

One of the things I learned in nursing school, was to always question MD orders I wasn't comfortable with as well as to keep my practice current. Doc's are usually great, but not infallable as we all know. I'll never forget one of my instructor's telling us a story about a high dose of a drug, that had been questioned by 2 nurses, the floor and the charge nurse, BOTH of whom questioned the doctor, who insisted that the dose he ordered was the dose he wanted. It turned out to be lethal to the patient. Guess who was included in both a lawsuit and discliplinary action? Both nurses. Nursing is art and science. But we haven't learned to use our powerful voices effectively on issues that affect us (Some nurses do, the ones that do rock). If you look at any nursing union, when the shit hits the fan, what is almost always first on the list is patient safety--before money, before benefits. I was sitting in a seminar not too long ago, and part of it was asking why did you become a nurse. Almost every nurse mentioned caring and taking care of people, being of service to humanity. Me? I of course mentioned those things, but I also told them that I have strong political beliefs, and that I want to be a part of how nursing is evolving, I want to affect policy, to be proactive for nursing and nurses as well as patients. I stopped short of telling them that I was a left wing pinko feminist. Too much information Thanks for the post!

even though one of the most miserable jobs we face is questioning orders and telling His Eminence that if he wants an overdose administered to a patient, he's going to have to come in and do it himself. Been there, done that.

What people don't know is how we're constantly assessing our patients. A seemingly innocent conversation about the weather or pop culture is telling us if the patient is alert and oriented, if his speech is affected, what his emotional status is, and how effective some of his comfort medications are. That sort of thing can't be done by people right off the street who don't know what they're looking for.

Bozos in administration always think nurses just wander around with clipboards recording a patient's bowel movements and dispensing pills that have already been counted out by a pharmacist. They seemingly have no clue that the best predictor of a good outcome for a patient is adequate staffing by licensed nurses. The first place they always try to cut costs is in nursing because they have no clue in the world what nurses actually do for their patients in terms of ongoing assessment and early intervention at signs of complication.

This nurse has had it and won't be going back to bedside nursing any time in the foreseeable future. Doing my job in spite of administration was possible twenty years ago. It no longer is, thanks to the constant burdens of non nursing functions like housekeeping added to an unsafe patient load. Sorry folks, but you're on your own. If you are unfortunate enough to go to hospital, please find family members who can stay with you. They're your best hope now. Nurses do their best, but there aren't enough of them to keep you safe.

And they both appreciate good ward clerks. :D

Tomorrow I take my final in 2nd quarter nursing class---I'm 1/3 of the way towards my RN, and I'm so excited that I picked a field that is as exciting and absolutely critical as nursing is.

Even more excited that hubby is starting nursing school in the fall, so I can use him as a sign-on bonus in the field :)

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Nursing schools in this country are overloaded. There is no shortage of qualified applicants---but a MAJOR shortage of spots, teachers, space, funding.

An ex-friend of mine who's in the military used to chastize me about my choice of career---"Ew. Who wants to look at gross body parts?" she'd always ask me. "Ew. Who wants to be forced to kill someone if given orders to?" I'd ask back. She never had an answer.

In our fight for STRENGTHENING THE HOMELAND, we've spent billions of dollars in finding creative ways of helping people die, yet pennies to fund creative ways of helping people live.

How can you have a STRONG HOMELAND if you're woefully unprepared in the event of a catastrophic emergency? We can be talking something as horrific as a nuclear bomb being detonated, or something as horrific as an epidemic of the flu--in either case, our hospitals and clinics are understaffed and there's no relief in sight.

My nursing school admits students 3x's a year, 25 students per quarter. That's 75 students entering the nursing program every year. Last year, there were over 200 applications for 25 spots.

In order for one to teach a nursing program, one must be a nurse practitioner--that's a graduate level degree.

In practice, a NP makes around $80k a year, if not more. In teaching a NP makes around $24-$30k a year,if not less.

Community colleges are where most nursing programs are---you can get a 2-year RN degree and then transfer right into a BSN program and get your bachelors in about a year.

But funding to community colleges has been cut. Federal financial aid has been cut. Pell grants have been cut. School tuition is rising.

My first quarter in the nursing program, I spent over $500 JUST ON BOOKS, another $150 on supplies. This quarter, I spent another $100 on books, and next quarter I'm looking at a minimum of 3 more books I have to buy at $85 a pop.

What state would our country be in if even a SMALL community were to be hit hard by a natural disaster or terrorist event or wide-spread illness? Hospitals are already overflowing, hospital workers are already overworked. There is a disgraceful Patient:Nurse ratio as it is. How successful can a nurse be when she has to administer care AND medications in a safe manner to 12 patients? To 20 patients?

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Why are plumbers paid more per hour than nurses? Electricians? Brick Masons? Construction Workers?

Not to demean those professions in any way--however, I would think that giving life-saving care to a patient, checking orders three times, giving medications, following-up---is a bit more....er....specialized than what a plumber does. It's a bit more....urgent, I would suppose (I say that now, but wait until it's 2am on a Saturday and I can't flush my only toilet!) The ramifications of having untrained and overworked plumbers isn't as threatning as the ramifications of having untrained and overworked nurses.

not God

...if not Deity help us all.

This is obviously a photo of Bush on one of his better days!

:)