Friday, June 15, 2007

Of Mice and Coelacanths

From an unsigned question-and-answer format article appearing on the editorial pages of today's local fishwrap:

"Didn't the Legislature do something?

Yes. In 2002, lawmakers told the state's universities and community colleges to set a goal of doubling the number of nurses being graduated.

Lawmakers didn't provide any money with the mandate, though. The deadline for doubling is this year, but the goal won't be met."

From the deep well of the veritably miraculous, natural-law-driven, and red-white-and-blue Free Market comes... nothing. That's why the market is nowhere mentioned in the article. Just the lack of a legislative rescue.

The nursing shortage is not only still with us after decades of dire concern, it is going to get much, much worse. And the healthcare market is doing all it can to exacerbate the problem, being "profit-driven" as it claims (if there are fewer nurses to pay then there's more money left over for the middlemen and women.) By its own design it is contributing to this critical problem. While self-destructing, of course.

Actually there are no "profits" in healthcare. Just subsidies, from which takings are maximized by limiting the provision of healthcare itself. Quite the opposite of "building a better mousetrap." Flimsier and cheaper mousetraps provide more "profit" to the big fish.

Appeals to the Arizona State Legislature have also been predictably near-useless, of course.

Before a species goes extinct its population dwindles. It is farcical to think that the number of nurses could ever become so small that they are unable to produce enough "offspring" to continue the profession, isn't it? Can we be sure about that?

From N=1 at "Universal Health":

"As a nurse who has been on the front lines of hospital overcrowding, of too many traumas and not enough trauma bays and trauma nurses, I know full well that nurses will carry the motherload of work, of agony, of sacrifice and of loss in a flu pandemic. Ogilvy PR staff willl be cozily sheltering in place, as will the HHS honchos, while nurses will be on the front lines of mass suffering, death and of loss. It will be nurses who run from patient to patient doling out limited oxygen supplies, who after running out of N95 respirators, will continue on and give care while they put their own lives at risk. And it will be nurses who remain with patients as others stay in the safe havens and shelter in place."

Just as disease can bring the remaining members of an endangered species to the brink of extinction, nursing as it is now practiced could very possibly take a hit from which it is not prepared to fully recover.

Maybe nurses are members of a dying species.


Dirk Gently said...

i suspect that, if we ever do get universal, not-for-profit healthcare, nurses will be more plentiful and get the respect - realized in better wages and conditions - that they deserve. patients and families universally understand and appreciate the contribution of nurses far more than does the medical-industrial complex.

just my opinion, but on the other hand i am rarely if ever wrong.

N=1 said...

Good article, actually. They one piece that wasn't mentioned is the growing nursing faculty shortage. By the time that funding is introduced (Bush is planning to cut 40+ million from the FY2008 Nurses Workforce Development Act, which would have funded some loans for nursing faculty education, but wouldn't go toward increasing their salaries, which are lower than that of two year new graduates'), I don't think there will be a real ability to recover from the shortage of nurses and qualified faculty, let alone education the numbers of people needed to step into nursing positions.

I appreciate the way you analyzed the problem. Coelocanth - that resonates! Thanks for writing this post.