Residents haven't been able to work more than 24 hours at a time for more than 8 years, and even then, ER residents rarely pulled more than 12-14 hours at a time. Certainly a long shift still, but considerably less than 36

Oh. Good. Always thought that was a dangerous tradition. "I had to do it so they should to" was always poor justification.

yeah, too much is too much. I think the work hour restrictions are even stricter now, at least for interns

However there are really no restrictions on how long nurses can work. When I was in the OR I did multiple 24-26 hour shifts.

If a nurse has his/ her thumb in your artery, keeping you from bleeding to death, do you really CARE what that nurse weighs? Grow up.

This article is about nursing- doctors have their own article:)

Nurses have most of the responsibilities that doctors have, with few of the privileges.

I would trust a nurse over a doctor in many cases. I've seen/heard of nurses catching mistakes before they become something serious. Thank you to nurses for the work you do. Some patients are not exactly the easiest to deal with either which I'm sure causes more stress to health workers.

Because AG99, this article is about burned out nurses, not burned out residents.

And yes, nurses do catch alot of resident's mistakes. Wait til you become more experienced and in the medical field longer. You will appreciate the nurses more and probably save your butt a few times.

I know many nursing assistants/techs who complain that the RN/BSNs are too busy doing paperwork to help out much with physical care. There's more to this story.

Nurses work hard- but most of them do not bear the patient care burden alone. This fact needs to be discussed more than it has.

This isnt just a healthcare industry issue. It's the American workforce in general. Corporate slavemasters trying to squeeze every penny, usually do it by making working work longer, harder, more efficiently for less. Not to make a better product, but to produce more profit for stockholders. Labor unions and labor laws have historically fought to prevent these abuses upon American workers. However, over time the laws have been chipped away at, and unions have been brought down by state laws. Which political party supports Big Business, more stock profits, unfair labor standards, and the elimination of the middle class, replaced by an increased lower-class? How exactly are they for Americans and the 99%?

This problem is in its infancy.

Nursing shortage has been a problem for a very long time.

These were the estimates prior to the new health care law.

Year : 2020

Supply : 2,001,998

Demand : 2,810,414

Shortage : -808,416

Percent : -28.8%

Now that we have the new health care law , nursing education programs will have to increase capacity by over 90% .

Will have to make up for all the nurse practitioners that are filling the doctor gaps too .

Also, many nurses are retraining. Over half students in my Daughters RT program were nurses.

I there is such a huge nursing shortage then why do I know nurses, even some in CA which has patient load restrictions, who are having a hard time finding full time, permanent employment. Something is not adding up with this article. It seems like a very self serving study conducted by nurses about nurses. I would put much more weight on this if it were done by an independent organization, not a nursing school. Statements like "[b]oosting the load from six patients to eight increased the risk by 31 percent over a nurse caring for four patients" shows how statistic can be manipulated. First of all why are they comparing a change of an increase from six patients to eight with the results with four patients, this makes no sense. I am not saying that a nurse who is overworked is not more likely to make a mistake, just that some of these "statistics" seem manipulated to tell the desired story. In addition, the article makes no mention of the fact that most jurisdictions limit the number of hours a nurse can work to try and prevent burnout.

JS in SD,

You are exactly right. The problem is that there is a huge nursing shortage, but the problem is that there isn't enough money in the system to pay for them. Most large hospitals, especially in urban areas, are swamped with patients that can't pay or are reimbursed through medicaid or medicare. In order to keep the doors open, they are forced to minimize headcount to control costs. This means that staff is stretched thin and wages are kept as low as possible, which leads to the burnout described in the article which is real.

Just check at a graduation ceremony for nurses and ask how many have jobs. The answer will be less than 10% and those with jobs are making pretty low wages.

armurrary....but yet they don't seem to have any trouble at all building huge fancy new buildings with chandeliers, plush carpet, gorgeous wood work and the best of everything, do they? One hospital where I live has built 3 fancy new buildings in the last two years....not to mention a complete re-model of the original one. Yea....they're broke alright.

groucheeoleman: What does that have to do with nursing????? I agree with your statement, I work at for a large university training hospitals and we have remodeling and plush new buildings (new children's hospital). That is what is part of the problem; putting money into new modern buildings and the administrations wages (board of directors and CEO) Hospitals and health care industry isn't broke...but hospital employees, nurses and other health care providers are not getting paid well, just the higher ups...corporate America at it's best.

Nursing is exhausting for both men and women. Rotating shifts, weekend work, patients waiting until they are at death's door to get care because the care is unaffordable, poor pay in alot of states and little to no respect as a professional. When the hospital administrator and all the MDs make 4 times what a Nurse makes, please don't bring up the cost of Nursing manpower as an issue. Funny how the well paid administrator and MD rarely complains about being burned out isn't it? I guess when you make anywhere from $119,000 to countless millions you really don't have too much to complain about now do you. And if you do complain you can afford the help you need to deal with your complaints. By the way Infection Prevention is EVERYONE's responsibility in healthcare; not just the nurses.

Also the doctor and nursing shortage is intentional in order to keep physician salaries very high. The AMA can simply start approving more med students into med schools/ However, they're worried about watering down the medical practice and lowering salaries. This sounds like the regular work-force to me. Corporations water down high-paying work disciplines by hiring in non-certified, non-degreed workers, who can do similar work for less.

I like the Healthcare Reform, but one backlash I dont like is more physicians will retire and quit the game because they start making far less from insurance companies and payers. The reality is that med school costs too much artificially, doctors want more to pay off those student loans and get rich quick, and the AMA (ran by those same doctors) control the product. If the AMA would start producing more doctors, then a lot of the problems would start to ease.

First, I believe there is burnout. That is probably true with any industry in a higher stress situation. I have been told by those in the profession that generally nurses stay working full-time for an average of 5 years. They go part-time after that. I also believe that.

In recent years my husband has been in the hospital for various procedures and an operation. There is absolutely no doubt our hospital with Mayo is more than adequately staffed. I would say over staffed. What I do see is lots of money going towards making the building like a hotel. Another hospital in town that takes those on government health care doesn't look nearly as well staffed nor hotel like.

Recently a doctor told me that it is up to the hospital if they take government health care patients. I was not aware of this.

Did want to say this as well. I found it quite disturbing that so many healthcare workers are in poor shape themselves. I would go so far to say most are overweight with some in the obese column and that includes doctors, etc. They are setting a very poor example. Equally overweight adds to fatigue, which adds to stress. They all need to be in top shape to do that sort of work.

Yes, I do care what he/she weighs. Obese people are physically slower and their diet makes them more lazy and lethargic physically and mentally - hence a liability to providing excellent health care. Obesity is the norm in the U.S. He's fat, she's fat, so why do I care if I'm fat, too.

i dont know what nurses do where these surveys were done but here nurses sit on their asses until there is a problem. cna's do everything and cna's are overworked and underpaid.

I use to believe in that non profit system, not anymore when I hear about the shake ups all the time..If they're not making money they simply cancel things out, where they should hire more nurses even for backup. Its going to be a long dark road.

cygnus,

Also the doctor and nursing shortage is intentional in order to keep physician salaries very high.

There are so many things wrong with your post, I don't know where to begin...

