Finding a Solution to our Health Care Crisis

Economist nursing is a global health care issue: What is the answer?

Economist nursing is an area of increasing concern in North America, but also all around the entire world. While economist nursing is not something new or different, economists and economic analysts are taking global health care issues more seriously, all of the time. This issue includes the status, as well as the plight of registered nurses, everywhere.

There is no doubt that there are serious labor shortages with respect to registered nurses, in every country of the world today. This is not just a shortage of registered nurses, but a shortage of all other levels of health care workers in hospitals, nursing homes and other facilities, including private homes, as well. From all over the world, there is a growing cry of concern, resounding as one voice, crying out and emphatically stating that there are not enough registered nurses and other qualified health care workers and that this shortage is getting worse, day by day.

Thus, one must ask, "What is the answer?"

Does the economist or economic analyst have an answer?

Part of the problem has to do with the wages that must be paid to registered nurses and other health care workers. It is not as if the registered nurses or others are overpaid. If anything, many of them are severely underpaid, for the amount of education and training that they have had to obtain and the volume of work that they are compelled to do. In many parts of the world, the work that is done by registered nurses is done without the expectation of any financial remuneration, at all.

Another issue has to do with how registered nurses are regarded around the world. Nursing is perceived as a vocation, not as a profession. In many countries, registered nurses are regarded as people relegated to the working class. Some are perceived as servants. Hundreds suffer humiliation, degradation and abuse while they are caring for others, even in our civilized world.

Many registered nurses are victimized by professional jealousy from their peers or other health care workers, as well as forced to take the responsibility for the errors or mistakes in judgment that other registered nurses or non-professional workers have made. Many are victimized by lawsuits, with or without just cause.

Hospital cutbacks present an ever increasing threat to registered nurses, as a pending economic recession makes this situation increasingly worse. Registered nurses are obligated to take on the tasks formerly designated to other non-professional health care givers, like nursing assistants, personal support workers, health care aides or volunteers. Their own case loads may suffer as a result.

Registered nurses who apply for employment, are often turned away from hospitals and nursing homes, because of the growing recession. Financial cutbacks result in layoffs.

Other registered nurses hired by hospitals and nursing homes, may be let go immediately, as soon as they become entitled to benefits or bonuses of any kind. The cost is too high for the designated budgets of the hospitals or nursing homes to bear. Registered nurses may be hired with the promise of a bonus and then, that bonus is absorbed by the system itself or by management, while they are obligated to seek work elsewhere.

Many registered nurses are forced to become self-employed workers or take employment in other fields of endeavor, often at a much lower rate of pay.

The work load is so heavy in many hospitals and other facilities that many registered nurses are injured or permanently injured and left to cope with their injuries, without any expectation of appropriate income that might be deemed adequate for their financial survival.

The end result is staffing shortages in almost every health care facility where registered nurses are employed. The likelihood of sustaining an injury or acquiring an illness continues to grow, both for the registered nurse and the patients.

One cannot but ask what happens to patient care, as a direct result. The risk continues to grow in many different directions, both for the registered nurse and the patients. Nursing research will show that the well-being of patients is adversely affected. So is the decision making process.

There is a growing tendency toward taking an economic approach, as opposed to a patient care centered approach in nursing. There is a fine line between the two. This situation is growing worse every day and it will continue to result in more and more tragic scenarios, all the time. In many parts of the world, it is becoming more and more of a crisis.

The countries with larger populations will feel the crunch even more so, particularly where wars, disasters, plagues or epidemics strike. This can happen anywhere or at anytime. No country is exempt from tragedy.

Registered nurses are continually leaving Canada, for the US. This is increasing the shortage of nurses in Canada. While it appears that there are many jobs for registered nurses, at the same time, depending upon the area in which they live, registered nurses may be forced to go to other communities, or to other countries to obtain employment. The economy in the area in which they live, may not allow them to be employed, as the health care budget only allows x number of dollars and only so many registered nurses can be hired.

The demand for registered nurses is increasing continually, as the population continues to become older, particularly in North America. There are not enough registered nurses to care for everyone, even now. This shortage will continue to grow, in spite of ever increasing attempts to train new registered nurses and the institution of new, less demanding programs with reduced training requirements being instituted.

What happens to the quality of care for patients?

Nursing research will show that the quality of care tends to decrease, as well. So will the quality of registered nurse doctor relationships and registered nurse-patient relationships. Nursing practice will suffer and gradually deteriorate, over time. Nursing judgments will be negatively affected, because of the basics of training may be lacking or the work load is too heavy. Perhaps there is not enough support staff.

Media concerns with respect to health care concerns and patient needs will increase.

Even with increased marketing and more advanced education, one might ask why would a young woman or a young man want to enter into a profession that is becoming less and less of a profession, with the likelihood of serious moral, legal and ethical issues and repercussions on the increase?

Perhaps more advanced nursing research, with a higher degree of marketing, raising nursing to a new plateau, holds some answers. Training more registered nurses and other health care workers would seem to be a part of the solution, but it is a drop in the bucket, with respect to what the actual needs are, even now.

Demanding higher academic standards of registered nurses seems to be another possible solution, but the cost is prohibitive, at least to some degree, unless other levels of health care are instituted simultaneously. These would have to be raised to a higher standard.

Cutting the cost of health care would seem to be an answer, but it appears that there are ever increasing, not decreasing, health care costs being manifest on a global plain. The more medical research that takes place, the more demand there is and will be for registered nurses to play a more significant role in terms of contributing to this health care research.

In many places, registered nurses are forced to take over the diagnostic roles of doctors and to institute care beyond the level of a registered nurse. Nurse practitioners are becoming increasingly in demand.

Ethical issues in nursing are becoming more and more complex as the medical fields advance in terms of new technology.

As nursing home facilities increase, which they will, there is the economic aspect of the profit-loss factor.

Is it economically feasible to place people in nursing homes or is it more realistic to pay someone to care for them, in their own homes? Who is entitled to the profit and who should be expected to bear the brunt of loss that is sustained? Should the loss be born by the government, the community, the institution, or the patient and his or her family?

The question becomes one of who will pay the cost for the registered nurses going out into the homes of these patients? Who will cover the cost of the community nurse education or training that is required in order to make this feasible in the first place? How will these programs be put into place? Where will the funding come from for the community nursing education?

Outsourcing is one way other companies or organizations have their economic needs met, but is this realistic or a feasible solution in terms of registered nurse shortages? Does a patient want to have health care via a telephone call or even worse, from someone in another country, who may or may not be able to understand them or speak their language? Tele-health is a relatively new trend, but does it offer adequate health care in terms of community care nursing, or is it one more drop in the bucket of patient needs?

One does have to ask what nursing care is all about. Is it about dollars and cents or is it about the well being, care and concern for the patient? Is it about the training and education of registered nurses and other health care givers or about how much cost the patient and his or her family can afford to pay?

In reality, the health and safety of the patient needing care should be the primary concern, not the dollars required for the care.

The shortage of registered nurses is not something new or different in our era, although it does appear to be increasingly magnified or magnified out of proportion, at times, in many parts of the world.

The economist nursing issue is a serious one and must be regarded as such everywhere and not treated as some imaginary threat that may or may not be real. The impact is being felt on a global level and will only grow until someone comes up with a more positive and constructive solution.