Perhaps you have at some time been accosted by a patient, a family member, or even a relative, and they asked, “Why are you a nurse?” Or even, “Why aren’t you a doctor?” You may have heard a colleague say, “Oh, I am just a nurse.” Similarly, you may have been in situations where you had to argue your very existence. Some years ago, the American Medical Association wanted to create a new breed of health care workers to be called Registered Care Technicians, who would perform all the functions of a nurse, with less education and less pay, and they would be subservient to the physician. Historically, as hospitals have looked for ways to cut labor costs, they frequently take one of two strategies: 1) cut the professional nurses and replace them with cheaper assistants; or 2) maintain the nurses, but cut the support staff, leaving the nurse to do all of the remaining work. Neither maintains nor improves patient care.
The need to cut the cost of health care continues to rise and the current financial crisis means that nurses, the largest group of health care professionals in the country, will feel mounting pressure in the coming months. In this light, the presidents of specialty nursing organizations that belong to the American Nurses Association (ANA) organizational affiliates all agreed this year to dedicate their May editorials to helping answer the question, “What is the value of nursing?”
Since nurses were added to a Gallup Polls survey 10 years ago, respondents have ranked nurses as the most ethical and honest profession 9 times.1 Nurses are recognized as patient advocates who are there for the patient 24 hours, 7 days a week, long after other caregivers have left the hospital. Three nurses have even advocated in their role as members of the U.S. Congress. Nurses recognize the patient is a whole person, rather than a just a set of symptoms. Nurses navigate our increasingly complicated health system and coordinate the care of patients. The Johnson & Johnson Discover Nursing campaign brilliantly describes and photographs the diversity of nurses.2 No longer just in hospitals and long-term care facilities; nurses are providing primary care in urban and rural centers, assuring the health of our school children, improving the public health, and assuring death with dignity.
And yet one of the hardest questions that nurses are asked is, “Is nursing cost-effective?” In the January 2009 issue of the journal Medical Care, Timothy M. Dall et al compares 28 studies in the literature to describe the economic value of professional nursing.3 The findings revealed that increased registered nurse (RN) staffing has been correlated with reduced hospital mortality, length of stay, infection rates, hospital-acquired pneumonia, and decreased “failure to rescue” cases. Estimates based on these studies suggest that by adding 133,000 RNs to the acute care hospital workforce, we would save 5,900 lives per year. Combined savings in medical costs and increased productivity would be $57,700 for each of these nurses. The authors conclude that
only a portion of the services that professional nurses provide can be quantified in pecuniary terms, but the partial estimates of economic value presented illustrate the economic value to society of improved quality of care achieved through higher staffing levels.3
There are countless examples of how care from an RN is cost effective in your own setting, and I urge each of you to learn more about the value of nursing and to have a compelling response ready the next time you are asked, “Why do we need nurses?”
FULL TEXT
Perhaps you have at some time been accosted by a patient, a family member, or even a relative, and they asked, “Why are you a nurse?” Or even, “Why aren’t you a doctor?” You may have heard a colleague say, “Oh, I am just a nurse.” Similarly, you may have been in situations where you had to argue your very existence. Some years ago, the American Medical Association wanted to create a new breed of health care workers to be called Registered Care Technicians, who would perform all the functions of a nurse, with less education and less pay, and they would be subservient to the physician. Historically, as hospitals have looked for ways to cut labor costs, they frequently take one of two strategies: 1) cut the professional nurses and replace them with cheaper assistants; or 2) maintain the nurses, but cut the support staff, leaving the nurse to do all of the remaining work. Neither maintains nor improves patient care.