1) Medicine does not obey supply and demand: If you live in an area with many physicians, do you go to the doctor more often? No, you go when youre sick. Are reimbursement payments from medicare or private insurance higher to areas where doctors are in short supply? No, they are the same nationwide

2) the ama does not control the number of physican training slots. medicare does. The big bottleneck is residency slots, and medicare can only fund a certain number, regardless of what the AMA says. Unless you think medicare is flush with cash right now...

also, firemen work long shifts and are there to save lives....

at st joseph's hospital in chicago. i sometimes would start off with 12-15 patients. and could end up with 24 or more!!!!

when i complained a bit, the nursing coordinators said, ''yes, paul. we expect the nurses here to work hard.''

there is 'hard' and there is ''crazy, insanely stupid, work overloaded and dangerous''.

the catholic hospitals were the worst for overloading a nurse.

but somehow, certain groups could pass all of their meds, on time, to 15-20+ patients and not ever miss a beat. gee, i really wonder how they did that, what with people with feeding tubes, poor swallowing and patients who would refuse and then say 'yes' and then refuse again. and you never saw them running to the pharmacy for a replacement med. after 30 years, i still can't figure it out, except for 'they cheated'. big time. but, what the hell!!! they worked for $10 less an hour. and never broke a sweat doing their job!!! how was that even possible????

who cares, i got out and went to greener pastures.

by law california nurses had (i don't know about now) patient loads of up to 6 patients on a medical/ surgical floor. but in chicago, you could have 15-25 or more patients! and you were very much expected to keep up!!!! i could not discharge patients and admit them fast enough, let alone look for problems. or talk to a patient to see how things were going for them. i was lucky if i knew they were still breathing!!

sorry, but without mandatory patient loads, some hospitals will pull some pretty unbelievable stuff on the patients, and the nurses. and the bill will be delivered while you are still in the hospital!!!

just all heart!!! ALL HEART!!!!

You better re-read the artical, its about NURSES...And if you spend ANY time in the hospital DO YOU SEE A DOCTOR? WHO is spending the most amount of time with you? Bet it's not YOUR doctor and the Hospitalist who has your butt for the day...leaves when the shift is done...

As a nurse myself, this makes perfect sense, to see an increase in infections due to understaffing, being torn in many direction...Do you think a nurse just holds hand of the patient? How about walking in a nurse's shoes? As a geriatric nurse, MY caseload is 38 SKILLED CARE patients!!!! And my nursing assistants due to Medicaide cuts and Medicare guidelines, make less than those working at fast food places...And I haven't had a raise in 3 years. But, you know what, I can't quit my job but do the very best I can. My philosophy is that I treat everyone like they are infected and I'm out to protect myself. One of the BIGGEST preventions out there is cheap and it's called HAND WASHING! Watch the docs, nurses, housekeeping, etc. to see if they are washing their hands...FYI...alcohol does not kill EVERYTHING... Check out some of the videos on U-Tube for training on handwashing or some of the do's and don'ts. Infections are out there...BUT don't ask for an antibiotic everytime you have a sniffle...you may find yourself resistent the next time you really are ill!

“Now that we see that burnout is playing a role in this relationship, we have to look at more than just the staffing,” said Cimiotti. “We have to look at the system, the organizational structure where the nurses provide care.”

Fat chance. The self-serving organizational structures are the underlying cause for much of the stress inherent in hospital work. It doesn't take much for management to simply add enough extra tasks to an already busy work schedule to get anyone overloaded, but they continue to do it....because they can.

mcturner: DOCTOR? WHO

Love it. I wonder how many here will get it?

My son has been in the hospital for close to two months now. He had a major blood clot which then turned to blood poisoning. The nurses have been wonderful to him. It is VERY evident that they work HARD for their money. But, anytime he has needed anything they have done all they could for him. I respect the nurses he has and they have really watched out for him.

Saying all that, he now has MRSA and a strep infection in his leg where they removed his arteries. So now he is undergoing an considerable antibiotic regime, and constant blood work. They cannot seem to get control of the infection. I am getting very worried now, considering they just told him he's going to be kept in for at least another week, because there is problems with his blood.......... I hate to say this, but its almost like the longer he stays there the sicker he is getting.........He is now down over 50 lbs and looks like a skeletal remains of a human. He is only 25.

Your concerns for your son and the long hospital stay are valid. I am a nurse with 20+ years experience and I will PRAY for your son. Have had numerous patients who lived I am sure because prayer saved their lives by bringing the Great Physician on the scene.

There are many contributors to these "comments" sections who are atheists, but don't be misled, God IS, no matter what they may think or say.

Medicare cut backs have hurt nursing in the long term care setting. There is no limit on patient numbers in the state i live in. the only nurmber they follow is fire code. There has to be enough employees (this can include housekeepers, dietary etc) in the building to evacuate in case of fire. I care for 40 plus patients a night with 1-2 CNAs and thats the norm. I can have up to 3 CNAs which is all good as long as there are not a crisis. If you have two patients that go into respiratory distress, or someone has a hypoglycemic episode, your pretty much screwed for the rest of the night. Not only you but others your in charge of including the aids and patients. There are no med techs to pass your medications. If you only have the 2 CNAs you must help them out as well. Now here is the problem i can do their job. they however can not do mine.Paper work for nurses is out of control. repeat documentation takes forever and we have not gone computer yet and the set up they have does not allow enough computers for all staff so guess who will be waiting to use the computer. My pay was cut 3% due to upcoming medicare cut backs. These long term facititys will put in more house keepers and dietary aids before hiring more nursing based on cost. The on call people will not answer the phone half the time so if you need help you have to stop whatever it is your doing and start calling people (who are also overworked) and beg them to come in and help you. I have changed companys and it is the same with others in this state. There needs to be stricter regulations patient to nurse ratio either based on patient care needs and numbers as well. CNAs have one of the hardest jobs in long term care setting the nurse greatly depends on their eyes and ears and knowledge of the patients. They too need a regulated on number of patients they care for. 20 each is a heavy load for a CNA and the pay is a joke.

My wife is a RN and has been for 4 years. I constantly hear stories about understaffing and catching errors by doctors and other medical professionals. The nurses job is incredibly difficult and the average nurse has over $100,000 in student loans to pay off! Nurses make substantially less than doctors and have virtually the same workload and responsibilities. I also see discrimination against nurses financially as it is extremely difficult for them to get the raises in pay that they deserve with their increase in experience and education.

The problem will only get worse as the financial disaster of Obamacare is foisted upon our country. There will be a constant atttempt to keep nurses pay low thus making many more leave the industry. The average age of nurses is way up and many will just retire instead of accepting lower pay, lower benefits and harder working conditions. Thank you Mr. Obama, you have truly begun the end of the greatest medical system the earth has ever seen!

We are living with this right now, my finace, 42 years old, had a quadruple bypass, mechanical mitral valve, and pacemaker lat september. His heart was in such bad shape the doctors gave him poor odds and he made a miraculous recovery...far surpassing any expectations. Last month he began feeling ill the coughing up blood so we went to the same hospital where he was admitted for pneumonia and kept on iv lasix and antibiotics for a few days then released. When he came home he complained to me of a sores and blisters inside his nostrils where his oxygen tubes were and within a day or two he had a raging staph infection all over the outside of his nose and upper lip. 12 days ago, after getting progressively worse at home, he was admitted to the same hospital again and now things are much mich worse. The staph in is his bloodtream, he turned septic, and now it is on his mechanical mitral valve adn his aortic valve. He is facing 6 weeks of intenesive iv antiobiotics at which time he may require open heart surgery again to remove the mechanical valve that the staph has collected on and possibly replace his aortic valve. His surgeon has flat out told us that this is a surgeons nightmare and carries a high mortality rate, compounded by the fact that he is only 10 months out form his first surgery and nearly dying. We are about to lose our home, lives, everything and possibly even my fiance...

