By Megan M. Krischke, contributor
Darlene Clark RN, MS, feels that nurses can and should play a more signficant role in health care reform.
Feb. 26, 2010 - While health care reform remains in limbo, the work of nurses delivering care at the front lines marches on. And as Republicans and Democrats debate policy, the expertise and experience of these working nurses is mostly left out of the conversation. Perhaps the most important thing nurses can do in this waiting period is to find a way to be heard.
"Nurses haven't played a significant enough role in health care reform," said Darlene Clark, RN, MS, senior lecturer in nursing at Penn State University. "In the advisory panel of over 100 people that President Obama convened on health care reform, there was only one nurse."
Professor Paul Clark urges health care leaders to give nurses more of a voice, as these frontline workers know how to cut costs and improve care.
"For the good of the health care system and for the good of patients, nurses need to play an expanded role in reform," concurs Paul Clark, professor and head of the department of labor studies and employment relations at Penn State. "Yet, nurses are so exhausted and stressed that even if they do have the opportunity, it is difficult to play that role. This isn't a conclusion we should settle for-we need to make time in nurses' schedules for them to have a voice because no one knows better how to cut costs and improve care."
Joan Johnson, RN, BSN, staff nurse at Virtua Memorial Hospital in Mount Holly, N.J., confirms the Clarks' suspicions that most frontline nurses don't have the time or energy to give health care reform the attention that perhaps they should.
"It has been my observation that the staff nurses I work with aren't talking about health care reform much. They don't voice an opinion one way or another or even indicate that it is on their radar screen," said Johnson, who works in the recovery room. "It doesn't seem like the little guys know what is going on."
"You see the headlines on the news," she continued, "but it is hard for someone who isn't a political person to keep track of what is going on. It is hard for me to correlate the changes the politicians are talking about and the changes I would see on a day-to-day basis. Maybe that would be different if I were working in a different part of the hospital or in a hospital with a lot of uninsured patients."
While waiting for national reform that may or may not come, the Clarks encourage nurses to make it a priority to improve patient care and working conditions where they are.
"Collective bargaining has much more power than the voice of a single nurse," Darlene Clark stated. "Begin by negotiating paid time off the floor. This time should be used to participate in committees ranging from labor management to architecture."
"The people who are currently making these decisions think they are doing a perfectly good job," added Paul Clark. "Often administrators aren't enthusiastic about inviting nurses to the table, but I think they will be pleasantly surprised at nurses' suggestions which will increase safety and save time and money."
Johnson agrees that nurses should make their own environment a focal point.
"You can improve processes where you think something could be done better," she said. "Observe where you think things should change. The frontline staff is on the floor when management isn't and you can see what works and what doesn't. Be proactive and make suggestions."
"We also need to see changes in our nurse education. We need to be teaching nurses to be leaders and advocates and how to speak to others about how important nursing is," remarked Darlene Clark.
Even with nurses taking a proactive role in their hospitals, the Clarks believe national reform will be the only way to truly turn the tide of medical care.
"With no reform we will simply have the status quo," concluded Darlene Clark. "There will continue to be unsafe staffing, medication errors and other safety and health issues due to unsafe staffing. Profits will continue to be more important than patient care. Unit managers will continue to be stuck in the middle, trying to cut costs and still have safe staffing levels.
"Nurses as a whole, along with many physicians, want some type of universal health care," she said. "While not every one is for it, a single payer system looks good to most of us working in health care. What we are doing now isn't working. Let's see what a little more government involvement could do for us."
See related story on NurseZone:
How Nurses Can Change Health Care
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