Decline in quality, says survey

Nurses feel that deteriorating working conditions have led to a decline in the quality of nursing care, say the results of an American Nurses Association survey released in February. Some 75 percent of the registered nurses surveyed feel the quality of nursing care at the facility in which they work has declined over the past two years; 56 percent believe that the time they have available for patient care has decreased. Additionally, more than 40 percent said they would not feel comfortable having a family member or someone close to them cared for in the facility in which they work. Over 54 percent said they would not recommend their profession to their children or friends. "The responses we have received from nurses who took this survey are alarming," said ANA president Mary Foley. The "ANA Staffing Survey" involved almost 7,300 respondents surveyed from late December 2000 through January 2001.

A growing temporary work force

The rapid expansion of the "contingent" work force--or temporary workers--is one of the most significant trends in the economy and is likely to have a profound effect on the entire union movement. Speaking at the AFT executive council meeting on Feb. 6, Jeff Grabelsky of the AFL-CIO's Building Trades Department reported that temporary agencies have expanded beyond the usual clerical employment that once characterized such companies. In 1991, for example, roughly half of the employees of temporary agencies were clerical workers; in 1999, only 36 percent were clerical, with industrial and construction workers making up 38 percent. The growth of temporary agencies in the construction trades is a harbinger for employees the AFT represents, noted AFT president Sandra Feldman. Nurses from temporary agencies were quickly brought in to try to break a strike of nurses at the Washington Hospital Center in Washington, D.C., last year, she said. Such agencies are increasingly a source of nonunion workers for services provided by employees in all AFT divisions. These temporary workers must be organized, said Feldman. "We have to have critical mass; otherwise, you can't get into the issues of quality and standards."

Bring your own "sitter"

A recent article in the Washington Post describes how patients are hiring personal assistants--at their own expense--to be with them in the hospital during long stays. "Even in the best hospitals, patients and their families are turning to private nursing help to supplement care from short-handed, overworked staffs," writes Post reporter Abigail Trafford. "As hospital nurses focus their efforts on patients in crisis, private 'sitters' are there to tend to patients' more personal needs." A neurosurgeon quoted in the article recommends private-duty nurses for patients on the medical floor, noting: "If you have good nursing care, you have significantly better outcomes." While there are no good statistics on the trend, says Trafford, private agencies that supply nurse's aides report a dramatic rise in requests from hospital patients. The reason for this trend? Short-staffing and an exodus of nurses from hospitals and the nursing field.