Oh Mr. Todd, I doubt very seriously that you have ever worked in the health care industry. Our profession is more regulated than almost any other.

Your generalization of 50% of nurses being overweight has nothing to do with the health care they provide to you.

I'm a nurse I have done this for over twenty years and I can tell you the scheduling,pay and ignorant people we serve astonishes me.

As nurses we are expected to note any changes that a patient has and be able to determine what may be involved, Before we can call a Doctor who will decide on what to do after they have received the information from that fat nurse.

We are expected to be smiling all the time,even when being treated rudely by many of the patients and the families we serve.

We are NOT waitresses,maids, doormats or just someone that was pulled off the street.

We are professionally trained,licensed and approved by the state to do what we do.

We also have to have continuing education hours ,seminar's,and trained for new medications,treatment's,and types of illnesses we may encounter.

Our livleyhood (our licences) can be pulled for a plethera of reasons. I doubt you face that each day.

Our work doesn't allow us the luxury of putting it off till tomorrow. Your life may depend on it.

So the next time you or someone you love is in a clinic,Hospital or nusinghome: remember that fat nurse has been training to do this and if they passed the test for their license it probably wasn't for the money.

Yes there are some nurses that aren't good at their job but there are far more that do it because they do care and want to make a difference.

If every thing you did in your job was scrutinized as closely and could cost you a lawsuit just for being human,tired or just having a bad day I doubt that you would be so non-empathetic.

No one likes Nurses,Cops,or Lawyers until they need one.

I there is such a huge nursing shortage then why do I know nurses, even some in CA which has patient load restrictions, who are having a hard time finding full time, permanent employment. Something is not adding up

Your right something is not adding up since every nurse I know has an easy time finding a job. That is Las Vegas Nevada.

guess when you make anywhere from $119,000 to countless millions you really don't have too much to complain about now do you.

The Nurses that make 90+K a year complain all the time. they love to back stab.

It has not been my experience that nurses, or any medical employees, have difficulty finding work. Their payscale is somewhat behind the curve compared to their education levels, but that isn't the largest difficulty they seem to have.

The greatest difficulty is the absolutely horrid scheduling. Medical staff routinely is scheduled double shifts, seven day weeks, etc. Holidays and the like are also a given, since health care cannot wait. Much of this scheduling comes from the shortages mentioned---and it is irrelevant whether these shortages are inside the workplace(they won't hire more) or in the system(there aren't more to hire).

If the cost of an education would be reigned in and the debt would be waived by dismissal of loan debt in return for service--we'd have more people becoming nurses.

Auto 101 I am a nurse in Vegas. Please tell me where I can make that kind of money. The hospitals here took a beating when the housing went bust. Jobs are not that easy to find since all the for profit hospitals are protecting their stock holders rather than patients meaning staff cuts. The not for profits in name only are cutting staff to to protect administration. The only county owned facility is so far in the red it's cutting staff to.

oy vey - what techs or CNA's? I haven't had that luxury of having a tech in years.

They are there All I know is that my mother takes just a day or two to find one.

dan------------ sorry, but ''the greatest health care system the earth has ever seen" ???

you mean IF you have health insurance? or if you are never sick, so your insurance company will take your money. because if you ever are' truely sick', they will find a way to cancel your policy. or try very, very hard to get you cancelled.

"the greatest health care system" is not what the usa has had for a very, very long time.

with omamacare, perhaps things will improve! it is worth our time to give it a try and try to make it work as best it can before we just disregard it, so completely. amazingly, you usually get out of something exactly what you put into it.

it seems odd to me we do not have a system where everyone can be covered for health care, at least a basic type of coverage. and at a reasonable cost!!! so someone who makes $15,000 or $25,000 a year can/will be covered with some kind of reasonable health insurance and not pay more for it than they do rent or food.

as a visitor asked me, don't you want all of your neighbors to be well educated and healthy? of course i do. (being from danmark, she had access to college through a PhD------ FOR FREE. and FREE HEALTH CARE! of course they pay for it via taxes. but they never have to worry about the cost of either.

AND GUESS WHO WAS FOUND TO BE THE HAPPIEST PEOPLE ON EARTH??? THE DANES!!! I WONDER WHY????????????

will we need more doctors to be trained? of course. will we need to adjust our tax system? of course, (and isn't that one long over due???) will we need to make changes so everyone is covered, and treated as important members of our country? naturally. and there is no time like the present to get going on it.

what ever happened to the idea 'we can make it work'??? i thought we could make just about anything work, if we want to do somkething. but it seems many of us just do not want to do it at all. or do not want to try to make it work!

why is that?

why do some people just not want to do what is good for our country? i don't get it. i really don't. nor do i get why so many people are afraid to even try!!! which i find particularly galling.

everything seems to becoming more and more singular. unless you are a wall street company. a member/an employee of a government agency----and the washington crowd is the worst!!!! once in they seem to think they have won the golden ticket---------- for life!!!!!! nothing to ever worry about ever again. but leadership from them??? well, notw that would be to much to ask for, wouldn't it? leadership?? whatever happened to that idea? so now we have the 2 groups who just vote straight party lines. of the 535 people in congress, we have a few thinkers and the rest just follow their party along!!! where is the leadership? there is little or none.

the best health care system on earth???? as i said, not for a very long time. and from the way it is now, it won't be the best again for a very, very long time. that would require people to see where the real problems are and figure out a way to fix them. is it easy? no!! is it possible to fix it?? of course! will we? i don't know. but if we do, it will take a much different mind set than the one we have now!!!

The CEO you are complaining about is in charge of a conglamorate corporation that own 100's of hospitals. Where do you think the big cost are? They are in administration and management just like our government schools.

You haven't seen nothing yet, just wait until Obamacare kicks in.

Steven - wtf are you complaining about - it's the "American Way!"

Obamacare doesn't increase the amount of paperwork that is necessary in order to get any money back from insurance companies. They have such huge staff because it is necessary to deal with the bureaucracy the HMOs have invented in order to nickle and dime the hospitals.

To some extent Obamacare tries to address these issues, but in general you are right, it really didn't go far enough.

You make a pointless argument. No matter who owns or operates the hospitals, people need care. The issue is implementing a more effective may to manage good patient care. Such political posturing doesn't address the issue at hand, let alone solve anything.

Yeah, "non-profit" is a funny term in the healthcare industry. It just means that a certain percentage of profit has to be reinvested back into the system, usually towards executive pay and new ventures.

oy-vay - i disagree with you... if money is being hoarded by the upper management of any company then you don't have as many resources available to create quality product. in this case health care.

Paul- i've read absolutely nothing about obamacare. for all i know you're right and it could make things much worse. I would argue that the fact that hospitals are conglomerated is a HUGE problem. Conglomerates create a situation much like Monopolies back in the day. They give one person or group of people too much power and strips the power of boycotting away from the consumer. if you don't like the way you are treated at one hospital and go to another owned by the same D-bag...what difference does it make?

if i misunderstood your point and we are agreeing then...damn straight!

