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September 4, 2000

Opportunity knocks

As a proud Canadian, the choice to move to the United States from Canada was not easy . After graduating in 1996 from a BSN program, I – like many of my peers – began the hunt for a full-time job. What I faced were endless letters stating there were no full-time positions, that the institutions did not higher new grads, and to reapply once I had experience. How are you supposed to get experience when no one will hire you?

The job search in Canada stretched coast to coast. After six unsuccessful months, I was frustrated and angry, and began to think I had wasted four years studying for something I could not make a living doing. Being a new grad, I also had student loans looming.

I had always heard that there were jobs in the United States for nurses. The thought of leaving my family and friends was horrible, but I had to start my career and make a life for myself. In November 1996, I wrote the NCLEX and began the job search in Texas. By the end of December, I had more job offers than I had in six months, plus I had the choice to work in a specialty unit, something that never would happen in Canada. I made the toughest decision that month, to leave everything and everyone I knew and loved. I hopped on a plane with two hockey bags of clothes and set off to the unknown.

It has been almost four years since I moved. Never once have I regretted my decision. Although I miss friends and family every day, and I don’t get to see them more than once or twice a year, personal survival and professional experience are what keep me from crossing back over.

There is word these days that the job market is opening up in Canada. Frankly, I am wary. There may be jobs now, but what about in six or eight months? What happens when a new government takes over and cuts health care again? Where does that leave all the nurses who moved home? Regretting their decision to leave the United States.

Sure, every one of us who left Canada miss it sometimes, but the educational and professional opportunities in the United States far outweigh what we would face if we moved back.

Younger screenings

I appreciate your CE offering on colorectal cancer. Last year, we lost our 12-year-old son, Ben, to colon cancer. He was diagnosed in a duke’s stage c and, despite surgical resection, chemo and radiation therapy, colon cancer took his life after a nine-month fight.

I find it disturbing to see so many articles stressing screenings for people ages 50 and up. Little is ever said about the increasingly younger people diagnosed with colorectal cancer. Working in an OR, I know this is true.

To my knowledge, Ben’s case is rare. Will this always be so? What can we, as health care professionals, do to prevent more children and young adults from being overlooked for screenings?

In a pig’s eye

The evidence to be "gleaned" from Sandra Hanneman’s pig research ("High on the Hog") is an unnecessary and sad regression of medical studies and blind denial of the uselessness of animal experimentation. No predictors of failure of

ventilatory weaning has been discovered in 25 years of human research on circadian rhythm, biorhythms and chronobiology? I find that hard to believe.

A few of the more obvious causes of failure:

• Fatigue! The patient must have that nightly bath.
• Fatigue! 5 a.m. chest X-rays and blood draws.
• Lights! How many of us normally sleep with fluorescent lighting?
• Noise! There is an entire staff of personnel outside the doors or, worse, curtains – talking, laughing, etc.
• Illness! It disrupts circadian rhythms.
• Physicians! We base ventilatory weaning and extubation on the schedule and convenience of physicians’ performing rounds and not the condition of the patient. That is not going to change.

In 25 years, we have refused to address the the simplest issues of light, noise and fatigue. Further evidence has shown that the use of animals for research, experimentation and surgical practice to be without science, value or ethics. Some of the top U.S. medical schools have stopped the cruel practice of researching human medicine with animals. The University of Texas Medical and Nursing programs should ban the use of animal research and get on "the cutting edge of medicine" by computerization and other advancements.

The research being conducted by Hanneman is, in a word, hogwash.

Michael D. Riffle, RN
Austin, Texas

Rude interruption

When I was living in California, I was reported to the Board of Nursing without my knowing about it. I found out when I received a letter from the board saying that the allegation about me had been investigated and the board found that I had acted in the best interest of the patient.

I was working at Patton State Hospital and had to draw blood for cardiac enzymes on a patient with a history of IV drug abuse. He told me that he had only one vein left and that the nurses on the medical unit allowed him to stick himself for blood draws. After attempting twice to find the vein and being unsuccessful, I allowed him to stick the vein. I went on to finish the blood draw myself.

Because I didn’t feel that I had done anything wrong, I charted exactly what I had done. I was fired for my actions, but successfully fought the discharge and was reinstated. No one mentioned reporting me to the Board of Nursing and I didn’t think about the possibility until I received the letter.

Of course, having been fired left me with a bad taste in my mouth for Patton State Hospital and I left a month after being reinstated. It was after I was working at my new job for about a month that I received the letter.

Fair is fair

"Crossing the Line" left the reader with the impression that hospitals are almost daring nurses to go on strike; "Go ahead, go on strike. We’ll just hire someone to replace you." Nurses may as well give up any notion of standing up for better working conditions, compensation, reasonable patient loads and – of all the nerve – respect.

