Please Explain: Nursing

Friday, February 15, 2013

This week's Please Explain we'll find out what nurses do, how they're trained, and why there always seems to be a shortage. Dr. Bobbie Berkowitz, Dean of Columbia University School of Nursing, explains the art and science of nursing. She's joined by Ghislaine Chery, nurse at Jamaica Hospital and for the Visiting Nurse Service of New York.


Dr. Bobbie Berkowitz and Ghislaine Chery

Comments [24]

Janet from Queesn, NY

It is very difficult for new nurses to find work!!!!! Also there is a lot of age descrimination. They want young women who already have experience. I would not recommend this field to the woman in her mid 50s who was considering the field. I speak from experience!!!!

Feb. 15 2013 07:49 PM
Anti-Corporate Traditionalist (Noach) from Brooklyn

Let me express my appreciation to all of the dedicated, hard-working nurses out there whose service is so essential.

Feb. 15 2013 04:01 PM
Anti-Corporate Traditionalist (Noach) from Brooklyn

~~~Refuting the "Emergency Room Fallacy"- Part Two~~~

Does anyone recall Paul Krugman's column of October 14th 2012, titled "Death by Ideology"?
( )

An excerpt:
______________Begin Krugman Quote________

Even the idea that everyone gets urgent care when needed from emergency rooms is false. Yes, hospitals are required by law to treat people in dire need, whether or not they can pay. But that care isn’t free — on the contrary, if you go to an emergency room you will be billed, and the size of that bill can be shockingly high. Some people can’t or won’t pay, but fear of huge bills can deter the uninsured from visiting the emergency room even when they should. And sometimes they die as a result.

More important, going to the emergency room when you’re very sick is no substitute for regular care, especially if you have chronic health problems. When such problems are left untreated — as they often are among uninsured Americans — a trip to the emergency room can all too easily come too late to save a life.
_______________End Krugman Quote________________

This is essentially the same point that I summarized in what I numbered "2" above.

Completely absent from this column of Krugman's, however, are the points I summarize in numbers "1" and "3" above, i.e., the axiom that society is a complex, inter-connected, inter-dependent organism; no man is an island.

On one hand, I find this glaring omission of such germane, salient critical points absolutely incredible. But then I ask myself: Would anyone who proved to be too thorough at deconstructing corporate propaganda, too effective in exposing corporate predation-- in all the depths of its wretched, obscene sordidness, remain at the New York Times for long?

What happened to Chris Hedges? (Notwithstanding the fact that I find him reprehensible in many respects. (For that matter, there are very few people I couldn't say that of.)

Feb. 15 2013 03:54 PM
Anti-Corporate Traditionalist (Noach) from Brooklyn

~~~Refuting the "Emergency Room Fallacy"- Part 1~~~

Mr. Lopate mentioned the "emergency room argument", invoked by apologists for the predatory, profiteering corporate status quo in health care. It must be pointed-out that this argument, first of all, ignores the fact that we _all_ pay, in any number of ways, when emergency rooms must compensate for lack of access to primary care.

Some examples/points:

1.) _Everyone_, no matter how wealthy or privileged, is at risk of finding themselves at the mercy of the nearest emergency room at some point. Being burdened by people there for primary care --or what could and should have been primary care (see below):
-causes emergency rooms to be overcrowded and is no doubt a cause of critical delays when seconds count
- increases the spread of communicable diseases

2.) In order for an emergency room to be legally-bound to provide care to a non-paying patient, the patient's condition must be deemed an "emergency". By that time, many conditions that could have been dealt with effectively and efficiently with access to primary care have deteriorated to a point of being far more difficult, complicated and costly to treat. Often it is too late to prevent permanent, severe damage and suffering, if not death.

3.) There are numerous other ways in which _all_ of society, ultimately, suffers when some its members lack access to proper, timely health care.
Perhaps the most obvious and striking examples of this are in the areas of communicable disease and mental health.

