News Scrapbook 1989

Tribune photo by Thomas B. Szalay

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

arm around his shoulder. George is 86 and holding his own in 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 Jack of them almost forced her out. Until she moved from hospital to home health- care nursmg, Gifford found herself with less and less time to spend with her patients. And more time to mull the burnout, lack of status and lack of participation in 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 tbei ultimate weapon - the time it took to become a I ery valuable commodity. Now things are changing for the nation's 1.5 mil- lion registered nurses. Gifford never doubted that they would.

"Nurses are the thread in the fabric 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 - Jong enough to develop heart diseas~ and cancer, and disabilities and frailties that reg ire borne health care or the Please see NURSE: C , Col. 3

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

By Jane Clifflrd Tribune Stall Wr1er I T'S A R~1 Tuesday and Lisa Gifford maneuve1 her van around curves and up and down thehillside streets of Fallbrook, doing work she love. "Good mor,rng," Gifford says as Tillie Lauters opens the scren door to her apartment. Tillie, 81, welcomes hennside, where her husband, George, is sitting in his 1>eking chair, waiting for his weekly visit from Giford. She walks er and Jeans close to him. "How are ]lu feeling?" she asks, slipping her

Tribune photo by Jerry McC/ard

Getting acquainted at USD

Incoming freshmen at tbe University of San Diego pack tbe 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 o

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.

FR M THE COVER 5 NURSi: Profession less uniform than previously .. r - d bo t th But the realities of the working nurse 'URSE I c, 5 ,,.. / Continued From C-1 But Lantz is more concerne a u e were a lot different from the dreams of r [ ) skilled care of a nursing home. qualifications of those applicants. He the student nurse. Eventually, Gifford 1n~ed F~om c-2 . • Americans in hospitals are more se- says that when he took over at the school made an important decision. nc1al aid for other career tram- riously ill The AIDS epidemic, the grow- four years ago, th e Jowe st grade-point "You can't sit on the sidelines and mg crisis of drug-addicted newborns, the average among applicants was 3·2 ; complain. You've got to join the struggle I. ncreas·1ng incidence of o_rgan tr_an_s- today, it's closer to 2.5. 'f ' . t hange it" "The reality is, we want to get not only I you re gomg O c . · . . Plants and O ther life-s_avmg m_ed1c1_ne Eventually she J·o1ned the Cahforma more students, but more qualified stu- , have given new meanmg _to mtensive dents,, Lantz says. "The goal is not how Nurses Association (CNA) and recently Care. Hospl·tals are faced with a greater , 1 t d a rare second term as Region many you accept, but how many you fin- comp e e need for nur es. In 1972, they could aver- 2 president (serving the 18,000 registered age one nurse for ev~ry two pati~nts. By ish. tt · nurses in San Diego County). 1986, the needed ratio was nearmg one- ''We're confronted wi th a higher a ri- But she hasn't completed the work to-one - 91 nur e for every lOO pa- tion rate. At one time, we accepted 60 that she sees needs to be done. So she ran tients. for, and won, a seat last fall on the board But as the supply/demand imbalance 'We have all these of trustees for the Fallbrook Hospital incre~ses, the quality of health care de- District. She'll continue to confront creases. "If crazy little sexpots health-care issues and devise strategies "Of course it does," Gifford says. and birdbrains on TV. for recruiting and retaining nurses. you don't have enough people, you can't She supports a laundry list of solutions do all the things that are necessary. The public needs a developed by nursing organizations There are hospitals closing wings and more accurate picture around the country, not the least of closing units because they don't have which is clarifying the importance of the enough staff." . . ofnursing.' nurse's role in health care and develop- Recalling her own expenence, she said _ J.anet A. Rodgers ing an improved image of the profession. hospital nurses.are fore~ to cut corners. To that end, a two-year multimedia Instead of givmg a patient a full_ ba th , campaign begins next month . called she says, a nurse is lucky to ha~e time t_o "Nurses of America." It was devised by grab a wet sponge. There' no time to sit students and graduated 58. Now, we may the Tri-Council for Nursing to educate and talk to a frightened patient about an accept 60 and only graduate 40." . the public about the profession. upcoming surgery or discu~ much of Lantz agrees that increased opportum- "We need to get the word out about anything that will happen dunng the hos- ties for women are luring away many what an excellent job nurses are doing," Pita) stay. qualified students. By 1987, only 4 per- says Janet A. Rodgers, dean of the_ school 11 th · ht IV the dress cent of incoming freshmen women as- 0 "You'll get a e ng s , • t of nursing at iversit of San 1ego. ing changes,'' Gifford says, "but the pa- pired to careers in nursing, a 50 percen And to como a negative of tient comfort that's so important to heal- drop from 1983. nurses? b d ' so busy " Nursing is still very much a women's "W ing slides because every O Y s : "Absolutely," ~odgers says. e h~ve The problem is compounded by dechn- profession (97 percent), but many young all these crazy little sexpots and bird- . · h I women apparently prefer business suits ing enrollment m nursmg sc 00 s. d t brains on TV. The public needs a more h be f rsing stu to scrub suits board rooms an cour · Nationally, t e num r o nu - ' 1 th , accurate p1·cture of nursing." . d ms rooms to operating rooms (un ess ey re dents in bachelor's egree progra d h The ultimate goal, of course, 1s to dropped almo t 32 percent between 1984 the ones performing surgerr), an . t e make nursing a more attractive choice and 1988 One reason is smaller gene~a- money and prestige that go with the Jobs. for those choosing a first - or second - tions. There just aren't as many potential Such things were little more t~an a career. feminist view of the future when Gifford college students. went off to Georgetown University in Other important hurdles: San Diego State University has seen 1 • State and federal governments, d T S ago says 1966. A simple desire to care for peop e the number· rop. en year • acutely aware of the impact of the nurs- f /d . tor at SDSU's sent her to the school of nursing. John Lantz, pro essor irec . _ b bl 1 ·ng shortage, must make funding for · I t ons "I felt a sense of duty, which pro a Y School of Nursrng, app ica I nurs 1 ·ng educatio a riority- above the 1 175 Th . ear he bad comes from being Catholic, and a sense numbered rough Y • is Y ' Please see NVR 'E: -3, Col. 1 about 118 applications. of responsibility," she remembers. Wage scales must be altered to nurses based on their level of ation. Now, students who com- 1 two-year associate degree pro- is, three-year hospital diploma ·ams and four-year bachelor de- )rograms can take the exam to oe registered nurses. And, once >ass, they're all paid the same. ospitals, which employ half the 1's nurses, must find ways to ir improve their lot. (The insti- have said that cutbacks in tare have tied their hands on , issues, and general belt-tight- at health-care facilities has staff reductions that leave s to do lots of non-nursing ,) l hospitals are where the short- is most critical. Gifford says nationally, the percentage of ncies for budgeted positions is and here in San Diego it is 8.3 ~rowing. e has no plans to go back. She's her professional nirvana work- or a home health-care service. office is a corner of her bed- ' at the desk cluttered with pa- and "While you were out" mes- slips she's written to herself. rives 500 to 600 miles a week d North County, the back of her acked with medical supplies, to nister care and compassion to

IO ndrrnets tJ g sisters

31 Extend. as a subscr,pt1on

63 Derek and Peep

her patients.

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 into 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."

It's a grueling schedule. Most weekdays start at 7 a.m. and end around 7 p.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- ing 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 me.") But she's in 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- spect." 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- pitals . .. "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 been trained to do. It's a whole lot more than putting pills in a paper cup and delivering