I’ve been a nurse for over 30 years and I never remember a time when there wasn’t a shortage of nurses. I worked in the newborn nursery of a hospital just after I graduated from nursing school. There was usually one RN per shift, with several nurse’s aids. The RN would care for the premature and sick babies and the aides the healthy, full-term babies. Sometimes I had so many preemies with tube feedings that I would just finish the last one and it was time to start over again with the first one.

As a teenager, when I was considering different careers, I was told that if I went into nursing, I wouldn’t make much money, but I would always have a job, because there was always a demand for nurses. I was told that lack of financial gain would be made up for in the satisfaction I would feel after a day of helping others. That lie belongs in a bedpan!

For a short time in the nineties, nurses were being laid off and new graduates of nursing schools had a hard time finding jobs. In the nineties hospitals, HMOs, and the insurance industry manufactured a phony surplus of nurses by training nonprofessionals to do many of the tasks that registered nurses had always done. In some cases the results were tragic. Unlicensed assistive personnel (UAPs), as they are called, carried out treatments and procedures they really weren’t adequately trained to do. No matter how sincere, hardworking and dedicated, UAPs are not nurses. It takes more than just learning the technicalities of nursing to perform as a nurse and give safe patient care. It takes a background in chemistry, biology, biochemistry, bacteriology, anatomy and the social sciences, as well as the study of nursing and practicing what is learned in carefully monitored clinical situations – something that takes years.

Many nurses left the profession and continue to leave the profession because of intolerable working conditions. Nurses complain that hospitals are short-staffed, resulting in nursing caseloads too large for the delivery of safe care. Nurses who refuse to work overtime can be charged with patient abandonment and be fired. Nurses complain that they can’t give effective, much less safe, care if they are working while dead on their feet. It isn’t long into a second shift that you realize you can’t exactly see straight and you’re trying to calculate medication doses and set intravenous pumps to deliver the right amount of medication and your mind just doesn’t work as fast as it did during the first eight hours. The wrong placement of the decimal on an IV pump can result in an overdose of 10 or 100 times the amount of medication a patient is supposed to receive – it’s called ‘death by digit.’

In a recent study by a University of Pennsylvania School of Nursing faculty member, it was found that patient mortality increased with the number of patients a nurse had to care for. Well, duhhhhh! Why did it take so long to do a study like that? I certainly support the scientific method, and I am glad the study was done so it can be added to the arsenal of weapons to fight for health care reform, but there’s nothing like a system run for profit, not for patients, to wait for a study to prove something obvious. One study isn’t going to force changes. It will take political action.

Laws forbidding forced overtime, unless there is a true emergency, must be passed, as well as laws mandating maximum patient loads for nurses. Many nurses are in unions; more need to be. Future nurses can have their loans paid off after graduating, which is well and good. However, there should be grants and stipends for nursing students, and all students, no matter their field of study. Of course, we need a national health program, run by the federal government, which will take insurance companies and profit out of the equation. We need socialism, a humane system that provides a decent standard of living, and decent working conditions; where the quality of social, health care and other human services is not dependent on how much a person can afford.

The author can be reached at pww@pww.org

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