Feb. 15 2013 03:50 PM
Ginny Neal

A few comments: for the new grads- our large LI hosp system is still hiring new grads into an excellent critical care fellowship program- In critical care, while we have nurses' aides, their role is very dimished than that of the floor aide's. We RNs generally do all the tasks-vital signs, cleaning, blood sugar management, answering call bells, emptying Foley bags, while managing ventilators, multiple IV drips, and various other pieces of equipment. Our responsibility to then note all we do on the electronic medical record has increased and is sometimes reduntant. Add to that, visitors are now allowed to be in the room all day leaving us to often repeat myriad questions to various relatives and friends. Despite it all, I can't help but say I would not be happy doing anything else, even after 34 years.

Feb. 15 2013 03:18 PM

Donna from NJ who spoke on the show

Leonard, I said I love you, where I should have said, "I love your show"...

Feb. 15 2013 02:08 PM
Carolyn from Brooklyn

Nurses are the missing link in the knowledge and humanity of the medical industry. Twice now in my life experience, without (two particular) nurses that cared for me I would have felt abandoned and vulnerable and had much more difficult experiences (once in the early stages of my delivery and once recently for an awful surgical procedure.) While there are good and difficult patients, perhaps some of those patients who are grumpy are so because often doctors disregard the questions and input of their patients or are fearful of saying anything that might be misconstrued or commit them. Nurses acknowledge those questions and requests and that step alone is remarkably comforting. When they follow through with their knowledge and skill it is a really excellent experience -- and one that allows of understanding and acceptance of conditions or procedures as part of your health experience. I will always have gratitude and great respect for nurses!

Feb. 15 2013 02:00 PM
Julia from Nyc

I'm a nurse practitioner in a NYC hospital specializing in electrophysiology, graduated from Columbus's nursing program in 2009, and absolutely love my profession. The relationship I have with my peers and collaborating physicians is wonderful. The amount of responsibility I have as a NP is exactly what I was looking for. I'm engaged daily in direct patient care, decision making, prescribing medications, ordering diagnostics,occasionally working on weekends but always have the expertise of my attending physician to direct questions to. I worked as a floor nurse while getting my masters and thoroughly appreciated the experience but the life and work of a floor nurse can be SO difficult. Literally back breaking at times. I frequently field questions from staff nurses I work closely with about being a NP and I always encourage individuals to pursue higher degrees. Many hospitals reimburse tuition for higher education. There is no reason for nurses not to be taking classes and continuing to learn.

Feb. 15 2013 01:58 PM
Karen Zanko Ocker from New Jersey

I am a retired nurse-anesthetist . During my employment at Columbia-Presbyterian 1974-1990 I taught anesthesia residents how to do endotracheal intubation.

I was one of the first nurse anesthetists hired at CMPC in 1974 after a 20 year faiths at that institution. The safety record of nurse-anesthetists is comparable to that of anesthesiologist a.

Feb. 15 2013 01:58 PM
Amy from Manhattan

On the effect of PPACA, there may be more pressure on the system when more people are going for early/preventive care but many people who haven't had such care are still going to emergency rooms because their conditions have worsened. The latter should decrease over time, but there'll be some overlap, during which the shortage may grow worse.

Feb. 15 2013 01:57 PM
jgarbuz from Queens

I am 66 and I have a Health Plan.My plan is to do whatever I can to stay healthy and God forbid never to have any one have to assist me. I plan to die before I ever need "assistance," God willing.

Feb. 15 2013 01:54 PM
Leslie from NJ

I am confused about the state of the profession for the following reason: last summer, I was enrolled in a college course that was predominantly attended by students in the pre-nursing program. The "word on the street" was that nursng school programs habe become so intenwely competitive that you basically have to have a 4.o gpa to get into one. Yet, there is also an impr4essions that there is a national shortage of nurses that is growing. If the shortqgenis so bad, why are the nursing programs making it so that yiu have to be a genius to get into them?

