Nursing against the Odds

Suzanne Gordon

Description

In the United States and throughout the industrialized world, just as the population of older and sicker patients is about to explode, we have a major shortage of nurses. Why are so many RNs dropping out of health care's largest profession? How will the lack of skilled, experienced caregivers affect patients? These are some of the questions addressed by Suzanne Gordon's definitive account of the world's nursing crisis. In Nursing against the Odds, one of North America's leading health care journalists draws on in-depth interviews, research studies, and extensive firsthand reporting to help readers better understand the myriad causes of and possible solutions to the current crisis.Gordon examines how health care cost cutting and hospital restructuring undermine the working conditions necessary for quality care. She shows how the historically troubled workplace relationships between RNs and physicians become even more dysfunctional in modern hospitals. In Gordon's view, the public image of nurses continues to suffer from negative media stereotyping in medical shows on television and from shoddy press coverage of the important role RNs play in the delivery of health care. Gordon also identifies the class and status divisions within the profession that hinder a much-needed defense of bedside nursing. She explains why some policy panaceas-hiring more temporary workers, importing RNs from less-developed countries-fail to address the forces that drive nurses out of their workplaces. To promote better care, Gordon calls for a broad agenda that includes safer staffing, improved scheduling, and other policy changes that would give nurses a greater voice at work. She explores how doctors and nurses can collaborate more effectively and what medical and nursing education must do to foster such cooperation. Finally, Gordon outlines ways in which RNs can successfully take their case to the public while campaigning for health care system reform that actually funds necessary nursing care.

Sujets

• Médecine
• USA
• Nursing
• États-Unis

Informations

• Publié par: Cornell University Press
• Date de parution: 15 mai 2012
• Nombre de lectures: 0
• EAN13: 9780801465048
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Nursing against the Odds

A volume in the series The Culture and Politics of Health Care Work Edited by Suzanne Gordon and Sioban Nelson

Nobody’s Home: Candid Reflections of a Nursing Home Aide Thomas Edward Gass

Code Green: Money-Driven Hospitals and the Dismantling of Nursing Dana Weinberg

NURSING AGAINST THE ODDS How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care

F

SUZANNEGORDON

ILR PRESS an imprint of CORNELL UNIV ERSITY PRESS Ithaca and London

Copyright © 2005 by Suzanne Gordon

All rights reserved. Except for brief quotations in a review, this book, or parts thereof, must not be reproduced in any form without permission in writing from the publisher. For information, address Cornell University Press, Sage House, 512 East State Street, Ithaca, New York 14850.

First published 2005 by Cornell University Press

Printed in the United States of America

Library of Congress Cataloging-in-Publication Data

Gordon, Suzanne, 1945– Nursing against the odds : how health care cost cutting, media stereotypes, and medical hubris undermine nurses and patient care / Suzanne Gordon. p. cm.—(The culture and politics of health care work) Includes bibliographical references and index. ISBN 0-8014-3976-0 (cloth : alk. paper) 1. Nursing—Social aspects—United States. 2. Nursing—United States—Public opinion. 3. Nurses—United States—Public opinion. 4. Nurses—United States—Social conditions. 5. Nurses in mass media. 6. Nurse and physician. I. Title. II. Series. RT86.5.G67 2005 610.73'0973—dc22 2004028248

Cornell University Press strives to use environmentally responsible suppliers and materials to the fullest extent possible in the publishing of its books. Such materials include vegetable-based, low-VOC inks and acid-free papers that are recycled, totally chlorine- free, or partly composed of nonwood fibers. For further information, visit our website at www.cornellpress.cornell.edu.

Cloth printing

10 9 8 7 6 5 4 3 2 1

For Claire and Sam Fagin

1. 2. 3. 4. 5.

6. 7. 8.

9. 10. 11. 12. 13. 14.

F

Contents

Preface Introduction Part One: Nurses and Doctors at Work Manufacturing the Dominant Doctor Designing the Doctor-Nurse Game The Disruptive Medical System Fatal Synergy Making Matters Worse

Part Two: The Media and Nursing

Dropped from the Picture

Missing from the News

Unavailable for Comment

Part Three: Hospitals and Nursing

Mangling Care

The New Nursing Universe

Nurses on the Ropes

No Nurse Left Behind

Management by Churn Failure to Rescue Conclusion: Changing the Odds Notes Index

vii

ix 1 17 21 55 76 95 121 147 151 173 200 227 233 253 284 312 351 384 401 451 475

F

Preface

he act of thanking people for their help in the production of a book so often seems to dissolve into clichés. But the truth is that only th T is book. The village is first of all inhabited by the many nurses, some through phrases such as “there are no words to express . . .” or “I am so grateful for . . .” can I pay homage to the village it took to produce named here, some not, who shared their stories, concerns, and hopes. Then it’s made up of people whose almost daily contact and conversation inspired me and kept me going. First I thank Carolyn Mugar and John O’Connor for their generous fi- nancial support of this project. It is very sad that John, a tireless advocate for health care reform, great supporter of nursing, and always ebullient personality, is not here today to see its completion. I thank my agent Anne Borchardt for all her support over the years. Fran Benson, my editor and now friend, did so much more than most ed- itors. Her editorial guidance helped me navigate tight passages, and the almost daily talks we had broke the isolation that threatens to engulf an author. Sioban Nelson’s vast knowledge of nursing and health care poli- tics—whether conveyed in face-to-face conversations or over the phone—was critical to my work. Isabel Marcus was always there when I called her—sometimes when she was in the most unexpected places— with my typical “I’ve just had an epiphany” (she must have wondered when the light bulb would finally go out and she could get some respite). And my long collaboration with Bernice Buresh has enriched my thinking about nursing silence. A number of clinicians helped me understand the complexities of the

ix