Too Few Nurses, Too Little Time

I have this theory that if we could get everyone to live healthy lifestyles and give health care providers more time to spend with patients, we could eliminate a huge portion of this country’s health problems.

Just think about it: many of our illnesses are caused by a poor diet and lack of exercise, and another bunch are caused by patients’ confusion about things that require more time to explain than their health care providers have.

Two recent news articles prove my point.

The first tells of the rising incidence of sexually transmitted diseases (STDs) in those older than 50 years. According to an article published in the November/December issue of MEDSURG Nursing, most health practitioners don’t even ask people over 50 about the possibility of contracting HIV/AIDS, herpes, syphilis, human papilloma virus (HPV) and other STDs.

The article was authored by Lisa A. Jeffers, MSN, CRNP, FNP-BC, NP-C, CWS, a nurse practitioner in Berlin, Md., and Mary C. DiBartolo, PhD, RN-BC, an associate professor of nursing in the Department of Nursing at Salisbury University, Salisbury, Md. You can read the entire study at http://www.medsurgnursing.net/archives/11dec/285.pdf.

Older people are “often neglected in terms of risk assessment, screening, and education regarding STDs,” the authors write, partly because of unease their providers have about the subject, but also because talking with patients about anything at length takes time, and no one seems to have any these days. Let’s face it: taking a detailed sexual history is nigh impossible with today’s time constraints, so the topic of STDs gets relegated to the bottom of the patient’s list of multiple problems.

The second story stated that in a recent survey, more than 40 percent of unmarried 18- to 29-year-olds said that they “knew little about birth control pills,” and two-thirds said that they “knew little about even more effective long-lasting contraceptives.”
"We have a whole generation now of young adults, the vast majority of whom are sexually active, who are in a fog about modern contraception," Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy said in an Associated Press story. "They don't know enough to make a reasonable choice."

To help patients sort out all the birth control options, Brown established the interactive website www.bedsider.org . It’s a great teaching aid, but in the end, patients will still have questions, and it’s a nurse who should be there to answer them. But again, this all takes time.

In today’s health care environment, it takes a village to care for a patient. Physicians, nurses, social workers, pharmacists, physical therapists and nutritionists – all of these are needed on the team because health care is complicated and so are a patient’s needs. Nurses are an important part of that village because they are excellent teachers, and it’s been proven that whenever nurses are employed to help or monitor patients, health care costs go down.

When health care institutions think about saving dollars, they think about cutting staff nurses. But eliminating nurses will, in the end, increase costs. That’s because when patients are not fully educated or don’t understand, there is an increase in the repeat doctor visits, medication mistakes, accidents and admissions.

Do you feel the time crunch when dealing with patients?

If so, what problems do you think it causes, or could cause?

Do you have any examples of how, if you’d had more time, problems would not have occurred?

Tell us about it.