Industry representatives would have us believe the current shortage of registered nurses is a natural evolution in the business cycle.
In fact, the conditions for a shortage were created through deliberate policies that under the guise of cost containment were intended to enrich employers and consultants alike -- at a terrible cost to our communities and to patients who have suffered the effects of dangerously understaffed hospitals and clinics.
Scores of hospitals were re-engineered. The idea that sick patients should receive care when and where they need it from the highest-skilled professional was dumped. In its place came corporate buzzwords like "patient-focused care" intended to remove the highest-skilled health professionals, including registered nurses, or replace them with lower-paid employees with far less specialized education. Limited training oriented toward task performance was used as a substitute for professional judgment and skill in the delivery of care.
The result was threefold: layoffs of thousands of health professionals, an explosion of riches for the industry and their consultants, and patients and communities stripped of care.
These trends, accompanied by the spread of managed care, accelerated the corporatization of healthcare. The largest chains accumulated profits the most quickly, hastening the privatization and monopolization of health services.
In California, the effects are especially acute due to the sheer size of the population, the concurrent lure of profits and the advanced market influence of managed care.
The current shortfall was willfully created with disastrous consequences. Some consultants will just move on to the next profitable industry. But community health systems, much like ghost towns after strip mining, will be left to rebuild from the ground up with much of our once-precious resources lost to us.
What is needed today is not just an alarm at the sudden emergence of registered nurse vacancies but a change in the practices that led to those shortages. As long as industry giants continue to put their wealth ahead of our communities' health, hiring a handful of registered nurses will have little impact on the deterioration of care standards we are witnessing.
Rose Ann DeMoro
California Nurses Association