"I was afraid the hospital would burn down before I could get into it. Now I have to watch myself with matches." So says Maloney, a slightly jaded, wisecracking nurse played by Joan Blondell in the 1931 film Night Nurse. She's speaking to a newer nurse, played by Barbara Stanwyck, who's still starry-eyed about the profession. Nursing may never have quite resembled what the film depicted, yet Maloney's words have a ring of truth, encapsulating a disappointment-even a bitterness and rage-many nurses feel today.
Consider the following portrait of an "average" nurse. She is 50 years old and works 10-hour days, often without a break. She thinks of herself as proficient, even expert, yet knows there's not enough staff or time to give patients the care they need. She listens to patients' complaints and is sometimes verbally abused. Management is not supportive enough; she gets little recognition for a job well done. She says she's emotionally exhausted. Nonetheless, she takes pride in her work but wonders how long she'll be able to keep up the pace.
This description comes from a new report, "The State of the Nursing Workforce in New Jersey: Findings From a Statewide Survey of Registered Nurses," describing respondents to a survey sent to about half of the state's nurses (about half of those surveyed responded). The summary concludes: "Our challenge is to create systems, processes, and environments that support [the average nurse] in her important work."
We've heard this before, I know. But after several years of feeling exasperated about our society's failure to take up nurses' concerns, I'm hopeful that now times are changing. Here's one reason why.
On December 6, 2007, the AARP Foundation announced that it had received a $10 million grant from the Robert Wood Johnson Foundation (RWJF) for a Center to Champion Nursing in America (http://www.championnursing.org). Under the leadership of Susan Reinhard, a nurse and director of the AARP Public Policy Institute, the center will build coalitions between nurses and the public.
Imagine it: the public working alongside nurses to call for bans on mandatory overtime, requirements on public reporting of staffing levels, and higher salaries for faculty nurses. At a press conference in December, RWJF president and CEO Risa Lavizzo-Mourey, a physician, noted that the center will address the basic question: "Who will care for us now and in the future?" The answer isn't simple. "It will take all sectors of society to turn this around," she said.
Bill Novelli, CEO of AARP, assured those present that this is just what the center will do, augmenting the grant with AARP's considerable resources. "The center will work in broad coalitions and be a strong voice for people who want change in health care," he said. Reinhard said that the first priorities will be redressing the faculty shortage and retaining nurses. For example, it might work to promote the use of tested innovations that retain nurses and foster safer care, as is being demonstrated by the Transforming Care at the Bedside project (see "Off the Assembly Line," Editorial, December 2007).
You might see this center as yet another policy initiative out of touch with the struggles that nurses face. But I believe it has the potential for making quips like Joan Blondell's a quaint relic for the next generation of nurses. I urge you to support this initiative. To start, go online (http://www.rwjf.org/pr/product.jsp?id=24111&catid=11) and watch a Webcast of the press conference and a follow-up meeting. Follow this initiative as it develops, and think about ways that you can work in partnership with the public in your own state or community.
We're the most trusted profession in the public's eye, but here's an opportunity to act on this trust. Doing so may help nurses to stay at the bedside-without abandoning or torching health care.