Rebecca Hendren, for HealthLeaders Media, December 28, 2010
In the next few years, will we look back at 2010 and identify it as the year healthcare began to change. From controversial legislation to plans for widespread reorganization and rethinking of the way care is delivered, 2010 has certainly been dramatic.
The issues have been no less profound in nursing. 2010 has seen an IOM report that offers a blueprint for the profession's future and nursing leaders have been fighting to ensure nurses' involvement in the rethinking of healthcare delivery. Along the way, there have been turf fights, labor battles, and more attention paid to the difficulties faced by new nurses.
Here's a rundown of the most popular nursing stories we covered in 2010 in case you missed them, or just want to have another look.
1. Has the Nursing Shortage Disappeared?
Around the country, new graduate nurses reported being unable to find open positions in their specialty of choice, and even more shockingly, many found it tough to find any openings at all. These new RNs entered school with the promise that nursing is a recession-proof career and that the nursing shortage would guarantee them employment whenever and wherever they wanted.
Many rejoiced that the days of hiring bonuses and begging nurses to join an organization were behind them. But the end of the nursing shortage is just an illusion created by hiring freezes and older nurses postponing retirement.
2. Nursing's Growing Role
Not so many years ago, nurses wore white uniforms and stiff white caps. This picture is as antiquated now as today's nursing model will be in 20 years. Today's non-cap-wearing, scrub-bedecked nurses are increasingly well-educated at colleges and universities that focus on care coordination and critical thinking, as well as clinical skills. They care for higher-acuity patients with more comorbidities and increasingly complicated care needs in the course of shorter lengths of stay. Nurses today are technologically savvy critical thinkers who coordinate care across a broad spectrum of healthcare. To be successful, they must be well-educated, well-trained, and able to lead patient care.
3. Ten Ways to Increase Nurses' Time at the Bedside
Bedside nurses are occupied in non-patient care tasks for a quarter of their shifts. Nurses lose three hours of patient care every 12-hour shift to non-direct care tasks, such as redundant paperwork and regulatory requirements. Some reports estimate nurses spend as little as 30% of their time with patients. Here's how healthcare organizations can help their nurses spend more time in patient care.
4. 'Onboard' New Nurses to Prevent Them from Jumping Ship
"Onboarding" new graduate nurses helps them overcome the reality shock of transitioning from school to practice. More than simply orientation, onboarding is the process of embedding new employees into the culture and ensuring they not only become productive employees, but that they become emotionally invested in the organization.
5. Nurse Residency Programs Pay For Themselves
Related to onboarding, nurse residency programs help new graduates make the difficult transition from school to practice and can help end the all-too-common fact of new grads leaving their first job within the first year. Similar to physician residency programs, the intent is to continue education, mentoring, and support to enable novices to become competent practitioners. They can also save hospitals vast sums of money.
6. Stop Losing Experienced Nurses
The nursing workforce is aging. The average age of licensed RNs is 47 and nearly 45% of RNs were 50 years of age or older in 2008. The looming crisis presented by experienced nurses leaving the workforce spurred the Robert Wood Johnson Foundation to launch a national program to find out what will keep experienced nurses in hospital settings and find out what effect existing interventions have on the work environment for older nurses.
7. Nurse Whistleblower Case Sets Dangerous Precedent
Justice finally prevailed in this disturbing case in Texas where a nurse observed a physician displaying serious lapses in competence and judgment that put patients at risk. Although eventually being found innocent, the case displayed the danger all healthcare whistleblowers feel when standing up to powerful interests.
8. New Nurse Testing Standard Raises Bar
The National Council of State Boards of Nursing raised the passing standard on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to ensure new nurses are sufficiently ready to take on the growing needs of sicker patients.
9. Better Nurse-Patient Ratios Could Save Thousands of Lives Annually, Says Study
If California's mandatory nurse-patient ratios had been in effect in Pennsylvania and New Jersey hospitals in 2006, those states would have seen 10.6% and 13.9% fewer deaths among general surgical patients. That equated to 468 lives that might have been saved, says Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing and the study's lead author.
10. Nurse-on-Nurse Hostility Remains an Issue
Back-stabbing, intimidation, and sabotage are all too common on some nursing floors, but many in nursing are working to change culture and offer strategies for how to stop these behaviors.
11. Doctors Sue To Stop Unsupervised Nurse Anesthetists from Administering Anesthesia
Two large physician groups claimed surgical patients were being put at risk because a new California regulation allows nurse anesthetists to administer anesthesia without the supervision of a physician, and sued to stop the practice.
12. Nurse Anesthetists Say They Practice Safely Without Physician Supervision
In reaction to the above story, nurse anesthetists across the country vehemently defended their ability to administer anesthesia without physician supervision, saying there's never been a study showing the practice to be unsafe. Representatives of the American Association of Nurse Anesthetists say studies have shown that certified registered nurse anesthetists perform the service with equal safety, or even more safely, than anesthesiologists.