I read with interest the Jan. 14 letter to the editor from Feudi Pandola (p. 20) commenting on your Dec. 17 article "Industry Pushes the Call Button" (p. 26). The letter pushed a button of mine regarding the shortage of registered nurses.
I believe the long-term shortage of nurses is the result of two ill-advised policies undertaken in the early 1970s. The first was a national decision to stop funding hospital-based schools of nursing as a way of cutting hospital costs. The other was to bring nursing education into colleges as a professional degree program. The idea was that colleges, not hospitals, should provide education.
How ill-advised! Lack of reimbursement caused hospital-based programs to fade out quickly, which was met with sighs of relief from many hospital managers. The result was that the nursing profession became two-tracked. The vocationally oriented associate degree in nursing (not given particular encouragement by organized nursing) and the "professional" baccalaureate degree.
In my opinion, nursing is both a vocation and a profession. The model should have been to train the "professional" nurse in the hospital. I have worked with, and for, tremendously professional nurses who were diploma RNs. For that matter, I've worked with tremendously professional RNs who had associate degrees. And I have seen excellent nurses who had bachelor's of science in nursing degrees who were first licensed vocational and associate degree nurses.
For that matter I've witnessed some bachelor's degree nurses who never mastered the vocational calling of nursing-which in my opinion should come first.
Diploma schools of nursing provided vocational education and at the same time aided direct patient care in the hospital setting as the student nurse progressed through the skill-building process.
Certainly, the "professional" building that comes from the necessary broader education could have been added to, instead of taken away from, hospital-based schools of nursing.
Would that have been possible? Certainly! The very basis of physician education, beyond the theory, is direct patient care-driven and based on lengthy hospital-based experience and teaching.
I would advocate a serious, high-level review of the way we train those who will become professional nurses. We should compare the costs of training nurses in hospitals and in colleges, factoring in the added costs to hospitals of not having nurses in training in the hospital and the cost of external continuing education.
I have a belief that the cost to bring a stable supply of the nursing profession back into hospitals may be acceptable, and the patients we take care of and the physicians we train will be the better for the change as we "reinvent the wheel."
Interim chief executive officer
Sierra-Kings District Hospital