But we have the best health care system in the world......don't we?

we haven't had the best health care in the world for at least 30 years!!!

why don't you folks wake up.

or do you think everything else went down hill (business, airlines, education, insurance, newspapers, et al) except health care???

are you even thinking???? or just hoping against hope?

don't ever send someone to the hospital without a private nurse. not if you really love them, anyway.

my 30 years, working as a nurse, in several hospitals, tells me so, that is why!!!

The CEO in the Hospital I work at explaines that non-profit is not the right term. The correct term is tax-exempt.

rightwingscrewball

WE have the best healthcare system in the world and obama is going to change that

Really? Explain to me then why millions of Americans can't afford healthcare? OBama is trying to IMPROVE that. Where is the GOP Plan?

The best health care system in the world?

Oh, if you only knew the things I know.

That's the truth..if only they knew the cover-ups that go on behind those hallowed hospital halls.

yay politics!

All too often the hospitals that are purchased by these conglomerates are the one that are on the verge of bankruptcy. Most of these due required indigent care, plus other welfare scams.

Best health care system in the world? LOL! The only thing we're number one at is COST. We rank 37th worldwide in quality of care. The facts are available at the World Health Organization web site.

BTW Nurses Rock! Thank you for your service and sacrifices.

LOL! The only thing we're number one at is COST. We rank 37th worldwide in quality of care. The facts are available at the World Health Organization web site.

please...not that tired statistic again. 50% of the rankings are based on overall health alone.

If you think 50% of your health is determined by your nurses or doctors, you are part of the problem

Being number one in cost while, however you cut it, NOT being number one in quality of care is OK then?

Being number one in cost while, however you cut it, NOT being number one in quality of care is OK then?

Definitely not, but its not primarily a failure of our health care system.

Its such a quintessential american reaction to look at our fat, lazy, diabetic, bloated, hypertensive bodies and poor health and cry that this is someone else's fault

If I bought a car, never changed the oil, got it in 10 accidents, drove it 90 mph everywhere I went, put in the worst quality gasoline, and generally took little care in it at all, then took it to a mechanic when it was completely unrepairable.....

is it the mechanics fault? Do we have an auto care crisis?

That is your logic...

Rush Limbaugh says, "We have the best health care in the world." He can afford to have his doctor visits, his surgeries, his medications, and he's still fat, still smoking, still an idiot. There is so few people in his "we", and yet so many people who can't afford a doctor still think that he's speaking for them.

mBabs-534459

Sorry but I beg to differ.

(Reuters) - Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday.

The United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.

"As an American it just bothers me that with all of our know-how, all of our wealth, that we are not assuring that people who need healthcare can get it," Commonwealth Fund president Karen Davis told reporters in a telephone briefing.

In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey.

Australians spent $3,357, Canadians $3,895, Germans $3,588, the Netherlands $3,837 and Britons spent $2,992 per capita on health in 2007. New Zealand spent the least at $2,454.

This is a big rise from the Fund's last similar survey, in 2007, which found Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product.

"We rank last on safety and do poorly on several dimensions of quality," Schoen told reporters. "We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care."

In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey.

Australians spent $3,357, Canadians $3,895, Germans $3,588, the Netherlands $3,837 and Britons spent $2,992 per capita on health in 2007. New Zealand spent the least at $2,454.

This is a big rise from the Fund's last similar survey, in 2007, which found Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product.

"We rank last on safety and do poorly on several dimensions of quality," Schoen told reporters. "We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care."

Critics of reports that show Europeans or Australians are healthier than Americans point to the U.S. lifestyle as a bigger factor than healthcare. Americans have higher rates of obesity than other developed countries, for instance.

"On the other hand, the other countries have higher rates of smoking," Davis countered. And Germany, for instance, has a much older population more prone to chronic disease.

Every other system covers all its citizens, the report noted and said the U.S. system, which leaves 46 million Americans or 15 percent of the population without health insurance, is the most unfair.

"The lower the performance score for equity, the lower the performance on other measures. This suggests that, when a country fails to meet the needs of the most vulnerable, it also fails to meet the needs of the average citizen," the report reads.

Blah, blah, blah! What does that have to do with patient count? Nothing you said solves anything. You're not adding to the discussion. I personally am tired of people using blogs like a psyche couch.

There's a potential for great minds to come together and find solutions that might actually work or direct dialogue in that direction. Instead, too many people bellyache and grandstand.

Be part of the solution or get counseling! Sick of pointless whining!

Says the person whining about other's posts. (LOL) Get a mirror if you want to see the problem.

I recommend that until all Americans can afford basic health care coverage, then the Congress & Senate should not receive their Cadillac health coverage paid for by the taxes of real hard-working Americans.

It doesn't matter, t least in the case of the nurses, because no one s going to pay them. Frthermore, if the licensed nurses didn't have to give baths and make beds, they could be using their skills to keep patients safe. RN's giving bedside care is the worst patient care delivery system on earth. Let the RN's do their jobs....which BTW includes catching the doctors' mistakes....and bring back nurses aids to do what are essentially non-skilled tasks.

Of course, that would mean paying a few extra minimum wage salaries, which would "negatively impact our bottom line" so it's not going to happen. Who cares if patients die? There are new ones born every day.

"Obamacare" is actually "Bushcare". And why do you think they're going to add nurses? CLEARLY you are not a nurse, because every nurse knows who carries the extra load if there is one.

Retired- Most RNs are NOT giving baths! Most patients aren't in the hospital long enough for that anyway.

Besides, most people who've had family/friends in hospitals or nursing homes will testify that their loved ones are not getting freshened up, let alone bathed, daily. I could be wrong but most of us don't go into the hospital with the expectation of coming home fresh and clean. It rarely happens and most of us don't expect it.

I love all this talk about "nurses catching doctor's mistakes", and wonderful they are. yes, nurses are great, and they are important, but they are not doctors. If they want to go to an extra few years of school, do a residency and sit for a board exam, then they can take on the liability and supposed increased pay of the physician.

oy-vay: I'm a doctor. I must have been hallucinating today. I could have sworn I saw 3 RNs giving baths. They have to do it because the hospital administrators want to be paid $200,000.00 and up so they cut aids and LPNs.

You are definitely wrong about keeping the patients clean where I work. Not only that, as she said, nurses catch a lot of mistakes and I greatly appreciate them. If you take someone who loves their job caring for others then you load them down with paper work and show them no appreciation then you get burned out, discouraged nurses that feel that they are overworked and under appreciated.

You know, giving a bath is not rocket science. You could pitch in and help take care of your loved ones, or you could go to the administration and complain about the problem.

Nurses are expected to take care of patients, work as secretaries, work as housekeeping and even do things that family members should be doing. On top of that they have to put up with doctors who sometimes think they are royalty and with administrators who don't care about anything but making more money.

As far as catching mistakes, I very much appreciate it when I have to go to an emergency and the nurse with whom I rounded calls me and says, "Did you want to order lab on that patient? You mentioned it on rounds but must have forgotten to write it down". That's the type of mistakes I mean and it does not require an M.D. degree to catch it.

you could go to the administration and complain about the problem.

You could, but the administration would just come down harder on the nurses, instead of hiring aides to address the real problem.

