Where Have All The Nurses Gone? Final Results of AJN's Patient Care Survey

Nurses Respond to Healthcare Restructuring

“…It appeared that conditions were worse in areas with high managed care penetration, like Massachusetts (Schindul-Rothschild et al, 1996). There, nurses found themselves in a cold, business-oriented health care environment.…”

“…Fueling the campaign, Judith Schindul-Rothschild, a nursing researcher and MNA member, published a national patient care survey. It revealed that two out of five nurses would not want a family member to receive care at their particular health care facility (Schindul-Rothschild et al, 1996).…”

“…6-7) unlicensed assistive personnel (UAPs), or nurse assistants, began to represent a greater proportion of the patient care workforce. Hospitals divided up the care process into tasks, shifting nurses from handson-patient care to serve as team leaders of LPNs and UAPs who now performed the "mundane" tasks of changing bedpans, and comforting and bathing patients (Fagin, 2001;Schindul-Rothschild, Berry, & Long-Middleton, 1996). Over time, the inadequately trained UAPs were given broader responsibility for patients, such as assessing vital signs, changing sterile dressings, and reading electrocardiograms (Fagin, 2001;Gordon, 1997, pp.…”

“…261-268;Schindul-Rothschild et al, 1996). Nurses took on higher patient loads and, in addition to supervising the LPNs and UAPs.…”

“…Acuity is a nationally used relative measure of patient care needs, measured by the hours of care required per 24 hours, by patient type. Reorganization of hospital care delivery resulted in outsourcing lower acuity types to outpatient care facilities, while patients in the next to highest category of care needs were placed in general care units (Heaphy et al, 2000;Pindus & Greiner, 1997, section 2;Preuss, 1998, p. 13;Schindul-Rothschild et al, 1996). During an interview a twenty-year emergency room (ER) nurse stated: "The people you are seeing on the floors now used to be in ICU.…”