On my long since defunct website, “Doctors For Freedom,” I always devoted my February column to nursing, my Valentine to the profession. And of course, I always included some sophomoric photoshopped rendition of Nurse Ratched. Yes, I realize that the above picture is clichéd, and imprecise given the ever-increasing presence of men in the nursing ranks. But I think it’s funny, so try to power through.
What is not as funny is the continuing nursing shortage, which has been worsening for over the past decade when I first started writing about it. This bit from The Atlantic in 2016 calls it:
“According to the Bureau of Labor Statistics, 1.2 million vacancies will emerge for registered nurses between 2014 and 2022. By 2025, the shortfall is expected to be more than twice as large as any nurse shortage experienced since the introduction of Medicare and Medicaid in the mid-1960s.”
Funny how that ties nursing shortage with the installation of de facto government health care. And the year before, do-gooder-in-chief Lyndon Johnson signed the Nurse Training Act of 1964 to alleviate projected shortages. A half-century later, the problem is only worse. We have a heavily graying population, which means more acuity, which means more costs, which means more budgetary pressure against those who actually do the work. Scumbag Big Insurance follows the prime rate of Medicare, keeping things expensive while keeping payouts low and always adding to the regulatory costs. Hospitals – themselves not paragons of fair play – are caught between flat revenue levels and high, mostly wasteful, administrative overhead. How many extra nurses could be provided annually for the cost of extortion JCAHO pre-inspections? How many nurses could get real raises for just by doing away with a fraction of the money blown on IT flatulence every year?
Nurses have the hardest, more often than not, most thankless jobs in the hospital. They get to absorb every bitch and whine from every patient and family member, in between mountains of pointless paperwork and retina-fusing computer screen staring for hours, all to fill in the gaps with a little bedside time, and ruining their health lifting an increasingly obese society. Physicians rely on good nurses, and they keep us out of trouble on a lot of sleepy, even error-prone nights. Good nurses are getting spread too thin, burned out, aging, succumbing to the dilutions of administration jobs and the NP ranks, or are just plain tired. And for my money, the good ones are worth a hell of a lot more than they are paid. The fix? Chalk up another lance, and go find a windmill, for all the success you’ll have porting dollars to the ones who actually provide the care.
But while we have you, ladies and gentlemen of nursing, thank you for somehow still showing up and keeping it all running. You are great, and sincere thanks.