You could pitch in and help take care of your loved ones

I tried that when my BF was in the hospital just a week ago. The nurse was swamped, so I asked if she could just tell me where to refill his water pitcher. She told me she wasn't allowed to let me do that and had to take care of it herself. This hospital is corporate-owned now, as so many are, and the corporations don't want to take even the slightest chance that someone might be able to sue them. This is what corporations are doing to our healthcare system. The only real consideration is profit for the parent corporation, regardless of how many "patients' bill of rights" or "mission statement" posters you see in the halls. The nurses in this hospital now have to work 12-hour shifts, and are frequently working an extra 2-4 hours to get everything done. No way patient safety is being seriously addressed with a schedule like that.

No nurses are not doctors. But then again, after couple of years dealing with patients and different drugs are ordered..... after a while, you get real FAMILAR with the dosages and the condtraindications of the medications that they give to the patients and type of labs needed. Many times doctors are so busy that they might miss a few critical labs.

It's like ordering 0.2mg of hydromorphone to a man in extreme pain or ordering nitrogycerin tab to a patient with chest pain but has a blood pressure of 88/50.

Or if you been changing your oil on your car for x number of years. After a while you get real familar with the oil changes, how to change the oil filter, where to fill your oil, because you have done it many times. Yes you are not a mechanic but when that one time you go to walmart to have the oil changed because you are busy....... then see the mechanic there pour oil into your radiator reservoir, you know something is wrong.

Residents makes mistakes. Let me rephrase that. They make many mistakes because they are still new and still learning.

I agree with most of your post. However, the bed bath seems to be a thing of the past. My Mom spent about 2 years in and out of hospitals before her death from Non-Hodgkins Lymphoma. In 3 different hospitals she received not one single bed bath. She fell more than once trying to get up to make it to the shower. In one hospital I asked for the gear so I could give her a bed bath and they said they could not/ would not give me the gear or let me do it. In fact, no one would provide even the basic comforts like chap-stick, lotion, or glycerin swabs for the mouth, etc. We quickly realized that we needed to have a family member with her at all times or else she would not have any care other than giving her medication.

Things sure have changed in the 20 or so years since I was a nurse. Not only did we have 5-8 patients but we did all the cleaning, linen changes, blood draws, IV's (taped and timed),medication administration and most of the treatments. We also gave daily bed baths to non-ambulatory patients, handled their bed pans and did our best to make them comfortable.

Paramed, I'm sorry to hear about your mother's substandard care while dying of cancer. I agree that staying at the bedside of your loved one is the best way to ensure adequate care. It shouldn't be this way, and for so many people, it's just not possible. I've been on both sides of the bed in the past few years. When my family member(s) have been hospitalized, I've always been able to (sometimes expected to) participate in bathing, hygiene, and repositioning. But patient care loads heve changed dramatically in the past 2 decades, my friend. I really, really try to perform some hygiene/toileting needs for my patients, but don't always make it. HMOs have made "sicker, quicker" a harsh reality. And every year. more state and federal rules are added to make our care "safer" while taking the nurse farther and farther from the bedside.

On another note, nurses and doctors have completely different roles. I've never wanted the preparation (and subsequent debt) headaches, or responsibility of the physician. I truly enjoy a collaborative working relationship with my docs. If a physician treats me poorly, he or she has just lost a very valuable asset. If I screw up, I apologize, and do my best to ensure I don't ever make the same mistake again.

Importing them from poor counties,including med students' that come for training never go home'

hospitals and nursing is, and has been, a ''factory'' job for at least 30 years now.

it is hurry up, get them through and get them out. hurry, hurry, hurry! and don't let one fall on the floor, or else we need to throw it away!!!

the ''humaness'' left a long time ago. it is just 'hurry up' and 'bill' and 'charge' ------ it is all so slap dash. should you leave alive, count yourself lucky!

VERY LUCKY!!

and when was the last time you got more than 15 minutes to talk to your doctor? and did they even listen?

doubt it on both counts!!

Unless you're in the home health field; in which case it is..keep them sicker longer, especially if they have Medicare (more money for the co.) If one thing heals, find another problem, administration basically lets the nurses know that they need to find something wrong so that they can milk the govt. for all that is possible.

Those nurses will come from the other countries and work for less. Of coarse they won't be able to understand your requests or be able to read the doctors orders but hey,at least you'll have someone to smile and nod their head at you.

flbikerchick is right. (post #4.6) I have seen retaliation one nurses by administrators. You should put any complaints in writing and send a copy to the state hospital association or medicare or call 1-877-753-8442.

We spend far to much time charting for the attorneys and not for the patient/ other staff. We end up double and triple charting stupid things and that keeps us from the bedside doing and seeing the things that prevent further issues. The addition of distracting technology does not add to patient safety but does make the "risk managers" job easy. Almost every "innovation" has taken away from what we nurses do for people and made the life of administration better.

Here is my concept of health care reform:

1) Take back medical facilities from the MBAs. Any medical entity ( hospital, nursing home, quick care, ambulance company etc) CEO, department director, unit manager etc must have an active clinical license and must spend at least 24 hours a month in active patient care. Not as a charge nurse, educator, facilitator. They must do hands on care. Because so many administrators have never done or are divorced from hands on care they do not understand workloads or how to deal with their "customers".

2) Remove the concept of patients as customers. We are not selling them a car. This is much more important and full openness and caring is paramount.

3) No more state monopolies on insurance companies. Allow cross the border competition. Let them do things like compete for better payments. Make insurance a free market.

4) Cut Federal payments for facilities who fail to meet minimum expectations. If the facility infection rate exceeds expected numbers due to poor staffing they lose dollars. If the numbers are better they get extra dollars. You have to spend money to make money after all.

5) Prohibit hospitals who have patients waiting for prolonged periods of time in the ER for admission beds from accepting patient transfers from other facilities. An ICU patient waiting for hours in an ER is not getting good ICU care and thus is far more at risk. Why should large for profits be allowed to mine money for care they don't have available. If a facility has to take an ICU transfer into an ER bed they are not providing ICU care and are causing back ups for patients coming in by EMS and waiting room patients. It's time to make care about care and not about money.

6) Break up multi state medical conglomerates. Make each individual hospital have at least 75% of their Board of Directors from the local community.

7) Make State Medical Boards / Nursing Boards more answerable to communities. Consider making them elected like school boards.

Of course none of this will ever happen because the MBA's have the power and money.

Most of the people who determine care are nurse managers. Are they money hungry too?

Not true. Nurse Managers do what their told. and at the top of that heap is corporate!

And the Nurse Managers will do ANYTHING to keep from going back to work "on the floor".

And the Nurse Managers will do ANYTHING to keep from going back to work "on the floor".

But they still have to because nurse cry too much My mother when she was director of nurses had to work the floor every holiday because we could not get enough nurses they were all "SICK" they were short on staff by 5-6 people every holiday This happened even when she was an administrator and she would have to work the floor.

You mean these patients that are now being 'supervised' in emergency rooms, when their needs are critical?

You wouldn't rather prefer that they just be mostly given preventative care and sent home?

Prevention health care is the key to the US health care issue. If every American could afford to visit a family physician to keep basic things like blood pressure & blood sugar level under control. then the large amount of ER care would decrease drastically. People with no family doctor or basic health care usually wait until they are at death's door & end up with thousands of dollars in medical costs from preventable conditions.

