The High Price of Health
In Your Own Words

The following comments were transcribed from 1,000 randomly selected surveys drawn from the American Journal of Nursing Patient Care Survey published March 1996 in the AJN.  It's the largest survey of nurses' views on health care and nursing practice ever conducted.] (And click here for the summary of this survey) [Excerpted from the American Journal of Nursing, November 1996/Vol. 96, No. 11]

On the Structure of Health Care Services-- Nurses are Very Critical of the Corporatization of Health Care Services

"I am disturbed at the change a 'for-profit' buyout has brought. The patient is nowhere discussed as the reason for our care."

--A 46-year-old clinical nurse specialist from Colorado

"I used to believe our hospital was a progressive organization committed to patient care and staff involvement. The reality now is the bottom line--to hell with patient care."

--A 41-year-old hospital staff nurse from New Hampshire

"I feel our health care system will collapse due to the lack of concern by the greedy $200,000-salary-making, Mercedes-driving administrators and CEOs"

--A 26-year-old-oncology nurse from Minnesota

On the Use of Nursing Personnel -- Nurses Across the Country Report Cutbacks in RNs at All Levels

"The new attitude since a recent merger took place at our facility by an extremely large, business-oriented company is, 'Do it and like it or you will be replaced--the nursing market is saturated.'"

--A 26-year-old ICU/CCU staff nurse from Ohio.

"In the emergency department, we lost our assistant manager and our manager was bumped up. So, in effect, we have no real manager."

--A 38-year-old pediatrics staff nurse from Wisconsin

Overwhelmingly Nurses Believe UAPs Do Not Improve the Quality of Care

"One incident I observed occurred when an aide disconnected an IV to help a patient change gowns. The patient lost a large amount of blood before I got to the room to clamp the tubing."

--A 40-year-old pediatrics staff nurse from Alabama

"I've especially seen a decrease in patient satisfaction with the emergence of care partners. It's frightening in pediatrics to have so few RNs due to increased floating, part-time RNs, and cross-trained personnel. It's not safe."

--A 31-year-old ICU/CCU pediatrics/neonatal staff nurse from Ohio

Restructuring Has Been Greatest in the Northeast and Pacific Regions

"There's been an increase in disciplinary actions against nurses in order to (I believe) keep the blame and responsibility from sticking to administration for poor staffing and management."

--A 47-year-old staff nurse from California

"I have seen a first-rate hospital get mismanaged over nine years to a level of orchestrated chaos. What you read in the papers and what is happening in the trenches is the saddest hoax perpetrated on the public. This place should be shut down."

--A 47-year-old ICU/CCU nurse from Massachusetts

Some Nurses Are Transitioning to Other Positions in Health Care

"I have already started reviewing cases for attorneys and find this is a way I can stay in nursing and use my expertise. It sounds promising and exciting."

--A 44-year-old nurse from Georgia

"I'm currently enrolled in an FNP program because I can't stomach working under this current environment for the rest of my career. Our satisfaction surveys have demonstrated that patients are not happy and nurses are dissatisfied. Still they continue to cut back."

--A 31-year-old staff nurse from Nevada

"I am currently working as a case manager. I miss direct patient care. But I don't miss being stretched so thin that I hardly had time to think, let along provide quality patient care."

--A 35--year-old case manager from Utah

"I have been a telephone consulting nurse for five years after being in a CCU for 15 years. I miss taking care of patients but will not do so in the current environment."

--A 35-year-old case manager from Utah

On the Process and Outcomes of Nursing Care -- Nurses Are Frustrated with the Lack of Time to Care for Patients

"Patients are treated like cattle. When my time comes to go, I pray I will die in my sleep at home."

--A 47-year-old staff nurse from New York

"All my patients get the same care, my very best. My very best just keeps getting spread thinner and thinner."

--A 23-year-old staff nurse from Oklahoma

"All I can say is that I am very disheartened. I feel that I run from patient to patient almost 'throwing' their meds at them, with time for nothing else."

--A new graduate from Texas

"In all my years in nursing never have I seen so much disregard for patient safety."

--A 48-year-old ICU/CCU first-line manager from Virginia

Nurses Are Most Critical of the Quality of Care in Intermediate Care Settings

"Nursing morale is at an all-time low. I plan to leave nursing in the near future and can't wait!...I shudder to think of what the future of nursing holds."

--A 42-year-old staff nurse working in a subacute care setting in Illinois

"This home hires most anyone off the street to do aide work. The turnover in aides is unbelievable and the quality of care the resident gets is poor to fair. Who cares--not the owner, not the supervisor, not the DON. There have been two unexpected deaths in our nursing center and somehow this has been covered over."

--A 59-year-old nursing home staff nurse from Missouri


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