Nurses

Nurses just want to have ... autonomy.

Facing a worsening nursing shortage, often accompanied by poor morale, some hospitals are trying retain nurses not with cars, cash, and Bahamian junkets but by making their jobs more satisfying. And that can also improve the quality of patient care.

With more than 100,000 open nursing jobs last year—and the numbers expected to surpass one million about 15 years from now when aging Baby Boomers will need more nursing care—the nursing shortage is a serious problem for hospitals. A story in Sunday's Washington Post said the practice of luring nurses with signing bonuses and incentives turned out to actually boost turnover, because nurses would change jobs to keep accumulating bonuses

Replacing a nurse can cost up to $100,000 because of temps, overtime, recruiting and training the new nurse. That doesn't include salary. So hospitals took another look at what they can do to keep their nurses. And the answer, at least in part, is giving nurses more control over patient care and opportunities to get more advanced training. Some are doing research into problems they observe, coming up with new care plans that improve quality.

Nurses on medical-surgical units in hospitals spend less than a third of their time providing direct patient care. But before you get all indignant and leap to the conclusion that they are spending 70 percent of their time chatting on cellphones, doing their nails, or watching American Idol, think again. Nurses work hard. Very hard. But, through no fault of their own, they are not always working at maximum efficiency actually taking care of patients.

"A picture emerges of the professional nurse who is constantly moving from patient room to patient room, nurse station to supply closet and back to patient room, spending a minority of time on patient care activities," according to the interesting time and motion study called "How Do Medical-Surgical Nurses Spend Their Time?" published recently in the Permanente Journal, brought to our attention by the Robert Wood Johnson Foundation.