News Scrapbook 1989

San Diego, CA (San Diego Co.) Evening Tribune (Cir. D. 123,064)

San Diego, CA (San Diego Co.) Evening Tribune (Cir. D. 123,064)

Tribune photo by Thomas B. Su lay

Nurse Lisa Gifford attends lo patient George Lauters. 86, at his home

a:m aro~nd his shoulder. George is 86 and holding his own m a battle with cancer. They talk quietly about the pain, the progress he's making, and then she helps him into the bedroom for a brief checkup. "We love her," Tillie says, looking after them. "She does her work thoroughly. And she sits down and talks to you. She's the best." The promise of days like this is what drew Gif- ford into nursing 23 years ago. The lack of them almost forced her out. Until she moved from hospital to home health- care nursing, Gifford found herself with Jess and less time to spend with her patients. And more time to mull the burnout, lack of status and lack of participation m decision-making that are almost a part of the job description for many nurses. They've lobbied, campaigned, even gone on strike to improve their pay and working conditions, but time proved to be their ultimate weapon - the time it took to become a 1ery valuable commodity. Now things are changi g for the nation's 1.5 mil- lion registered nurses. Gifford never doubted that they would.

"Nurses are the thread in the fabnc of the health- care delivery system," she says, matter-of-factly. Society is beginning to appreciate that as the fabric comes apart a little. According to the American Association of Col- leges of Nursing (AACN) and the American Nurses' Association (ANA): • Surveys among the nation's hospitals and nurs- ing homes showed that more than half were experi- encing moderate to severe shortages of qualified nurses. That was two years ago. • Federal government estimates indicate that, by next year, the demand for nurses who have bache- lor's degrees will exceed supply by 390,000. By the year 2000, the gap will widen to 578,000. The shortage is not caused by a mass exodus of malcontents from the field. The truth is, more nurses than ever are working. The problem is that more nurses than ever are needed, because: • American& are living longer - long enough to develop heart diseas1· and cancer, and disabilities and frailties that req ire home health care or the Please see NURSE: C- , Col. 3

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By Jane Chfflrd Tribune StiJ.ll ll'ner I T' · \ R. I Tuesday and Lisa Gifford mancuve her van around curves and up and down thebillside streets of Fallbrook, doing work she love. "Good moning." Gifford says as Tillie Lauters opens the scren door to her apartment. Tillie, 81, welcomes bennside, where her husband, George, is ·1ttmg in bis ocking chair, waiting for his weekly visit from Giford. She walks oer and leans close to him. "How are ou feeling?" she asks, slipping her

grows, angels of mercy look for ways to attract more souls to their profession

Tribune photo by Jerry McCiard

Getting acquainted at USD

Incoming freshmen at tbe University of San Diego pack the university's soccer field near Linda Vista Road for the an- nual freshmen orientation exercises. It's a way for the new students to get

know each other and the university as they compete in such games as relay races. About 1,000 freshmen participated in the USD exercises yesterday morning. Classes start Tuesday.

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NURSi: Profession Jess uniform than prevwusl

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63 Derek and Peep

But the realities of the working am NU SE were a lot different from the dreams the student nurse. Eventually, Giffc Continued From C-2

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them to a patient's bedside or draw- ing fluid into a syringe. "You can teach a monkey to do that," Gifford says with a very straight face. "Nurses are educated by in-depth college-level courses in anatomy and physiology, biology, pharmacology, sociology, psycholo- gy, logic ... " Some, like Gifford, are pursuing advanced degrees, but all nurses must take 30 hours of continuing edu- cation courses every two years. They must be proficient in rapidly advanc- ing treatment procedures and know how to operate a growing inventory of high-tech medical equipment. For all this, nurses still make less than comparably educated profes- sionals - according to AACN, the average starting salary at hospitals in 1988 was $22,416. And, Gifford says, while pay has improved, a nurse still faces the prospect of going · from bottom to top of the profes- sion's wage ladder in about seven years. But, then, money's not the draw. "Yes Harry I'll be up " Gifford says i;to the phone. It's 9:15 in the evening. She's been going since sunrise. But Harry's worried about his wife. She has cancer and Gifford's been a regular visitor to their home. . Gifford recalls, "One day she said to me, 'I'm so glad that I didn't die fast. This has been such an experi- ence ... "It's things like that that keep you in nursing, keep you mindful of what you really are doing ... helping peo- ple."

Continut'd From C•l skilled care of a nursing home.

It's a grueling schedule. Most weekdays start at 7 a.m. and end around 7p.m. She's on call 24 hours a day, seven days a week. She has to work. She's a 47-year- old widow with four children, rang- iag in age from 6 to 15, counting on her. Most nights she's exhausted and there's very little room for a social life ("I go to the theater in San Diego. The children take turns coming with But she's ia charge. She's putting her expertise to work. "You get the flavor of what you can do for the patients, for their fam- ilies. You have physician respect, consumer respect and personal re- Gifford's view is from the trenches. The physicians she works with know that. So, together, they work for the good of the people they serve. She wonders aloud why the same cooperation can't exist in hos- "I left because I was unable to in- crease the realm of my responsibili- ty," she says. And she believes that the future of nursing, maybe the fu- ture of hospitals, depends heavily on reversing some of these trends. "Hospitals have to let the nursing profession take over management of its practice ... We all know, if you own something, you take better care of it," she says, alluding to nurses' "ownership" of the jobs they have It's a whole lot more than putting pills in a paper cup and delivering me.") spect." pitals ... been trained to do.

