Columnist Susan Snyder: Conditions are problem for nurses

Sunday, Feb. 20, 2000 | 10:17 a.m.

Susan Snyder's column appears Sundays and Tuesdays. Reach her at snyder@vegas.com or 259-4082.

Theresa Morrow says not to believe the hype.

Nevada has enough nurses, said Morrow, a Las Vegas nurse for 18 years.

Morrow testified at a state Legislative hearing a few weeks ago on behalf of her nurses union. She says a health care administrator told legislators Nevada has 248 openings for nurses.

Morrow said Nevada has about 16,000 nurses, and under American Nursing Association standards 248 openings isn't a shortage.

The shortage comes from within, she said. Administrators often leave shifts short a nurse or two. Or patients are added to a hospital's nurse-to-patient ratio without considering how much care that patient really needs.

State guidelines call for nurses to determine how much care each patient needs, Morrow said.

"Our problem is there's not enough compliance. The hospitals determine how many nurses are on a particular unit. It's very frustrating," she said.

And out of frustration, nurses quit.

"That's what's leading to a shortage," Morrow said. "There's a lot of good, experienced nurses who won't work. I have a lot of respect for the ones who hang in there. But the sad part is there are fewer and fewer who will."

Floors for general surgical patients or intermediate units for patients just out of intensive care have the most problems, she said.

New graduates typically are assigned to a year on one of these units. Morrow says they "suffer through that year" and move on. Experienced nurses don't hang around.

Morrow spent her first six years on a general surgical floor, then began outpatient wound and burn care.

"I just couldn't take it anymore," she said. "I worked 11 hours and 55 minutes. And I would still go home at the end of a day and not feel like I'd done everything.

"The number of days you go home feeling completely satisfied are few and far between."

She cited an example from a local intermediate care unit where the standard was three patients to each nurse. Administrators decided it should be four.

"They think, 'What's one more patient?' " Morrow said.

Well, it's a heap of work if the patient is being weaned off a respirator or needs hourly physical therapy because his muscles have stiffened from being in bed, Morrow said.

"I know nurses who have left because of getting more patients," she said.

Solutions start with realizing that most of Nevada's nursing shortage is by design, not default, she said. Administrators deciding how many nurses are on a floor need to ask nurses what's best.

And there need to be some perks for those who stay. She said at least one hospital offers retention bonuses every six months. Many offer signing bonuses, where half the money is withheld until the contract expires.

Sounds expensive. Maybe it would be cheaper to make hospitals the kind of places nurses like to work in again so they'd stay.

Most nurses, Morrow said, really want to.

"It's a hard job. We don't go into this thinking it's going to be a cakewalk," she said. "But under harsh conditions, it's a nightmare."