Preliminary Results of the Health Care Worker Survey. Health and Safety Is Not Taken Seriously by Many Health Care Institutions. Top Reasons for Going Into Health Care. Desire to help people Interest in science / research Working with patients. Main Issues Concerning Health Care Workers.
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Top Reasons for Going Into Health Care • Desire to help people • Interest in science / research • Working with patients
Main Issues Concerning Health Care Workers • Short staffing • Irregular hours • Workload • Lack of management support • Bureaucracy • Workplace / Governmental politics • Lack of respect • Budget / Funding constraints • Difficulty working with physicians • Labor issues
What do you like the least about your job? • “Working from crisis to crisis.” Employee Health Nurse • “Dealing with non-health care worker administrators.” Physician • “Very challenging to convince doctors to institute safety into practice.” Industrial Hygienist
Have you thought about leaving work? • “Yes, politics of the position – sometimes you feel there needs to be an act of Congress to change anything.” Employee Health Nurse Practitioner • “Yes, my department hardly receives any support from the administration… also in the way of providing enough staff.” Employee Health Nurse
What is the biggest problem you face at work? • Low staffing • Lack of funding for training • “Injured workers coming to me after the fact.” Workers Compensation Coordinator, RN
How could your job be improved? • Increase staffing • Better control of work environment • Increase funding
The White Dress A presentation to the 10th Conference on Occupational Hazards to Health Care Workers Seattle, WA July 31 - Aug 1, 2002 Dr. June Fisher, TDICT Project, Trauma Foundation, San Francisco
A Cosmetic Approach to Health Care Reform The White Dress“Hotel Lobbies”Botox at HopkinsBoutique Medicine
“RN Pin” taken from Jim Coleman, Ltd.(http://www.jimcolemanltd.com/ana)
“There’s a terrible nursing shortage going in right now…and I have this romantic notion that if the uniforms looked more attractive more people would want to go into the profession.” - Designer, Yeohlee Teng, as quoted in “The White Dress,” The New Yorker, March 18, 2002
“The designer took a seat on a floral-patterned chair and looked around the lobby, a large two-story space with expensive lighting and, in one corner, a grand piano. In recent years, hospitals have begun to look more and more like hotels…. These changes are made partly in order to promote ‘a healing environment,’ but they’re also expected to improve the institutions image” - Excerpt from “The White Dress,” The New Yorker, March 18, 2002
Waiting room of the Cosmetic Plastics Center and Same-Day Admissions Facility at Massachusetts Eye and Ear Infirmary
“It is 7:30 a.m., dark, drizzling, chilly as I board the shuttle bus. This, I ask myself, is the pampered existence of the world’s elite? Today, I am experiencing first-hand the world of “concierge” or “boutique” medicine, a specialized type of health care available only to those willing to spend thousands more than standard insurance premiums in order to guarantee quality, access, and a bit of pampering.” - Taken from the article, “The Wealth Care System: When CEOs and VIPs need health care, they get the best money can buy. A reporter finds out just how good that is,” Washington Post, May 28, 2002
“As a resident of Cleveland, I am well aware of the luxury packages the Cleveland Clinic offers to wealthy customers, and so the May 28th front-page article ‘Healers Go for the Well-Heeled’ resonated with me. I am saddened, though, because many of these “elitist” practices -- such as personal communication, home visits and language interpretation -- are not, but should be, the standard of care for everybody.” - Letter to the editor, Washington Post, June2, 2002
“We’ve engaged in a massive and failed experiment in market-based medicine in the U.S….Rhetoric about the benefits of competition and profit-driven health care can no longer hide the reality: Our health care system is in shambles. Despite spending twice as much on average on health care per person as Sweden, Norway, Denmark, Canada, Australia, Japan and every other developed country, over 42 million Americans have no health insurance at all, and tens of millions more are not covered for all their medical needs. The recession we all fear could easily push the number of uninsured to 60 million.” - Congressional testimony from Dr. Marcia Angell, former editor of the New England Journal of Medicine, May 2, 2002
“The United States in particular stands out as having the most severe health care access problems related to cost, the greatest medical expense burdens, and the most pervasive inequities in care between adults with above-average and below-average income.” - “Comparison of Health Care System Views and Experiences in Five Nations, 2001,” Findings from the Commonwealth Fund 2001 International Health Policy Survey
For-Profit HMOs Health Care Associates (formerly Columbia/HCA) made more than $1 billion in profits last year. It operates nearly 200 hospitals across the nation.