BA: glad you wrote. youd dbld your pay by going into Pharma. I knew a nurse who went into insurance claims so she could get off her feet. Nursing is where the tough jobs are in hospitals. IT's where the money should be. Med insurance sales, execs, pharma sales and execs, hospital administrators and the lawyers for all are taking way too much of the money out of the system. the expense of ins Co.s contesting every Doctor ordered expense is incredible. And Docs order too much because they get paid based on what they order. It's a muffed up system for sure.

Doctors do not get paid based on what they order. Most order tests to practice Cover Your Ass medicine to keep from being drug into court for malpractice when they supposedly miss something. Most physicinas who practice in hospitals today end up taking orders from administrators and nurses who have no where near the experience nor education of the physician is liable for taking care of the patient. if anything there are two many nurses in administrative positions and not enough on the floor taking care of patients. Everyone in the system is burnt out, and this Obamacare is only gonna make it worse.

BA@TRI18, Saying that all nurses burn out is an over-generalization. I think it depends if you got into this profession for the right reasons and with your "eyes-wide-open". I have been a nurse for over 20 years and I still feel as passionate about my career today as I did when I first started. I also have had the pleasure of working with many exceptional nurses from coast-to-coast who feel the same. We may not like all the paperwork or computer charting but I recognize that this is a necessary part of communicating with other members of the health care team. No the money is not proportionate to the level of responsibility but I don't ever recall money being a factor in my decision to enter this profession. I am happy you found your niche and that you are doing well. As for how to address the problem of burn-out; the fix will be multidimensional. The nurse who is burned out will need to accept personal responsibility to communicate this and care for his/her needs (take a vacation, get counseling, peer support, exercise, diet, and all the things we counsel our patients to do to care for themselves). System change will need to occur that starts at the unit level (provide education, time off, counseling, and yes...less patient to nurse ratios). There are many more ways to address this problem and I bet the brilliant nurse researchers who conducted this study have already begun to design such.

Most posters here I agree with. But you still have to recognize the people in the medical profession and related industries, (ins, pharma, etc) living absolutley opulent lifestyles while the patients move toward poverty attempting to pay for it. This has broken the bank on medical care. 6,000 sq ft houses ! 8,000 sq ft houses ! Really ? A 4,500 sq ft house wouldn't do ? Do people in medical care and the related industries really need to impoverish their captive customers in order to live like that ?

Those customers don't die if you make a mistake.

Morlack- Last time I checked, in retail you are not responsible for the health and wellbeing of your customers. Nurses have to ensure that their patients are bathed, fed, get all the tests and medications they need, deal with the patients family, respond to every request or complaint of the patient and document everything. Miss one seemingly little thing and a patient could die. The burnout that this article is talking about is with hospital nurses which deal with really sick people. If I am the one in the hospital, I would like to have a nurse that is able to devote adequate time to my care and not be preoccupied with the knowledge that he/she doesn't have the time to get everything done.

Also, in retail, you only deal with each customer for a few minutes at best. Nurses have to provide 24-hours-a-day care for their patients. The study did not count the patients that come in for minor treatment and then are discharged from the hospital an hour later.

We are talking about 5-6 long-term patients per nurse, who are in the hospital for days, weeks, or even months, and require round-the-clock care.

Morlack, Are you really comparing nursing to working retail?! This is the problem, most average Americans don't understand what RNs actually do. Perhaps you should do some research or talk to an RN before you make a comment like that.

Lol @ retail. I work at a busy county ER. Yes, I deal with #$%% managers and doctors too. I also have to deal with pissed off family members, drug addicts who drains alot of your time asking for pain meds for non-existing illnesses, psych patients who need to be watched constantly that are homicidal or suicidial, detoxing patients, combative and hostile drunks, very sick septic patients with alot of drug and lab orders, cardiac patients who is coding now (dying or no pulse if you don't know), stroke patients who receiving their tpn drugs and have to be watched 1:1 for 2 hrs for any bleeding, and of course those patients who have a hang nail and demands why they have to wait 15 hrs and want to be seen right away.

And of course, 30% of our time is charting or documentation. EVERYTHING gets documented. Vitals, meds given, when the doctor comes see you, the assessments, even if I come and give you a meal or pillow. Why? Blame lawsuits. Any bad mistake and we can lose our license. Can't say the same for retail.

I worked at retail once. I also an Iraq and Afghan vet. I can safely say retail is peanuts compared to the ER. I can also say that I'm more overworked as a nurse in the ER than being deployed overseas.

Very well said!!!

I am also a 30 yr. registered nurse, who has worked ER, ICU, the OR and with an anesthesia group of doctors. Had-enough is 150% on the mark. The amount of documentation that is done for every patient is done because of lawsuits. Any mistake could cost an R.N. her license if the hospital or physician writes her up for it. Retail is a piece of cake and can't possibly be compared. The most important difference: do you in retail have to take a written board to work and be licensed??? Get a grip and find out the requirements for becoming a registered nurse before comparing it to a retail job that only requires a high school diploma. Again, great comment had-enough.

morlack... i would like to sum up the responses to your post by stating .... 'you made a crap analogy'

I work in a nursing home and have for years talk about patient over load..how about 30 to 50 residents per 1 nurse and if you think nursing home work is easy, then you have never worked in one. @hadenough and JackieK..Very well put !!! now matter where you work as a Nurse its a High Burn Out Job and in my Opinion you have to be tough as nails. Only a nurse can understand the stress our profession deals with on a daily basis...

morlock your forgot how you retail staff need to work evenings and weekends and don't even get me started on the holiday shopping season!! Becasue we all know that hospitals and nursing homes and clinics send their patients home by 5, monday thru friday...

And let's don't forget the little side issues.....working large trauma center ER's, I had every finger broken at least once, too many broken ribs to even keep track of, teeth knocked loose, bruised kidneys, I've been bitten, spit on, choked, threatened, exposed not only to every bacteria and virus you can think of but heavy metals, pesticides (When there's a big spill, you don't stop to hose them off and sometimes don't even bother with names, you just start shooting everyone up with atropine before they start dying on you), and all of that is just another day in paradise for a trauma nurse.

Ohhh, and let's don't forget the ones who have been patted down in the field who roll in and pull a knife that's as big as a damned machete or a handgun, or a hundred other weapons on you and do their dead level best to kill you because you ruined what THEY thought was a great high. Never mind that they weren't breathing....they didn't know that because they were cruising at 10,000 feet without a aircraft. And if you disarm a bomber in the middle of the night, you'd better damned sure make certain someone calls the administrator and the Director of Nurses because if you don't they will drag you out of bed at noon chewing your butt because when they got ino work the TV and newspaper folks were waiting and they didn't know why. "Don't ever make me look that stupid again."

Morlack, your kidding right? Did you even think about what you wanted to post before you did it? As a nurse who has worked in all areas of the hospital I can assure you that working as a nurse caring for the sick and sometimes dying patient has absolutely nothing remotely in common with working retail! Nurses clock in at 0630 and sometimes don't leave the hospital until 9 p.m. I can't count the times I didn't have time to put my things in my locker but instead was running to a patient's room to perform CPR because the patient was coding. There were many shifts when I didn't have time to eat, pee or sit down. Retail, really??

