Improving nursing conditions.

Abstract

Letters Health AffairsVol. 21, No. 2: The Determinants Of Health Improving Nursing ConditionsNancy Donaldson and Jane Hirsch AffiliationsUniversity of California, San Francisco, School of NursingUCSF Medical CenterPUBLISHED:March/April 2002No Accesshttps://doi.org/10.1377/hlthaff.21.2.305AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View articleTOPICSNursesNursingQuality of careHospital qualityHealth care providersPatient carehealthaffHealth Aff (Millwood)Health AffairsHealth Aff0278-27151544-5208Project HOPE - The People-to-People Health Foundation, Inc.Adams BarryBoston, Massachusetts32002The Determinants Of HealthThe author responds:Ray Bingham’s and my experiences are in no way unique. Certainly there is no single solution for the almost endless ills affecting nursing and U.S. health care. However, the fundamental problem is not complex. There is inherent conflict in a market-driven health-care system where economic profit is given as much consideration as the final product, if not more. All too often patient outcomes may be viewed simply as externalities or spillover costs or benefits. So entrenched is our economic consciousness that greater financial incentives have been proposed as a solution to attract nurses back to patient “care.” The irony cannot be missed. Experienced nurses know that this is not the answer. In fact, nurses around the country (even recent graduates) are walking away from salaries that, under any other circumstances, would be considered substantial.For too long the nurses who provide hands-on patient care have looked to the “top” for change—change that would consider patients’ needs before money, egos, and careers. As Claire Fagin and Jean Chaisson clearly point out, that has not occurred and will not occur as long as those remaining in positions of power are unwilling to stand up. As a result of that vacuum, bedside nurses have become the visionaries needed to speak for their profession and the public by, for instance, demanding regulated staffing ratios.Further research may also inform policy, as Nancy Donaldson suggests. However, scientific evidence is often overlooked in the world of politics and the marketplace. (For instance, science was not considered when reducing RNs at the bedside.) As policymakers and analysts struggle to undo the damage, the voices of the nurses and physicians who provide direct patient care should inform them. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 March 2002 InformationCopyright 2002 by Project HOPE - The People-to-People Health Foundation, Inc.PDF download