If anything, the article should galvanize those nurses who want just and proper working conditions, compensation, etc. How can hospital administrators look nurses in the eye and say that "the money just isn’t there" to hire more staff, increase pay, or provide better benefits, but when push comes to shove, hospitals find thousands upon thousands – if not millions – of dollars to hire replacements? These replacements should be ashamed of themselves. We are all in this together. We need to start thinking less like nurses and more like business people whenever we go job hunting. I don’t know of a single nurse who has negotiated her salary or any other "perks" at the time of hire. Basically, it’s "Here’s what we’ll pay you. Take it or leave it." And, being nurses and not business-savvy, we humbly accept as though we are thankful to have any job. Hospitals are looking for someone to provide a service and we should be able to sell those services to the highest bidder.

A recent study conducted by Vanderbit University shows that for every seven nurses who leave the nursing profession, only three nurses enter it. Also, that same study states that the majority of nurses are over the age of 40. It doesn’t take a genius to see that we are in dire need of nurses now and the outlook is dismal. There were times when I was the only American nurse on the floor because hospitals were, and still are, recruiting outside of the country. Doesn’t that tell you something?

If ever there was a time to unionize, now is it. We keep hearing of the "booming economy" and rising income, but who’s income? Certainly not ours. At the same time that hospitals are laying off nurses and other hospital personnel, hospital CEOs are getting paid salaries in the hundreds of thousands of dollars along with company cars and who knows what else. We "expendable, dime-a-dozen nurses" can only dream of having saved over thirty to forty years of working what these CEOs make in a little under two years. Let’s not forget that if these CEOs get "relieved of their duties," they won’t get two weeks severance pay; they’ll get the "golden parachute" – something you I will never see.

Staffing is dangerously inadequate, putting the nurse’s license on the line not just on a daily basis but on an hourly basis. More importantly, it puts the patients’ health and well-being at risk. Pay is pathetically low, benefits are mediocre at best, and respect for the profession is virtually nonexistent. We need to stand our ground and demand that we be compensated fairly and have our demands met.

Take the initiative

I am responding to a reader who said there are no CME requirements in Arizona. Washington has none, either. When I was practicing in California, I had CME requirements that assured I at least did something educational in my profession. Washington just wants a fee every year. No CME. Doesn't matter if I graduated in 1972! As you know, nursing changes almost monthly. What we did even two years ago is different than today. I feel for those who do not take the initiative to continue their education. Too bad it's more than just Arizona with the problem

Sherrie Shafer RN, BSN, CEN
Bremerton, Wash.

It’s about rights

Carla Cope unfortunately has missed the boat ("Readers Respond"). So the CNA nurses were unprofessional and the U.S. Nursing Corp. was. This is not the issue. The issue is about using scab labor, which diminishes the strength of the union and the individual nurse’s ability to voice her opinion in the arena of collective bargaining. It is about your rights as a nurse to get good benefits, good pay and respect within the institution you work. So some nurses were unprofessional from CAN. This may have been an isolated incidence and does not reflect the CNA union as a whole. Those of you nurses who think you’re doing the right thing by speaking highly of scab nurses are not doing yourself any favors, believe me.

Randy Claxton, RN, MS, NNP
Phoenix

Nursing’s plight

I'm a Canadian graduate nurse and left Winnipeg, Manitoba, almost two years ago because of the job market in Canada. Yes, there is a nursing shortage in Canada, but no one is willing to hire full time. Colleagues who've remained have been hired on as part-time, but work full-time hours.

The CNA also decided to delete the two-year college diploma program. This in itself has contributed to nursing’s plight. I since have learned that they were considering revoking that policy. Students can more afford a two-year college program vs. a four-year university program.

Maria Whitehead, RN
Farmington, N.M.

Unsung heroes

Nancy Devine's article "Arctic Commute" (July/August) brought back fond memories of my own experience working with the Community Health Aide/Practitioner Program in the Bristol Bay region of Alaska. Most readers would not recognize the job title "health aide" mentioned in the article. These people are truly the backbone of health care in most remote Alaskan villages. They are generally village residents, therefore intimately acquainted with the people they serve. They provide primary and emergency health care to their family, friends and neighbors within the microscope of village life. If the phones are in working order, they consult with their referral physician. If not, they have to rely on their good sense and a few weeks of training. If the weather is bad, they may provide 24-hour acute care for days at a time, with limited resources, until the weather clears enough for their patient to be flown out to the hospital, and it is not uncommon for patients to require ongoing emergency care while en route.

Public health nurses and other itinerant health care professionals in Alaska have played an important role in reducing the incidence of preventable illnesses. However, when the itinerant nurses, doctors, dentists, et al., finish their visit, it is the health aide who continues the work at the tundra level.

My nursing hat goes off to the often unsung heroes and heroines of Alaska's "bush" health care. They gave me a renewed understanding of what the "care" in health care really means.

