I rarely post articles written by other authors but found this post quite interesting and worthy of sharing. The book is well written with compassion and a caring spirit, and I would highly recommend it to you.
The below article is published with permission.
Don't forget the nurses when talking about health care reform.
Don't forget the nurses!
After all, who's there at your bedside 24/7, after the doctor has left the room and your insurance company (if you're lucky enough to be among those insured) is closed for the day?
Irene Stemler, RN, author of the book, Heroic Acts in Humble Shoes: America's Nurses Tell Their Stories, says, "Nurses are the real heroes in health care. If you want to really get the lowdown and solve the problems in health care, talk to the nurses."
What makes nurses happy? What does it take to keep them at your bedside, providing compassionate care and fierce patient advocacy? It has to be compensation, right? Wrong. At least, not completely, and it's certainly not at the top of the list.
Ms. Stemler says that if health care reform is to work, it needs to address the needs of the nurses. "Nurses are the people who run down every detail to make sure you stay safe."
She interviewed dozens of nurses in the course of researching her book and says that the things nurses care about the most might surprise you. Here they are:
- Respect. Every nurse interviewed for this book talked about their need to feel valued by their patients and their peers for the work they do. They'd like to be acknowledged in a positive way by the physicians as well.
- The ability to do nursing work. Seems rather obvious, but that's not the reality. When budget cuts are made, non-essential positions are usually the first to go, including housekeeping, clerical, and transportation. The actual work doesn't go away; it's the worker. Who is left on the unit to file those papers, transport the patient to x-ray, or empty the waste cans? The nurses, whose positions are vital to patient care, only now, they're asked to assist with non-nursing duties.
- Innovative scheduling. Believe it or not there are hospitals that rarely, if ever, hire part-time staff, and their nurses are required to work 3 weekends on/1 weekend off. Survey the nursing staff and determine how you can be more sensitive to their scheduling needs, and do it!
- Compensation. Yes,
money is important, but it's not always the deciding factor. Hospitals should offer competitive salaries, but exorbitant recruitment bonuses don't engage nurses to stay past the contract date, and might even cause a rift between current employees (not receiving an incentive) and their newly hired peers.
- Professional growth environment. In addition to offering tuition reimbursement and on-site classes for certification, nurse managers should allow for staff to leave the unit and participate in these programs.
- Health & wellness programs offered onsite. Nurses have told me, "You can't pour from an empty pitcher," and I agree wholeheartedly. Flight attendants caution us to apply our own oxygen mask before assisting our neighbor, and so should nurses. Nurses should be mindful of establishing healthy work habits and participating in wellness programs, and hospitals should encourage this type of healthy behavior.
Nurse retention is just as important as nurse recruitment, and in fact is less expensive in the long run. A recent study found in Health Care Management Review (Waldman, et al. 2003) found that hospital turnover costs can be as much as 5.8% of the operating budget. So, a hospital with a $500M operating budget is spending up to $29,000,000 on turnover. According to another study found in the Journal of Nursing Administration, (Jones, et al. 2005), the cost of nursing turnover is estimated at 1.3 times the RNs salary. So, using an average RN salary of $60,000, it costs the hospital approximately $78,000 when a staff nurse leaves an organization.
Hospitals are well advised to listen and act upon the needs of their nurses because there's a new at-risk group that's emerging: the newly licensed RN (NLRN). The Robert Wood Johnson Foundation recently funded a study found in the journal Nursing Outlook (2009) that looked at the reasons why nurses leave an organization. The timing for the article couldn't be better because we're finding that approximately 18% of NLRNs leave their first employer within their first year, and about 26% leave within two years.
The results point to the nurses' perception that there isn't enough time to complete the work, and that the tasks performed on the unit don't represent what was learned in school. In addition, they felt they didn't have enough time to spend with the patient, and there wasn't enough communication with physicians and recognition from them for the work nurses do.
Probably one of the most valuable steps a health care facility can take as a part of health care reform is to create a meaningful nurse recognition program, with input from nurses. "And don't let the effects of the recession fool you," Stemler warns.
"Nurses might be staying in their current positions because their spouses are unemployed or they're coming out of retirement while their 401k plans are readjusting, but once the economy improves they'll have more flexibility to look for the ideal employer.
"Infuse the program with spirit and genuine appreciation and you will encourage the nursing staff to remain committed to your organization," she says.
Heroic Acts in Humble Shoes
America's Nurses Tell Their Stories
By Irene Stemler, RN, BSN