Not really true. As someone hospitalized more regularly than I'd like, I can assure you nurses are NOT doing PT, OT or anything like that. You can let that fantasy go.

Around 10am, PT/OT and other allied health folks come up to your room and whisk you away to therapy sometime after breakfast. Most of the time, your nurse knows they're coming but can never tell you when- because that's not in the nurse's control.

Whoa! PTs, OTs,RDs. etc are not extensions of either nursing or medicine. These are serious specialties performing skilled functions (all require a Master's degree). I can't do their job and they won't do mine. (ok, legally they can't do mine, but believe me, they don't want to!)

There are plenty of graduate nurses out there that haven't been hired for more than a year. American born kids straight out of nursing school. There is no nursing shortage. The hospitals are too dam cheap to train new graduate nurses and the graduate nurses can't get a job because they need 1 yr experience.

http://www.indeed.com/forum/job/Nurse-RN/New-Graduate-Nurse/t154339

http://thehealthcareblog.com/blog/2012/06/04/why-new-nurses-cant-find-jobs-no-really/

http://www.workingnurse.com/articles/why-nursing-school-grads-have-trouble-finding-jobs

http://suite101.com/article/why-cant-new-graduate-rns-find-jobs---is-nursing-shortage-over-a236593

http://seattletimes.nwsource.com/html/businesstechnology/2017720619_nurses11.html

http://www.usatoday.com/news/health/2010-07-09-1Anurses09_ST_N.htm

Red tape? Good. Look at H1B1 visas where tech companies are importing engineers from India and other countries on the cheap. Yet we have Amercian engineers with experience that cannot get a job. You really think that they moved phone customer services to India and China because we have shortage of people here? I don't think so.

ICU is about 1-2 patients. ER is 1-6 patients depending on acuity, Medsurg is 5-6, nursing homes is 15-20 patients.......... it really depends on where you work. So 5.7 hrs average sounds about right.

I don't get the sense many posters are interested in exploring this issue from a factual point of view. But it's still nice to see actual data and facts being brought to the discussion.

At Tommy-boy, I'm a nurse in Houston, and we take an average of 6-7 on days, plus any discharges and admits, so i laughed at the 5.7 pt. work load also.

How truly accurately you speak. Was thinking, "Where is this hospital that only has 5-6 pts for each nurse." Your numbers are what I've experienced in 5 different states. Obamacare will make 10-11 patients per nurse look like a dream job because the number will surely rise to 15-20 per nurse. The question to be asked is how many patients will die per night? Ever done the paper work on a patient who dies? That'll keep ya busy for a couple of hours. Patients who get an infection will be the lucky, cause at least they didn't die.

I think it's just that when a nurse sees an article this, validating her stress & burnout, it is a wonderful release for them to speak out in this forum & actually know that someone is finally listening to them.

B I N G O ! Best RN post yet! Hospitals refuse and have refused for some time to actually PAY for experienced nurses. Except of course if you're a traveler, which I was for years and my GF is now. Travel-Nursing is the ONLY way to get paid for your experience.

And taking Ms. Velasquez's statement further. Now we have New-nurses teaching New-nurses.

Inexperienced nurses are scary and the public doesn't realize just how scary. Had to tell a new nurse before hernia repair surgery: "You can't send me to surgery with a Potassium of 2.7, I'll have a cardiac arrest on the table!" She had to call the surgeon, who showed up in my room, 3 mins later and said, "Your potassium is, too low, for me to do your surgery today. Had I not known, I'd be the patient who got to die.

sure sounds like the nurse's union screwed the nurses by asking for to much $$$. this is the same reason jos in the usa go overseas. wake up !!

yeah,ok that makes alot of sense.

Down here in the Southern New Mexico the local hospital has fired several experienced nurses just before they reached Retirement.

It is "Old Hat" in the Construction industry in the US to fire people just before Christmas, so they won't have to pay any Holiday Time, or bonuses, I guess this is the Health Care industries way of bringing those "management tools" into the Hospital Business.

Nope it sounds about right. Same as nurses, they hire the bare minimum amount of nursing assistants and er techs. Even they get overworked.

Oy-Vay, your are pretty sharp, sure there is "more to the story".

The whole system is a mess, but "keep us talking", do some more "studies", and do nothing about the problem. I see the same themes over and over in all these "overworked Nurse" stories, sure, the CNAs get the shaft, but they are even easier to replace than the Licensed Personnel.

Very few care about the problems of the RNs, fewer about the LPNs, who cares about the CNAs? Well, believe it or not some of us Licensed Personnel care a great deal, but what are WE supposed to do-it is the "system" that treats workers like disposable tissue.

Yup I agree, I was a nursing assistant/med tech for 17 years working in hospitals and LTC facilities and I can tell you right now this does not stem from only overworked, burned out nurses. A part of me want's to spend some time and elaborate on this topic....But I'm starting to feel nauseous thinking about it. I burned myself out a few years ago and haven't fully recovered. My brain still will not allow me think about that type of environment. It's a shame too because I was good at what I did. I did everything by the book and took no short cuts. Oh well...

I beg to differ with you.....working 10-12 hr shifts and you don't get many days off. What planet and hospital do you work for??? And guess what...overtime has been shut down, not many pay overtime. It's called getting the most out of your workers and not paying them much. My pay has been frozen for the past 5 years and my vacation, sick and personal time are all pooled together called "PTO". You only get a few hours accumulated every 2 weeks. Also, when stats are down, forced to stay home to not cost the hospital money. I have been an RN for 30 years, worked ER, ICU, and the OR.

After working 3 or 4 ..12 hour shifts that usually turn into 14 hours, it takes @ least 2 days for your body to recover enough from the leg & back aches. Then the decompression of mental anxiety eases up enough so that you might actually enjoy 1 of those days off.

Well, you're wrong. There are a small few # of doctors who might be difficult, but in my experience, When I've called a Doctor, they have responded appropriately and saved their patients' lives through their knowledge, even the difficult ones. Of course, I never called unless I truly needed for them to interact in an immediate patient crisis. Without doctors, any intelligent nurse would find another job.

And this notion that if nurses were paid more they could do more is hogwash. Nurses burn out because it is not humanly possible to do what we are asked to do safely. Nurse to patient ratio is the critical issue.

The public is also part of the problem. Nurses are not personal maids. The greatest disillusionment in nursing is to discover how disrespectfully the public (patients and their families) treat nurses. I can remember thinking that there would be more respect if I were a bartender than I get as a nurse. Hearing Thank You is such a rare thing that I can remember the less than 50 patients who thanked me in 20 years.

So true, when you are in the middle of an already stressful day, something hits the fan, so you drop everything to handle that situation & behind you there is a family member irate because you forgot to get "Moma" an extra pillow or the special flavored juice she likes the best. Instead of punching the woman, you smile through gritted teeth, apologize & let her know that you will be with her in just a short while.

Clark you hit the nail on the head! I have worked in healthcare 12 years, and it isn't my peers or physicians who make me wonder why I became a nurse. It is the ungrateful patients and their families. There are some very nasty, demeaning, ridiculous people in this world and I see them daily. They think they can do as they please, let their children run wild, talk to the staff any way they please, etc. I am the first to tell them to take their loud, crying kids to the lobby until they can calm them, enforce visiting hours if the visitors are causing issues, call security for assistance, and pretty much tell them how it will be whether they like it or not. I am very compassionate with my patients but I refuse to be abused any longer. When the patient says they want to leave, or the family wants them gone I hand them the AMA form and tell them to read over it and let me know when they have decided they definately want to leave. If they complain they don't want to be in my hospital or have a test, I remind them they chose to come and that I didn't not come to their home to drag them to my facility.

