Stranger in a Strange Land

Most of you know I have been working as an RN in one way or another since the mid 1980's. I have to say since then I have witnessed miracles of science that my grandparent would have considered to be stuff of science fiction writers. I have also seen many many things that gave me pause and caused me to reconsider my chosen profession. Actually, because of many of the strains nurses have had to deal with, I changed from a "real" nurse to a case manager. From there the move was to managed care for TRICARE. Then to a psychiatric hospital as a case manager and then the director of the CM department. There were buy outs and merger's that changed the mission of each organization along the way. Each change prompted a re-evaluation of why I chose nursing as a profession in the first place. Currently, I have been in the same position at the same organization for over 7 years. That is the longest I have been anywhere. Now there are so many things that are again causing me to re-evaluate why I remain a nurse. The biggest is probably healthcare reform and the current political landscape of the country. There have been nursing shortages before and I am sure there will be again. Somehow this time it is shaping up to be a perfect storm. There will undoubtedly be millions more on the healthcare roles. Many more patients will seek medical help that have serious issues that have never been tended to before. This in and of itself is not a bad thing. But who will care for all these people? There is a nursing shortage right now. It takes minimum of two years to turn out a bedside nurse. Those with experience takes longer. Those with advanced education takes longer still. What happens in the meantime? How about doctors? There is a shortage of family practice doctors right now. Pediatrician's are in short supply, right now. There are medical schools across the country that are moving to a shortened med school, but what caliber of doctor will that produce? We don't know. And amidst it all there continues to buy buy-outs and mergers that are changing the face of medical care in the country. So back to my original query...why did I choose to become a nurse in the first place? Well, my childhood was spent in major hospitals in Texas either because of my own cancer, my mother's various surgeries or my dad's struggle with Guillane Barre Syndrome. I grew up around nurses and doctors. They were very special people in my life. As a single mother of two, I found myself in need of a job that would put food on the table and allow for some sense of security for my kids. It was a natural thing for me to work at a hospital as a Unit Secretary. There I met some of the most amazing people I had ever met before. From the surgical transport techs to the lab techs to the nurses and doctors that cared for the patients, they were all dedicated to making people feel better. They moved through the hospital hallways in scrubs and labcoats and people actually seemed to be different in their presence. Children played with stethoscopes that hung from staff members necks. Elderly people leaned against a nurse after their partner just passed away. Sometimes, it was really bad. Sometimes the staff was tired and overworked and stressed. But they always managed to care about the people they served. Service. That is what it is all about I think. But in this current era of medical care is that still true? I work at a place that cares for children. As you can tell from the posts not just kids that have medical issues, but kids with mental health issues. To make it even more profound these kids largely are under served, under insured and basically poor. Some of them are in the protective services system and move from placement to placement until they become too old to be a kid anymore. Over the last 7 years I have watched this place and the people who work there go way out of their way to care for these kids. Fund raisers, donations, tours, the United Way campaign are parts of my life just like all those hospital visits were so long ago. Now I work mostly in an office or in doctors offices talking about the work done at this place. It gives me a great deal of hope to talk about the work done here. It makes me feel like I am making a difference when a kiddo gets something good from what we do. I am a nurse, first and foremost. I am not a marketer, I am not a sales person, and I am not an administrator. My first duty is to the patient no matter where they are. I have had a very long and happy career in nursing and if it were to end today, it would all have been worth it if something that I did made a difference in just one person's life. Am I serving still? I would like to think so. I also know that if something changed today that prevented me from being of service, I would walk away. Perhaps with some sadness, but I would still go. Will I be doing the same thing this time next year? Can I weather the coming tide? I guess it is just too soon to tell.

TheTruth About Healthcare Reform

What do we truly need to know about healthcare reform? Is it the high cost of medicines and getting care? What if over half of the medical professionals that currently care for us were not there anymore? Where would we go? In a given year, there are 58 million Americans age 18 or older who have a dignosable mental disorder. That is roughly 26%. This does not include those under the age of 18, which may raise the percentage to about 45%. Psychiatric nurses are a disappearing breed according to a recent article in the Journal Of Psychosocial Nursing. More than half of the current psychiatric nurse will leave their jobs by 2018. Only 4.2% of the psyhciatric nursing force is younger than 30. There are approximatley 90,765 psychiatric nurses in the country to date with a total number of RN's estimated at 2,909,357. When looking at job satisfaction among nurses, the Psych nurse retained their same jobs and employers at a rate of 80% for those eomployed in a hospital setting. These are the RN's who care for the sickest of our mentally ill. A ratio of psychiatric nurse per 100,000 population showed Texas (12.7) and Nevada (17.1) having the lowest number of psychiatric nurses. Accordning to NAMI's Grade the States report, Texas received a D. There may be a correlation between the lack of available professionals and the poor scores. We know there is a current lack of child psychiatrists and a limited number of child and adolescent beds in San Antonio. We can try to attract professionasl to the city, but why would they want to try to work within a ssytem that is broken? Perhaps the Nursing programs across the state should look at the psoitives to offering a module preparing nurse for a career in psychiatry instead of imbedding psychitric models in the med/surg blocks. And those of us who work in psychiatry need to offer our stories to those who might seek this out as their area of specialty. Clinical coaching programs could offer a great avenue for aging RN's to pass on their experience and strength to new nurses and pass their lamp of hope to a new generation of nurse who choose to care for the mentally ill in our society. Nurses have been the underpinnings of the healthcare in our country. If they are in short supply, we will all suffer. Send this on to a nurse who may be looking for a new niche to fill.