Nurses Needed

Reprinted from PN/Paraplegia News April 2013

A shortage of nurses should not exist at all, anywhere.

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Here in western Montana where I live, nature is doing its spring-like thing.

Probably the first harbinger of spring is the Canadian geese who are permanent residents of the Bitterroot Valley. Unlike their traveling relatives, our geese stay year round in some of the areas with warm springs that never freeze over. 

As mid-February passed, a pair of native geese landed at the pond at my place and laid claim to it as their nest. Mid-February is a little early for geese to be selecting a nest, so spring will probably be early. You’re probably wondering why I’m writing about geese, but read on.

Mature geese mate for life. They’re truly dedicated to one another. This dedication makes me appreciate nature. I only wish we were as dedicated, specifically in the way our government is operating in regard to spinal-cord-injury (SCI) nursing care. 

Even though veterans’ care is generally nonpartisan and for the first time in a long time we have a Congress and administration that is giving the Department of Veterans Affairs (VA) more revenue than it has asked for, we still have a significant problem with adequately trained SCI nursing care.

Good nursing care is the difference between life and death, short and extended stays, timely or delayed delivery of medical services, and attention to a paralyzed patient’s unique needs.

There are 22 VA Medical Center Spinal Cord Injury Centers in the United States, and six SCI extended-care facilities. More than sufficient funding was allocated this last fiscal year by Congress to hire full-time staffing for all these centers, regardless of their specific function. Unfortunately, that is not the case.

Each month PVA does a survey of every facility to determine the staffing of all the specialties, not just nurses. If there was ever a year we should have had full-time staffing, this is it.

I recently was released from the SCI center in Long Beach, Calif., after an extended stay. Long Beach is a great facility and where I underwent my initial rehab in 1974. A good thing about writers staying in the hospital for a long time is they’re usually good observers.

While the Long Beach center is better than most in nurse staffing, a problem shouldn’t exist at all, anywhere. The nursing shortage in most cases is not the fault of the chief of service at the SCI centers. It puts them in a difficult situation of trying to get help from hospital administrators who have instructions to hold down costs.

Hiring freezes are made at higher levels, and when we see the administration and Congress playing fiscal chicken, it’s the veterans who suffer. Hiring freezes place supervisors in SCI centers having to work nurses overtime, hire unqualified workers from outside services, and have nurses work shifts with an insufficient number for the inpatient load. 

With almost 40 years as a paraplegic, I have used Seattle SCIC, Palo Alto SCIC, and Long Beach SCIC. During that same period, I was also in senior management in PVA and received the monthly reports on staffing at all the centers.

Over that period, I never had it reported to me or experienced personally the centers ever having adequate staffing.

A quick example: In January 2013, throughout the entire system we were more than 147 nurses under the minimum. This means we had 278 beds unavailable.

I could go on with other material to back up my information. Unfortunately, the problem is at the highest levels of government. We in PVA bring this problem to VA’s attention constantly. Sometimes it helps, but most of the time things don’t change too much. We’ll keep working at it, and our leadership never lets up. 

At the beginning of this editorial, you wondered where I was going with the geese. I wanted to demonstrate that geese are dedicated to each other for life.

I wish I could say as much about our government’s dedication toward taking care of its most severely injured veterans. I would like to think that my and my comrades’ sacrifices were at a higher level and were worth more to my country than geese are to each other. The ongoing nursing situation makes me wonder.

Have a great spring. 


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