In Rhode Island and nationwide, the health care industry is struggling with a major shortage of nurses. Locally, hospitals are using temporary nurses and even hiring from abroad. Yet it’s not just recruitment that’s a challenge: Many nurses are quitting, saying they’re burnt out by long hours and understaffing.
This year, RISNA successfully lobbied for legislation that will require hospitals to publicly disclose their staffing levels; it’s also backed bills to ban mandatory overtime, to require nursing homes to post their nurse-to-patient ratios, and to expand publicly subsidized educational opportunities for nurses. As the group’s president for the last two years, Weber is at the forefront of those and other battles.
PBN:Tell me about RISNA.
WEBER: We’re 100 years old this year, the voice of professional nursing in Rhode Island. The association was created as part of a national movement to standardize nursing, so we could say, “This is what patients can expect.” We’ve been active ever since in making sure that nursing standards are maintained, and in education and a lot of other things.
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PBN: How has nursing changed?
WEBER: Before it was mostly primary care, bathing people, doing wound care and things like that. A lot of nursing was based on intuitive sense, and education was called “training.” Nurses were seen then as really handmaidens to the health care professionals. Now we have evidence-based practice, greater technology, research. Our education is deeper and broader. We have advanced practice. We have more roles, not just in the hospitals but in the community, at universities, in the law.
PBN:Does that make it harder to be a nurse?
WEBER: I think it makes it more exciting, because people know they can come into the profession and wherever their interests take them, they can usually find something. One of the problems we have in nursing is that because there are so many other options available to women, it’s harder to attract people. Having a variety of avenues that people can practice in is one of the things that continue to attract nurses.
PBN:What do you do specifically?
WEBER: I’m a psychiatric nurse clinical specialist and a gerontological nurse clinical specialist. I work part time out of The Miriam Hospital in their geri-psych department going into nursing homes, and then I have my own part-time private practice.
WEBER: We’re at about 8 percent in all facilities, and in nursing homes and long-term care facilities it’s even greater, 10 to 15 percent. And we know there’s an increase in demand, because people are sicker and they leave the hospitals more quickly than they used to, and go into long-term care facilities, or go home (but still need a nurse’s care).
PBN: What keeps people from becoming nurses?
WEBER: Even though every study has shown that nursing is the most respected and trusted health care profession, people see that it’s still hard work, you still need your education. It’s a very demanding profession, and people still demean it on some level. I remember people asking me, “Why don’t you just become a doctor?” Well, I didn’t want to be a doctor. I love being a nurse, and having the patient contact and advocacy role that comes with nursing.
PBN: I saw an article saying more Americans will be getting their primary care from nurses rather than from doctors, and that’s not a bad thing, because nurses may be better trained to do it.
WEBER: Many nurse practitioners are now in primary care, and they’re not a replacement for physicians; we see it as a team. There are things physicians are educated for, and there are things nurses are educated for. Nursing, by its very nature, is a holistic profession. We integrate into our education mind, body, spirit. We integrate a wellness model. So our approach is different. We’re very big on educating people to take care of themselves. Nurses in primary care address different issues than a physician would address.
PBN: Are nurses gaining more control over their practice, or losing it?
WEBER: I see both. It depends on the setting; it depends on the hospital. In some, nurses are gaining more power, more control. When I look at when I first went to nursing school and now, we’re like 1,000 miles ahead. We’ve worked very hard getting to a place where we have a say in what happens in patient care. We’ve also worked very hard gaining good relationships with other health care professional organizations, and educating legislators. So overall, I’d say we’re in a much more powerful position than we used to be.
PBN: Yet, the United Nurses and Allied Professionals said last week many hospitals have cut their nursing staffs “to the bone.”
WEBER: A lot of facilities have cut their nursing staffs to the bare bone, especially their (registered nurse) staff, so that nurses are expected to do more with less. It’s not safe, and that’s one of our concerns at State Nurses. The rate of work-related injuries among nurses is very high. … Nurses are expected to work a lot of overtime, and there’s research that shows the accident rate, the mistake rate among nurses goes up as they work over eight hours.
PBN: How do you feel about legislators’ response to the problems in nursing homes?
WEBER: I think they should be helping to educate (the staff), to help them understand how do you delegate, who do you delegate to, what leadership do you need. At State Nurses we’re coming up with a number of programs to bring into nursing homes, to help them with these issues.
