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Guest Commentary: July 5, 2001
The Nursing Crisis
The Honorable Danny K. Davis
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Nurses are an absolutely essential component of our health care system -- no piece of medical equipment will ever replace the around-the-clock surveillance provided by our Nation's nurses. There is simply no substitute for the element of humanity that nurses bring to medicine.
Therefore, I find it extremely alarming that one in five nurses plans to quit the profession within five years due to unsatisfactory working conditions. By the year 2008, the Bureau of Labor Statistics projects that we will need 450,000 additional registered nurses in order to meet present demand. This projection neglects the fact that around that same time, 78 million baby boomers Will start becoming eligible for Medicare.
How did we end up in this situation? Imagine for a moment, if you will, that you are one of the millions of young people across the country trying to decide upon a career. Suppose nursing is a profession that sincerely interests you. Would you still be interested upon discovering that nurses can expect to work nights, weekends, and holidays? Would you still be interested after learning that nurses routinely work 16-hour shifts or longer, and can be forced under threat of dismissal to work mandatory overtime? Would you still be interested after realizing that nurses receive lower salaries, less vacation, and less retirement benefits than their classmates who chose other professions? Would you still be interested after finding out that, with the advent of managed care, nurses now have to spend almost as much time scrambling to fill out paperwork as they do caring for patients? Would you still be interested when you learn that the very real possibility exists that you may be the only hospital staff member available to supervise the well-being of an entire floor of critically-ill patients? It doesn't take a great deal of insight to realize that no matter how passionate your intentions, the disadvantages of the nursing profession have become increasingly prohibitive.
Yet, as bad as the nursing crisis is for nurses, its worst consequences will be felt by patients, Last year, an investigative report by the Chicago Tribune revealed that since 1995, at least 1,720 hospital patients have been accidentally killed, and 9,854 others injured as a result of the actions of registered nurses across the country.
Interestingly enough, instead of attacking the Tribune report, nurses applauded it because it proved to the American public what they had known for a long time -- our nation's nursing corps is being stretched too thin, in part due to reckless pennypinching by managed care companies, and in part due to government underfunding of hospitals.
How bad is the crisis? In the mid-90's, short-sighted budget cuts, both by the government and by managed care companies, forced many hospitals that were staffed entirely by registered nurses to rely on lesser-trained practical nurses and nurse aides instead. Nurse aides, many of whom are not required to have high school diplomas, now constitute over one-third of nursing staffs in many hospitals. In my hometown of Chicago, the situation is so dire that housekeeping staff hired to clean rooms have been pressed into duty as aides to dispense medicine. Hospitals now routinely order nurses to care for 15 patients or more at a time, almost double the recommended patient load. Overworked nurses are being forced to juggle more tasks than any single person can be expected to handle, and are being asked to do procedures that they haven't been adequately trained for.
Our nurses have reached the end of their rope. To quote Kim Cloninger, a registered nurse from Illinois: "I wake up every day and hope I don't kill someone today. Every day I pray: God protect me. Let me make it out of there with my patients alive." Or perhaps more tellingly, Tricia Hunter, executive director of the California branch of the American Nurses Association states: "I don't know a nurse who would leave anyone they love in a hospital alone."
This is the face of nursing today. The nursing profession needs our help. As a profession, nurses have a rich history of doing whatever it takes to provide adequate patient care. Nurses generally don't make a big fuss over working conditions. The fact that they are tells me that something is seriously wrong with our health care system today.
Therefore, I support legislation that enacts upwardly adjustable nurse staffing ratios as a condition of participation in Medicare and Medicaid, and I support legislation banning mandatory overtime. I also support the Patients' Bill of Rights introduced by Mr. McCain, Mr. Edwards, and Mr. Kennedy in the Senate, and by Mr. Ganske and Mr. Dingell in the House because it includes a provision that protects health care professionals from retaliation when they speak out for their patients.
Lastly, I support the Nurse Reinvestment Act, H.R. 1436, because it addresses the need to attract more people into the nursing profession. I support all of these measures because if we don't act to solve our current nursing crisis, we will all pay the price at some point down the line.
Note: This column has been adapted from a speech Rep. Davis delivered on the floor of the House, June 28, 2001.
 How to contact Representative Danny Davis (D-Illinois)
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