A shortage of nurses elevated the misery of a woman in my support group during a recent health crisis, she informed us. Because I participate in a clinical trial, in which I am vigilantly monitored in both Bloomington and Indianapolis hospitals, I was surprised. But I quickly began to realize that her ordeal could not possibly be unusual and then to fear that our current health care system is becoming more unfriendly, inhospitable to patients and to nurses as well.
My friend Dana arrived at Bloomington Hospital’s emergency department with a problem that many people confront after below-the-belt surgery or radiation: a bowel blockage. Dana ended up spending the entire night in the emergency department. When she asked why, she was told that administrators at the short-staffed hospital had closed an entire floor.
Once in a room, Dana discovered that it took 45 minutes for the overworked nurses to answer her call button. The young woman who inserted her NG tube was supposed to care for four patients, but had been assigned to six and to the infusion center. While Dana was kept awake the second night by the audio of her roommate’s TV, she found herself shivering and wondered if she had a fever. Before being discharged the next afternoon, she discovered that the thermostat had been set at 60 degrees. Understandably, the following week Dana became exasperated during an automated phone survey from the hospital: “On a scale of 1 to 4, did we make it easy for you?”
Dana emerged unscathed from her wretched hospitalization, but her experience reminded me that something similar had happened to me a few years ago, although back then I did not know why. Also undergoing a blockage, I too had spent an entire night in the local hospital’s emergency room, parked in a sort of closet. After being moved to a room the next morning, I needed to consult a stoma nurse about my nonfunctioning ileostomy. However, another 24 hours crept in their petty pace before one appeared. At that point, I was in no state to profit from her expert advice.
By calling our health care system unfriendly, then, I mean to underscore not hostile or antagonistic but tardy, hurried or distant responses from clinicians — careless care generally related less to their personal failures and more to the constraints within which they operate.
No wonder, since it turns out that there is a shortage of nurses in Indiana and even more so in California, Texas, New Jersey, South Carolina, Alaska, Georgia and South Dakota. According to the American Association of Colleges of Nursing, the shortage is expected to intensify. Especially in the context of an aging population, the retirements of a generation of baby boomers — one million of the 3.8 million registered nurses in the United States will leave the work force between now and 2030 — have created and will continue to create staffing crunches. Hospitals are not the only sites affected. Many public schools do not currently have full-time nurses in their employ.
As I was learning about this, I went to the hospital for a periodic blood draw. The nurse about to access my port paused to tell me that the receptionist in the infusion center had resigned, but would not be replaced. The nurses were expected to take up the slack. “It’s gone from the human touch to ‘get it done and get it billed,’” she said. Then she explained that her department would soon be given a new computer system to learn so I should phone before my next appointment. Finally, she assured me that having gotten her complaints off her chest, she would be as gentle as possible, and so she was.
During the following weeks, I continued to mull over nursing scarcities since, paradoxically, poor supply has nothing to do with poor demand, not only from people who need nurses but also from those who seek to become nurses. Many candidates want to enlist in nurse training, despite the long hours and the taxing physical and emotional demands of the job. But baccalaureate nursing programs are not enrolling a sufficient number of undergraduates. Nursing schools turned down 75,000 qualified applicants in 2018 because they didn’t have enough people to teach required courses and because of budget constraints.
Apparently there is an aging and depleted nursing professoriate partly because highly trained nurse educators — who must have advanced degrees — often make less money in academia than they would if they worked in a clinical capacity for a hospital, a corporation or the military.
As a humanities professor, I was surprised to discover this: I had assumed that only humanities professors were undervalued and underpaid. Dedicating oneself to a pedagogic role, choosing to instruct future generations of nurses, entails investing in expensive graduate work and also in taking a pay cut.
There is something wrong with this picture, I was brooding when I found myself back in Indianapolis for a meeting with my oncologist and a blood draw by a nurse who has been accessing my port for so many years that I know all about her children and she knows all about mine. I was therefore shocked when she confessed — after she removed the needle and affixed a plaster — that she was leaving.
At a loss for words and clearly troubled, she stammered as she hugged me. Eventually, she resorted to quoting another nurse who had also just decided to quit: “I’d rather be a greeter at Walmart than work under these conditions.” The comment jarred me into a new awareness. Nursing shortages will strain overburdened nurses, which will surely increase shortages in the days to come.
Susan Gubar, who has been dealing with ovarian cancer since 2008, is distinguished emerita professor of English at Indiana University. Her latest book is “Late-Life Love.”
Source : Nytimes