“Two-thirds of new drugs approved in 1989-2000 used active ingredients already on the market…. Only 15% of drugs approved during this period were both based on a new molecular entity and deemed by the FDA as providing significant improvement over existing medicines”. (from “Changing Patterns of Pharmaceutical Innovation,” National Institute for Health Care Management, Research and Educational Foundation) Source: FDA 2001
“In recent years, more than 100 public hospitals around the country have closed, and almost 300 have converted to private ownership or management. A recent study found that one out of every 100 public hospitals closes each year, and two more convert to private ownership.” - Roni Rabin, "Complex Sale of NCMC is No Cure-All," Newsday, 15 March 1999, p. A5, A20-21.
“Medical crisis could catch S.F. flat-footed” “Drowning in chronic drunks and short on beds, city’s ER facilities ill prepared for bioterror - or even the flu” The San FranciscoIndependent, July 16, 2002
Racial and Class-based Inequity in Health Care “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” - Rev. Martin Luther King Jr.
Medical Error “ Most medical errors, it is said, result not from individual recklessness, but from basic flaws in the way hospitals, clinics and pharmacies operate.” New York Times, November 30, 1999
“To Error is Human: Building a Safer Health System” “… the results of the study in Colorado and Utah imply that at least 44,000 Americans die each year as a result of medical errors. The results of the New York Study suggest the number may be as high as 98,000. Even when using the lower estimate, deaths due to medical errors exceed the number attributable to the 8th leading cause of death. More people die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297), or AIDS (16,516).” - Institute of Medicine Report, December 1999
ANA Staffing Survey • 40% of nurses surveyed said they would not feel comfortable having a family member or someone close to them be cared for in the facility in which they work
“In hospitals with low numbers of registered nurses, patients are more likely to suffer complications like urinary infections and pneumonia, to stay in the hospital longer and to die from treatable conditions like shock of gastrointestinal bleeding….’I estimate that hundreds, or perhaps, thousands of deaths each year are due to low staffing.’” - From article by Denise Grady, w/ quote from Dr. Jack Needleman “Shortage of Nurses Hurts Patients Care, Study Finds,” New York Times, May 30, 2002
The Nursing Shortage Recruitment of foreign nurses – a drain on health care resources in developing countries
“The nation has a serious nursing shortage, with 126,000 jobs unfilled, 12 percent of capacity, says the American Hospital Association. The shortage is a result of hospital mergers, layoffs and heavy workloads. Many hospital nurses shifted to other work. The average salary, $46,000 a year, has not increased much in a decade. Even though hospitals are trying to hire again, nurses are no longer available.” - “Shortage of Nurses Hurts Patient Care, Study Finds,” New York Times, May 20, 2002
American Nurses Association, Health and Safety Survey, Key Findings, September 2001 Stress and Overwork • 67% reported some type of mandatory or unplanned overtime every month, (10%) as many as eight or more times a month • Fewer than 20% of nurses responding to the survey felt safe from work-related injury • >70% cited the acute and chronic effects of stress and overwork as one of their top three health and safety concerns
American Nurses Association, Health and Safety Survey, Key Findings, September 2001 (cont’) • 60% feared a disabling back injury • 45% of respondents were concerned about contracting HIV or Hepatitis B from a needlestick injury • 37% were concerned about the possibility of being infected with Tuberculosis or another disease • 25% named an on-the-job assault as a great concern • 21% were concerned about latex allergy • 19% of nurses surveyed ranked the possibility of a fatigue-related car accident as one their top 3 health and safety concerns