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Minnesota Star Tribune: nurses perform "medical miracle"

February 20, 2004 -- Today, the Minneapolis Star Tribune reported on a promising campaign by the Minnesota Hospital Association and the Minnesota Organization of Leaders in Nursing to encourage nurses to take the lead in improving their working conditions. The article, written by H.J. Cummins, explained how teams of nurses from three of the seven Minnesota participating hospitals created and implemented solutions to key problems. Ideas included improving career ladders and nurses' involvement in discharge planning, and making good interpersonal skills "a part of every job description."

The piece explained that the president of the Minnesota Hospital Association, Bruce Rueben, supported this initiative because "we understood there were significant, noneconomic issues that should be addressed outside the context of the negotiations." Staff nurses were encouraged to reshape their workplaces--with administrative support. One hospital chose to improve discharge planning, which focuses on patients' understanding of their health care plan upon departure from the hospital. Nurses revamped their discharge planning and started addressing out-of-hospital care from the time of admission and throughout the patient's stay. Another institution made changes to the notorious flat nursing career ladder, so that nurses who did extra work or improved their skills earned higher salaries.

One group of nurses wanted more respectful communication in their workplaces. The article focused on one nurse who felt disrespected by a computer technician who had embarrassed her in front of others. The "respectful communication" plan encouraged the nurse to speak up and demand an end to the abusive communication, which she did. The computer technician apologized to her in front of the group.

Media attention to the abuse that nurses endure at work is long overdue. However, the incident with the computer technician does not seem representative of the workplace abuse problems most nurses experience. Nurses have long cited physician disruptive behavior (verbal and physical abuse) as a significant factor in worsening nursing morale and satisfaction and decreasing nurse retention. In addition, in some clinical settings, such as the ED, abuse by patients and families can be significant, especially in the context of the stressful environment created by short-staffing. It is not clear if the article failed to address these larger issues because they are more sensitive--i.e., because it's easier to address problems with computer technicians than with powerful physicians, patients, or the overall clinical system--or for some other reason, but the failure to do so is a significant problem.

See H.J. Cummins' article "Nurses brainstorm cures for job issues" in the Minneapolis Star Tribune. (free registration)

Learn more about this initiative at the Minnesota Organization of Leaders in Nursing.


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