Rebuttal to Presentation of the Nevada Hospital Association on Nurse Staffing Ratios and Acuity

Nevada RNformation, May 2004 by Gonzalez, Lillian

Rebuttal: This task force should be scrutinized as it relates to the composition of its members, its goal, and how the conclusions of this study will be used.

1. Member composition. Nursing students, although highly motivated to make a difference in their future profession, may lack experience and insight to be effective participants. Hospital staff nurses might shy away from addressing serious issues that could make their employer uncomfortable. The objectivity of nurse executives and nurse recruiters should also be considered, especially if they are employed by hospitals.

2. Motive. Are the three subcommittees initiated by the NHA really designed to find the root cause of their shortage? Or is it an effort to deny, rationalize-, -and circumvent ways to safely and morally address their nurse shortage? The objectivity of a task force controlled by the NHA to look at its own nursing shortage should be questioned.

3. Action. According to a recent study by a top national leader of nurse research, Peter I. Buerhaus, et al, published in the November/December 2003 issue of Health Affairs, "...RNs over age 50 and foreignborn RNs account for practically all of the [100,000] increase in RN employment in hospitals in 2002." In fact, today, almost one third of those taking registered nurse boards in this country for the first-time are educated abroad. According to the article, "Ethical, economic, and other issues related to using foreign-born RNs to supply the nursing demands of . the U.S. healthcare system must be acknowledged and debated." I know of Nevada hospitals embarking on aggressive campaigns to import more nurses to address their shortages. While visa-seeking and new graduate nurses might improve hospital bottom lines in the short term, potential long-term consequences must be identified and considered. Without legislative oversight, the powerful AHA and its affiliates will continue to use tactics that have failed to retain competent registered nurses and that compromise patient care.

Summary: Indeed, when my travel agency nurse recruiter warned me Nevada nursing was "difficult," she understated the problem. An analysis to determine why Nevada hospital staff nurses are so dissatisfied that hospitals are unable to retain them should be a focus of any Nevada legislative task force. I believe conclusions will be similar to what previous national studies have found: that nurses burn out due to the unsafe, unrealistic numbers of human lives they are required to manage; and that nurse-to-patient ratios is one option that must be considered as a means to improve the care given to vulnerable, hospitalized Nevada patients.

by Lillian Gonzalez, BSN, RN

Registry Nurse