Feb. 15 2013 01:50 PM
Amy from Manhattan

Dr. Berkowitz said nursing also use medical diagnoses; what about the reverse? Do doctors pay attention to nursing diagnoses?

Feb. 15 2013 01:49 PM
MHR in JC from Jersey City

My niece is currently a senior in high school in NC. She plans to major in nursing in college - specifically neonatal nursing. Do you have any advise for a young woman about to begin her studies in this special field (and potentially entering the workforce in 4 & 1/2 years).

Feb. 15 2013 01:48 PM
Christine from Westchester

How are nurses being trained in technology.. much more pervasive than it had been. Things like EMRs etc. (Electronic Medical Records)

Feb. 15 2013 01:46 PM

At the St. Joseph hospital in LA, the nurse's union was eliminated and all nurses became "independent contractors". Is this a trend? and how will it effect nursing care?

Feb. 15 2013 01:45 PM

I'd like to hear about advanced practice nurses and their roles in patient care.
-nurse midwives
-clinical nurse specialists
-nurse anesthetists and
-nurse practitioners

Feb. 15 2013 01:44 PM
Anti-Corporate Traditionalist (No Contradiction) from Brooklyn

The Visiting Nurse Service should be exemplary for being *Not-for-profit*.

Subjecting critical health care to arbitrary and capricious "market forces" is nothing short of obscene.

The U.S. is the only modern, industrialized nation without some form of truly universal health care.

(So-called "Obama Care" is a massive subsidy to the predatory pharmaceutical and insurance industries; a transfer of wealth from the taxpayers to corporate masters, i.e., a perverse, reverse "socialism" that is considered "virtuous", "moral", even "G-o-dly" by the very demagogues and disinformation artists who inveigh against "evil socialism", "Big Government", the "cycle of welfare of dependency", etc., etc.

See what single-payer advocates such as former New England Journal of Medicine editor Marcia Angell, M.D. say about "Obama care")

(And that caller the other day to the Brian Lehrer show who defended profiteering corporate health care by arguing that physicians cannot be expected to work for nothing was clearly mis-(dis-)informed. The false-dichotomy straw man presented by said caller should have been refuted by B. Lehrer as well as his guest but was not.)

Feb. 15 2013 01:44 PM

I have a daughter that just graduated nursing school. I hear so much about the nursing shortage, yet it is very hard for a new graduate to get a position in the hospital. Does your guest have any helpful input?

Feb. 15 2013 01:42 PM
mary ellen from wantagh

to see what nursing is really like, go to IHATENURSING.COM ... it's an eye openener... and from the field.......

Feb. 15 2013 01:41 PM
Bruce from NYC

My wife worked as an RN at NY Hosp. Queens. She did 12 hours shifts that often went up to 13,14 hours sometimes 15, 16 and never got paid overtime. Sometimes she had too return next day for another shift. she often did aide;s tasks because of short staff or they just didn't feel like doing it. It left her exhaused and definitely affected her job performance and home life as you could imagine. Thankfully she got out of that awful situation and is now a public school nurse. Now much lower pay but much better qulaity family time and less stress now.

Feb. 15 2013 01:40 PM
jgarbuz from Queens

Too many credentials, too little actual work. Same in teaching. The idea is to get away from actual contact with the sick people or the kids AQAP! To move up the bureaucratic ladder, not to bring more actual comforts to the patient. That's left to the underpaid "assistants."

Feb. 15 2013 01:33 PM
Christine from Westchester

I understand that we're facing a nursing shortage and the schools can't actually manage the number of students needed. Can you ask your guest how they are working to meet the needs?

Feb. 15 2013 01:31 PM
Noach (Independent) from Brooklyn

Anyone remember those commercials, "Ask for a 'Real Nurse', an RN"?

Feb. 15 2013 04:36 AM

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