Nursing shortages are usually short-lived, peaking during economic booms. But even during the current recession, hospitals have been unable to get close to full staffs.
A variety of reasons account for the shortage, according to Lynn Olman, president of the Greater Cincinnati Health Council, a non-profit association of health providers. For example, hospitals haven't done a great job recruiting men and minorities.
But dissatisfaction with nursing -- or rather, with changes in health-care administration -- is also significant.
"I do think there are a lot of nurses who are frustrated with their work," Olman says.
Many nurses have the impression dollars -- not patient care -- is the highest priority at hospitals, according to Mike Haas, co-chair of the Registered Nurses Association, AFL-CIO, which represents more than 900 nurses at University Hospital, Veteran's Hospital and Hoxworth Blood Center.
"It seems to be that the determining factor in health care today is profit," Haas says.
University Hospital, owned by the Health Alliance of Greater Cincinnati, is 17 to 18 percent understaffed in nurses, according to Haas.
Almost 900 nurses at University Hospital were poised to strike when their contract expired July 1. Ninety-seven percent of nurses who voted June 18 authorized a possible strike, Haas says. But a last-minute deal June 28 not only prevented a strike but also gave the nurses a better contract than they expected.
The new three-year contract, approved July 2, gives nurses free parking, a child care center and, most important, a plan to end mandatory overtime by Jan. 1, 2004.
Unlike many labor disputes, this one wasn't about pay; union members say the issue was working conditions and how tough it is for nurses to ensure all patients receive quality care.
Nurses are expected to care for up to 12 patients at a time, according to Annette Asbury, a registered nurse for 11 years, four of them at University Hospital. Each room holds six patients at a time, and sometimes the hospital has to put patients in a hallway.
"It affects a patient's feelings," Asbury said June 24, before a union meeting about negotiations.
It takes Asbury half a shift just to see a dozen patients, much less give all of them what they need.
"It's very unsafe for the patient," she said. "It's not like the old times, where another nurse can back you up."
The profession of nursing isn't getting the same respect it used to, according to Cheryl Covert, a nurse for 30 years, 19 of them at University Hospital.
"It's about being able to provide patient care," Covert said June 24.
Nurses are naturally caring, and that quality is being used against them, she said; nurses can't work two consecutive shifts and provide the same attention to detail for 16 hours straight, especially when they were not expecting a double shift. Surprise shifts create a lot of chaos in nurses' lives, she said.
"There's a lot of having to stay because there's nobody to come," Covert said.
Hospitals face pressures from all sides, according to Olman. As a proportion of the population, the number of 24- and 25-year-olds in the United States is now at an all-time low, she says. Many nurses are opting for less hectic jobs in doctors' offices or pharmaceutical companies.
"What we have is a profession that's not as appealing as it used to be," Olman says.
At facilities such as University Hospital, public dollars typically pay half the patients' bills and private insurance pays the rest. But cuts have come from the public and private sectors alike.
"They're getting cuts on both sides," Olman says.
At the same time, everything is getting more expensive, from the price of prescription drugs to salaries, which account for two-thirds of a typical hospital budget, Olman says.
A Health Alliance representative did not return calls.
Many nurses, such as Haas, choose to work at University Hospital because it cares for the county's poorer patients.
"I absolutely love what I do," Haas says.
The good news is 12 straight days of negotiating resulted in a new contract that addresses all of the nurses' main concerns and more, Haas says.
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