I love caring for elderly patients, because they are usually polite and grateful. The problem entails with their families. I am there to care for the patient not get their visitors blankets, food, drinks, ice, more than two chairs in the room, etc.

Right on Rider96; I remember when we nurses would get chewed out if a patient left AMA; I guess that "patients have rights' push changed this attitude somewhat, because then the attitude became "well, if they want to go at least get them to sign the AMA slip.

The 'frequent flyer' drunks and druggies did not like that one bit, they were used to the game of getting the whole Staff in an uproar and having the Nurses "beg" them to stay, then they would be the entire focus of everyone's attention and they could berate a whole lot of Staff members, not just one.

When the attitude changed and one of these 'frequent flyers' would come in I would just tape an AMA sheet up on the wall next to their bed and ask them to please drop it off at the Nurses Station on their way out. Guess what-more of them actually stayed, it took all the 'fun' and 'drama' out of Nurse bashing for these Drama Queens.

Lol yeah now that's funny. People don't go into nursing because of money. They don't pay enough for the amount of work they do.

If it's all about the money, why is my department ER have a high turnover rate of 30% per quarter?

My garbage man earned more than I did for many, many years. And while I appreciate and understand the value of a good garbage man, it still didn't seem quite fair.

Yup, those 30 million should just stay home and die, right?

Patients get to die is the answer to your question.

I'm sure those nurses have more than just 1 patient to take care of. Yes, we do have lazy ones, we have good ones.

And yes, nurses spend way too much on paperwork. Depending on their acuity. They might have to document their assessments and vitals every 15 mins to every 8 hrs.

Just like doctors have to do defensive care, order everything to protect them from lawsuits....... well nurses have to document everything to protect themselves from losing their license. And in hospice care, anything can go wrong. And if someone dies? More paperwork.

Blame malpractice lawsuits.

Hospice in its current form is a scam. They are assigned your insurance money, whether they spend it or not. So the goal is to pocket your money and avoid spending anything on you. No insurance?- they give you a couple of glossy pamphlets. That is what they mean by we will help you regardless of your inability to pay. Regardless of how close to death you are they will not accept you if they even suspect that you may come close to costing near what they are making on you. ANY VOLUNTEER WORK done for them is making the greedy owners richer and they probably think its hysterical to have people making them money for free! The original good intent of hospice has been railroaded out of existance by the never ending corporate greed that has this great nation on its knees.

That has to be one of the most ridiculous posts I've seen here.

ParaMed, I agree with you. I remember in 2001 I was working PRN at a Nursing Home. The Nursing Director told me that Hospice was going to come in and give the Staff a Presentation.

Since I was PRN I agreed to take care of the whole facility for the 30 to 40 minuets the presentation was expected to take, so that everyone could get the training. "If I run into any problems I will call you", I told the nice DON.

The Hospice presenters came in, wearing their $300 dollar suits, (I was more than a little surprised about their 'slick', monied appearance), and the entire Staff went down to the Conference room.

The CNAs had left a rude, demanding 400 pound patient on a stretcher in the hallway, (safety rails up, do not become alarmed), so they could go down and attend the Inservice, since getting her into her bed was at least a thirty minute job for three of them, and they were "required" to attend the training. I ran around giving Meds and answering lights, I was doing OK, but after an hour the constant demands of that Patient "put me to bed, put me to bed right now, don't you hear me you idiot, PUT ME TO BED", were getting on my nerves.

I went down to the Conference room to see how much longer they would be. The CNAs were sitting in the back dozing...the Hospice Presenters HAD NOT EVEN STARTED!!!! I was SO ANGRY I cannot even express it in words...

It was obvious to me on that day that Hospice, in the US, had taken a 180 degree turn from what it was originally intended to be. The "Big Money Boys" had taken it over, and I guess that is the way it still is. What a pity, and a shame, Hospice was founded on different principles than THAT!

Alot of comments here concerning the amount of money "us" nurses make when the root of the article is concerning how nursing shortages affects everyone. People sitting in offices determining how many nurses per patients is cost effective, not safety. As a nurse for 23 years, I can honestly say most of the comments on here are ridiculous. Unless you work in the field, you really have no idea. A typical day can be emotionally and physically draining. In one day I can be delivering a healthy baby to a excited couple, in the next room consoling a devestated couple with a fetal demise. People should really think before judging.

Or CEOs keep giving themselves X amount of payraises for the same amount of work for every year.

What happens to health care costs. 1. cost stays the same 2. go up. 3. go up but is offset by money and lives saved from infection.

Right. It's discussting to see that everything has degenerated into a " factory". Not that I have anything against factory workers because I was one. But when dedicated professionals no longer have the time to do anything but work at the keyboard that's sad. Everything is like that now. Work 12 hrs. a day ( sometimes 24 hrs. at a moments notice for EMT'S. The people who show up when you fall down and can't get up ) and much of that inputting. Experience is a burden. They want the young and the computer savvy who already know a lot of systems and don't have to be trained on it. But nursing? No problem. Just throw them into it fresh out of school and they will learn soon enough. Not a surprise that you end up with people more fit for administrative work than actual hands on nursing.

I say all administration should be reduced to a skeleton staff..most of their work could probably be done by a good secretary. Then hire more staff that actually has hands on contact with the people that are sick.

There is actually an article in the NEW ENGLAND JOURNAL OF MEDICINE from Dartmouth University that says that the real way to reduce hospital costs is to reduce the number of administrators.

as it gets worse, more nurses will just quit working.

there is no shortage of nurses.

there is just a shortage of nurses who will NOT work under the current conditions! there are lots of easier ways to make a living! lots of them!

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in the old days a 'big, heavy' patient was 300 pounds. now they come in 600, 700, 800 PLUS POUNDS!!

i had one patient say to me, "move me'', and i said, ''move yourself''. he said he couldn't. and i told him i would move him as soon as sufficient help showed up, as i could not take the chance on my back going out, trying to move him. who was going to help me being single?? no one.

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one patient came in and she had to go into the bathroom sideways, she was too large to enter the normal way. over 650pounds. she crushed the bed pan----flat!. sometimes she would just take a 'ship' and we would have to look for it. there wasn't much else we could do.

but what these people were thinking as they went from 200 to 300 to 400 to 500 or 600lbs and beyond is certainly beyond me!!!!

''MOVE ME!!!!" yeah, right.

do you think you are to fat when you can't move yourself? can't walk? or can't get into the bathroom front ways? or you flatten the plastic bed pan everyone else uses?

of course not, it is perfectly normal!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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as for 'the burnout is just starting'. no it isn't . the nurses will just quite and go else where to do other work. like work for an insurance company, get married, do case management, a million things. the patients will be the ones who suffer. not the nurses!!

True. The heaviest patients are always the ones who insist on nurses and techs lifting them. These fatties refuse to use a bedpan, like everyone else; instead, they want a whole team of hospital staff to carry them to the toilet.. also these patients weigh around 500 pounds and they frequently break toilets and beds. They also break the backs of healthcare workers. They are the most selfish people in the world.