But Lantz is more concerned about the qualifications of those applicants. He says that when he took over at the school four years ago, the lowest grade-point average among applicants was 3.2, today, it's closer to 2.5. "The reality is, we want to get not only more students, but more qualified stu- dents" Lantz says. "The goal is not how many you accept, but how many you fin- ish. "We're confronted with a higher attri- tion rate. At one time, we accepted 60 'We have all these crazy little sexpots and birdbrains on TV. The public needs a more accurate picture ofnursing.' - Janet A. Rodgers students and graduated 58. Now, we may accept 60 and only graduate 40." . Lantz agrees that increased opportuni- ties for women are luring away many qualified students. By 1987, only 4 per- cent of incoming freshmen women as- pired to careers in nursing, a 50 percent drop from 1983. , Nursing is still very much a womens profession (97 percent), but many young women apparently prefer business suits to scrub suits, board rooms and cou;t- rooms to operating rooms (unless they re the ones performing surge17), and_ the money and prestige that go with the Jobs. Such things were little more t~an a feminist view of the future when Gifford went off to Georgetown University in 1966. A simple desire to care for people sent her to the school of nursing. "I felt a sense of duty, which probably comes from being Catholic, and a sense of responsibility," she remembers.

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• American:; in hospitals are more se- riously ill. The AID ~p1demic, the grow- ing crisJS of drug-addicted newborns, the increasing incidence of organ t~ans- plants and other life- _ aving ~ed1cme have given new meamng _to intensive care. Hospitals are faced with a greater need for nurses. In 1972, they could aver- age one nurse for every two patients. By 19 86, the needed ratio was nearing one- to-one - 91 nurses for every 100 pa- tient . . But, as the supply/demand unbalance mcreases, the quality of health care de- creases. ,, . "If "Of course it does, Gifford says , you don't have enough people, you cant do all the things that are necessary. There are hospitals closing wi~gs and closing umts because they don t have enough staff." . . Recalling her own expenence, she said hospital nurses are forced to cut corners. Instead of giving a patient a full_ bath, she says a nurse is lucky to have time t_o grab a ~et sponge. There's no time to sit and talk to a frightened patient about an upcoming surgery or discuss much of anything that will happen during the hos- pital stay. "You'll get all the right IVs, the dress- ing changes," Gifford says, "but the pa• tieat comfort that's so important to heal- bod ' b " ing slides because every ys so usy_. The problem is compounded by declin- ing enrollment in nursing schools. Nationally, the number of nursing stu- dents in bachelor's degree programs dropped almost 32 percent between 1984 and l988 One rea on is smaller genera• t10as. There just aren't as many potential college students. . . San Diego State Umvers1ty has seen the numbers drop. Tea years ago, says John Lantz, profe sor/director at S~SU's School of Nursing, apphcattons numbered roughly 175. This year, be bad about 118 applications.

made an important decision. "You can't sit on the sidelines a mg. complain. You've got to join the strug1 if you're going to change it." .

financial aid for other career train- • Wage scales must be altered to pay nurses based on their level of

Eventually, she joined the Califon education. Now, students who com- Nurses Association (CNA) and recen plete two-year associate degree pro- completed a rare second term as ~eg grams, three-year hospital diploma 2 president (serving the 18,000 reg1ste1 programs and four-year bachelor de- But she hasn't completed the w become registered nurses. And, once nurses in Saa Diego County).

gree programs can take the exam to they pass, they're all paid the same. • Hospitals, which employ half the nation's nurses, must find ways to further improve their lot. (The insti- tutions have said that cutbacks in Medicare have tied their hands on, wage issues, and general belt-tight- ening at bealth-<:are facilities has forced staff reductions that leave nurses to do lots of non-nursing But hospitals are where the short- age is most critical. Gifford says that, nationally, the percentage of vacancies for budgeted positions is 13.4 and here in Saa Diego it is 8.3 She has no plans to go back. She's found her professional nirvana work- ing for a home health-care service. room, at the desk cluttered with pa- pers and "While you were out" mes- tasks.) and growing.

that she sees needs to be done. So she for, and won, a seat last fall on the ho of trustees for the Fallbrook Hosp District. She'll continue to conf! health-care issues and devise strate for recruiting and retaining nurses. She supports a laundry list of s_olut_ developed by nursing orgamzat1 around the country, not the leas! which is clarifying the importance ol nurse's role in health care and deve ing an improved image of the profess To that end, a two-year multim campaign begins next month . ca "Nurses of America." It was dev1se1 the Tri-Council for Nursing to edu the public about the profession. "We need to get the word out al what an excellent job nurses are doi says Janet A. Rodge~, dean of th~ sc

of nursing at

iversit of San D1eg< Her office is a corner of her bed-

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nurses?

"Absolutely," Rodgers says. "We I sage slips she's written to herself. all these crazy little sexpots and t She drives 500 to 600 miles a week brains on TV. The public needs a n around North County, the back of her

accurate picture of nursing." The ultimate goal, of course, r:

. van packed with medical supplies, to administer care and compassion to

make nursing a more attractive cb.-.-::---~----------- for those choosing a first - or secon career. Other important hurdles:

• State and federal governments, acutely aware of the impact of the nurs- ing shortage, must make funding for nursing educatio a riority - above the Please see NVR 'E: -3, Col. 1

•