As a registered nurse, I was dismayed to see some of the comments by Rose Ann DeMoro of the California Nurses Association (Jan. 20, p. 25). She's right about the anecdotal patient-care stories. They are horrible, and no patient should ever have to experience detrimental care at the expense of a healthcare model. But are we sure managed care is to blame? "Managed care" has become the garbage pit for everything that is wrong in healthcare. The concept of managed care in a pure form is not a bad one. Perhaps it's the business practices within the model that are at the crux of the problem.
Unfortunately, what DeMoro claims as advocacy for patients and the return of healthcare decisions to doctors, nurses and patients is really thinly veiled self-serving, special-interest language. The CNA cannot provide safe, high-quality healthcare for all Californians. It can attempt to protect traditional nursing roles at the expense of organizational success. DeMoro is also right on one other issue. Quality is the pivotal parameter, not cost.
The answer to these problems is not emotional defensiveness and militancy on the part of nurses. Some nurses have been so busy reacting to the changes they haven't had time to proactively participate. Nursing must continue to be the choreographer of the patient-care process and will be a key component in our country's healthcare future. Let's stop adding to the chaos and start contributing solutions.
SUSAN ODEGAARD TURNER
Principal and chief executive officer
Turner Healthcare Associates
Thousand Oaks, Calif.