Marilyn Ludden, RN
Glenns Ferry, Idaho

Enough is enough

I read "Crossing the Line" in the July/August issue and found it troubling, but also typical. It's another example of unprofessional behavior by nurses that keeps us from attaining professional status. The scab nurses should be ashamed of themselves. Personally, I am so disgusted with the profession and its failure to organize that I have decided to abandon it altogether. Nurses are not professionals – never have been and never will be. That is a fact. We are nothing more than hourly wage earners with a job instead of a career. There is no such thing as a nursing career unless you have an advanced degree. At any rate, unions are not necessarily the answer, but at this time they are all we have. Too bad nurses are too stupid to know what's good for them. The American Hospital Association is the enemy and until nurses take a militant approach instead of pussyfooting around (nurses are wimps), we will never get anywhere. Good luck to them, but I'm outta here.

Tommy Startzman, RN
Las Vegas

Rodeo atrocity

As a practicing Colorado RN, I want to say I was ashamed to see the rodeo piece in the July/August NurseWeek. Why is a nursing publication giving implicit approval of the so-called sport of rodeo in which blatant abuse of animals is a regular part of the program? Aren't nurses supposed to have compassion? Why should that not extend to the nonhuman animals who are forced to take part in this spectacle and who are humiliated, cruelly manipulated into being aggressive by the use of electric prods and other torturous devices for the casual entertainment of humans? How about making a list of the injuries they suffer, such as broken necks, spines, legs; punctured lungs; extensive bruising, hemorrhaging; and death.

The cowboys have a choice; unfortunate creatures do not. I find no sympathy for their [cowboys’] injuries.

It is time to rethink some aspects of western culture, such as this, that teaches our children it is acceptable to brutalize other creatures. This is one of the many factors in our society that desensitizes our children to violence. As George Bernard Shaw so aptly stated: "Custom will reconcile people to any atrocity."

Nurses need to get up to speed on social justice issues and NurseWeek’s article certainly doesn't advance that.

Judith Cunningham, RN
Boulder, Colo.

Striking out

Thank you for the article on organized nursing and the outside agencies that get hired to work for the striking nurses. I can't complain about the nurses because they need the work, but isn't it interesting that the hospitals cry poverty every time it's time for job shifting, reduction in staff, or plain old-fashioned hospital closing, but the minute staffs talk about organizing or they do strike, the hospital finds lots of money available to pay these outside agencies to work rather than pay their people

what they are worth to keep their staffs in place. Instead of striking, may I suggest keeping people on the job and organizing pickets outside the entrance? Hospitals can't stand bad publicity and if the nurses stay on the job and picket during days off or off duty before coming to work, the fear of patient abandonment is gone. The hospital still has to explain why there are

pickets outside their property and the nurses get to take care of their patients. A well-done article.

Paul Seale, RN
Tucson, Ariz.

Fair is fair

I agree that most nurses are more inclined to tell you that they are not in the field of nursing because of the money. I agree that most nurses are truly concerned about the well-being of their patients and the quality of care they receive. I don't believe that this survey in San Angelo is reflective of the truth and how nurses feel about money. I think the problem is that nurses are so used to being paid diddly for the amount of responsibility they incur they have gotten used to doing more for less money. It is a shame that a BSN nurse out of school makes anywhere from $13 to $17 an hour. A graduate from a four-year program in computer design, software engineer, etc., can make $60,000 to $90,000 a year and nobody dies when they make a mistake. So are nurses really happy? The strike in California is an indicator that we are not. I don't care what anyone says, money is important. Nurses have families to feed and bills to pay. I have been in nursing for 14 years; in the last six years, I have not noticed a significant increase in nurses’ salaries compared to other workforces’. The bottom line is we have an important job that incurs the highest level of responsibility to ourselves and our patients. There is nothing wrong with wanting to be paid a fair salary for the work we do.

Randy Claxton, MS, RN, NNP
Phoenix

Pro-active results

After reading "Crossing the Line" in the July/August issue, I felt the need to comment. I have been a registered nurse since 1969, graduating from Good Samaritan Hospital School of Nursing in Phoenix. I have never been in favor of nurses joining unions, but at this time in my career and life, I have began to wonder if this is the right decision. Nurses need to unite across the country as well as in Arizona. At our hospital, the discontent has become so noticeable that myself and several other employees polled the hospital and found out that our concerns were universal. We then wrote a "pro-action statement plan" and submitted it to our vice president of patient services. We made no demands except to be treated with respect and that communication be open between staff and administration. This was a joint effort between our department, including RNs, ORTs, housekeeping, Central Services, etc. We submitted this statement and plan a couple of weeks ago, and have already started to see some results that we find encouraging. We discussed salaries, benefits and everything in between. We would like to form a "pro-active committee" throughout all departments. This committee would meet to discuss problems, concerns of every department in the hospital. We could have done this without the administration, but we are hoping that they will encourage this forum. So, maybe a union is not needed if nurses and hospital workers unite in a pro-active manner.

Jack R. Taggart, RN, CNOR
Cottonwood, Ariz.

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