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Reader's Digest: Nursing shortage is "America's Biggest Health Care Crisis"

September 2003 -- One of the cover stories in this month's Reader's Digest is a powerful, 10-page piece by John Pekkanen explaining the causes and significance of the nursing shortage, including recent research showing how short-staffing harms patients and harrowing real-life anecdotes to help readers understand just how it can affect them. The piece recites some of the usual data about the shortage and nurse dissatisfaction, but its focus is on the hospital experiences of actual patients and nurses. These stories reveal a system on the verge of breakdown, where angry family members struggle to get the attention of overwhelmed nurses and patients die needlessly because there simply aren't enough nurses. The article includes a sidebar called "Take Control of Your Care" with tips on how readers can try to reduce the worst effects of the shortage on their families before they choose a hospital, such as checking RN-to-patient ratios; these tips underline how central nursing is to the hospital experience.

The article doesn't cover every important aspect of the crisis. There is no mention of the role of traditional attitudes or media images, which perpetuate poor treatment of nurses, demoralize practicing RNs and discourage recruitment from non-traditional sources, such as men and minorities. And although Pekkanen rightly suggests the real solution to the shortage will come from "investing more" in nurses through measures such as the ANA's magnet hospital program, he does not discuss recent legislative efforts to address the problem, such as the safe staffing legislation pending in some states or federal measures such as the Nurse Reinvestment Act.

Still, relative to other stories in the mainstream press, the article is unusually insightful and effective. Pekkanen makes one point that is so rare for such articles, and so poorly understood by anyone besides nurses, that it deserves to be quoted: "Technology can never fill all the critical roles that nurse play. For instance, every time a nurse enters a patient's room, she observes his or her color, demeanor, state of mind and speech. Any subtle change can signal trouble. [Deceased liver donor] Mike Hurewitz failed to get this sort of assessment--and none of the devices he was hooked up to could perform that job." Similarly, an RN later describes how, supervising her own husband's post-operative care, she barely managed to stop a nurse's aide who was starting to reinsert a dangerously contaminated spinal catheter. Pekkanen ends the article: "If [this nurse] hadn't been camped out in the room, she wouldn't have caught the mistake. Most frustrating to her, she knows that any RN would have known what to do. But there were no nurses around."

At the end of the article, a note promises a follow-up piece in the October issue called "One Day in Critical Care: A Nurse's Story." See our analysis of this article.

Click here to see the September 2003 article in pdf.

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