We are on the verge of the nation's worst nursing shortage in
history. Dedicated nurses are leaving hospitals in droves, and
there are not enough new recruits to the profession to meet demand.
Even hospitals that were once very highly regarded for the quality
of their nursing care, such as Boston's Beth Israel Deaconess
Medical Center, now struggle to fill vacant positions. What
Dana Beth Weinberg argues that hospital restructuring in the
1990s is to blame. In their attempts to retain profit margins or
even just to stay afloat, hospitals adopted a common set of
practices to cut costs and increase revenues. Many strategies
squeezed greater productivity out of nurses and other hospital
workers. Nurses' workloads increased to the point that even the
most skilled nurses questioned whether they could provide minimal,
safe care to patients. As hospitals hemorrhaged money, it seemed
that no one-not hospital administrators, not doctors-felt they
could afford to listen to nurses.
Through a careful look at the effects of the restructuring
strategies chosen and implemented by Beth Israel Deaconess Medical
Center, the author examines management's efforts to balance service
and survival. By showing the effects of hospital restructuring on
nurses' ability to plan, evaluate, and deliver excellent care,
Weinberg provides a stinging indictment of standard industry
practices that underestimate the contribution nurses make both to
hospitals and to patient care.
Subjects: Health Sciences
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