Thursday, October 21, 2010

Guest Blogger: INQRI Grantee Susan Letvak

As the Initiative on the Future of Nursing report illustrates, nurses:
  • Are the largest component of the health care workforce;
  • Spend the most time with patients; and
  • Understand care processes across the continuum of care.
Evidence, like the findings generated by the INQRI program, links nurses to high-quality patient care. I commend the committee on their work in understanding the important role of nurses and making such compelling recommendations for ensuring that nurses’ voices are heard and their skills put to the greatest possible use.
To that end, it is vitally important that we give nurses the resources they need to be able to deliver the quality of care that our country expects and deserves while also helping to cut costs. The report talks much about developing leadership opportunities and supporting lifelong learning endeavors to allow nurses to continue to grow in their roles. I agree that these efforts are incredibly important. However, my research shows that an even more basic need must be addressed to support these vital caregivers. We have to guarantee that nurses are not only a well-trained workforce, but a healthy one as well.
High levels of workplace stress, and the physical nature of nursing, have led nurses to experience high rates of musculoskeletal pain and depression. Our recent Robert Wood Johnson Foundation INQRI study found that almost 3 of 4 hospital employed nurses work with some degree of pain and 18% have depression. Most concerning, these health problems have led to a loss of job productivity and a decrease in quality of care (specifically more medication errors and patients falls and a decrease in self perceived ability to provide quality of care). Focus groups with nurses demonstrated that little is currently being done to address the individual health concerns of the nursing workforce. The current economic downturn is presenting even higher job demands on staff nurses who have health problems and those who are being required to “pick up the slack.”
In this era of health reform, patients in the U.S. will be looking more and more to nurses to deliver their care. We have to support nurses to allow them to be at their best when they care for patients. This will ensure that care to be of the highest quality at a reasonable cost.

Susan Letvak, PhD, RN, is an Associate Professor in the Community Practice Department at the University of North Carolina – Greensboro’s School of Nursing. She recently completed her INQRI-funded project, “The Effects of Nurse Presenteeism on Quality of Care and Patient Safety.”

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