Nurse shortage From state to state, nurses are decrying working conditions and the impact on patient care -- a movement that has reached even Molokai.
hits patient care
The national crisis reaches
Molokai as its 6 nurses
go on strikeHawaii association honors
outstanding nurses for
National Nurses WeekBy Helen Altonn
Star-BulletinThe six nurses at Molokai General Hospital planned to strike at 7 a.m. today because they haven't had a pay raise in three years.
It would be the first nurses' strike in Hawaii in more than 15 years. The last was at Wilcox Memorial Hospital on Kauai.
And it would be an ironic end to National Nurses Week -- a week intended for celebration that has turned into a demand for action across the nation to deal with a health care crisis.
"Registered nurses are in no mood for celebrating because of a deepening national health care staffing crisis that leaves patients and nurses at risk of serious harm and even death in America's hospitals," said United American Nurses, the union arm of the American Nurses Association.
Hawaii is short about 400 registered nurses and the situation is expected to worsen here and across the nation, with nurses burning out and leaving the profession and few young people going into it.
Lorraine Pescaia, Molokai General Hospital registered nurse, said the number of nurses there has dropped to six from 12 in recent years and the administration hasn't tried to replace those who left.
Mary Bonifacio, director of nurses, said: "In actuality, our census count is so low, we don't require more than that (six). Years ago our census was higher, both for long-term care and acute, but that has not been true the last year or so." A pay raise for the six nurses would total less than $5,000 per year, according to the Hawaii Nurses' Association.
"Even though it seems like a small amount, when you look at our fiscal condition, we lose enough money that any amount really adds to the bottom line," said Dr. Philip Reyes, co-medical director of the hospital with Dr. Emmett Aluli.
Aluli acknowledged the difficulty "on every angle" of such a strike on an island where everyone knows each other and many are related. "But there is such strike fever in the air," he said. "We just had our teachers (strike) ... It's going to be more tough for us because of possible long-term impact. We're not sure how long it's going to go."
The Hawaii Nurses' Association brought two national specialists on the health care crisis here in March to help address Hawaii's nursing plight.
They were Peter Buerhaus, nursing professor and senior associate dean for research at Vanderbilt University School of Nursing, and Jack Needleman, Harvard University assistant professor of economics and health policy.
The two conducted a study for the federal government on the impact of nursing staff on patient welfare in hospitals.
Nancy McGuckin, HNA executive director, said the recently released report confirms what nurses have been saying about the importance of nursing care for the public.
"It is a huge step in trying to identify and quantify nursing," she said. "It is making the invisible visible. That's a huge leap, and it's only the beginning."
Stephani Monet, HNA director of education and practice, said nurses are distressed because many workplace issues have never been addressed.
"We have gone through periodic shortages before. They address the supply side, then once they get enough nurses, they're not interested in addressing workplace issues."
Now, unhappy nurses aren't recommending nursing careers to their families or friends, Monet said. "It's really having an impact on the profession."
She said the nursing association recently surveyed 3,431 nurse members about workplace conditions and received 936 responses (27 percent).
Of those, 315 said they were ordered required to work overtime an average of 20 times last year, for four to eight hours each time.
Asked if they were told refusal to work overtime was "patient abandonment," 130 said yes.
Asked why they agreed to an overtime mandate, 254 said to assist co-workers, 149 said they were threatened with discipline or termination, 81 were told refusal was grounds for licensure discipline, and 105 perceived a threat to their license.
Monet also noted a major increase in violent incidents with patients. Workplace violence was reported by 180, or more than half of those who worked forced overtime. Substance abuse is a large factor in emergency rooms and psychiatric units, Monet said.
In other activities, Monet said HNA's ethics committee is preparing to survey nurses on end-of-life issues. Issues also are being addressed in labor management committees, she said.
The association is concerned, she said, because nurses dissatisfied with their working conditions won't recommend the profession to others.
Lenora L. Lorenzo, a nurse practitioner, has been honored as Nurse of the Year by the Hawaii Nurses Association. Hawaii association
honors outstanding nurses
for National Nurses WeekBy Helen Altonn
Star-BulletinLorenzo was among nurses receiving awards at a banquet Thursday honoring Hawaii's nursing profession during National Nurses Week.
"There are negative things out there," said Stephani Monet, director of education and practice at the Hawaii Nurses Association, "but there are also things to celebrate. You keep working on the problems and celebrate your victories."
Highlighting the victories are nurses such as Lorenzo, an educator, practitioner and scholar who "exemplifies nursing at its highest level," the HNA said.
She was named Teacher of the Year last year at the University of Phoenix, Nursing Division.
She teaches CPR and community programs at schools and hospitals and works with the Waikiki Health Center's award-winning Hawaiian Healing Outreach Program at the Ho Ola Like North Shore Clinic.
Other awards include:
>> Advanced Practice Nurse of the Year: Sara Fitzpatrick, advocate for nurses as government relations chairwoman for HNA and federal political director and government relations chairwoman for the Hawaii Association of Nurse Anesthetists.
>> Staff Nurse of the Year: Louis Casorla, critical-care nurse and strong patient advocate who "develops great rapport and understanding as he patiently communicates the details of often-frightening procedures to his patients, many of whom return to visit. ... He is a stellar example of professional nursing."
>> Staff Nurse of the Year: Karen Murai, honored for contributions to the well-being of new mothers and their babies at Kaiser Hospital. She was recognized for strong communication skills for her work on the OB/GYN Clinic's "Advise Line."
>> Nurse Educator of the Year: Gloria Woodwell, medical-surgical nurse for 30 years. Concern for Hawaii's nursing shortage led her to resurrect the Candy Striper program at Kona Community Hospital. She redesigned and implemented Kona's Youth Volunteer program leading high school students into nursing careers, and created a program to facilitate transition of RN graduates into medical-surgical nursing at Kona Community Hospital.
>> Ruth Kemble Award for Volunteer Service: Elaine Slavinsky, who serves on the HNA's Governmental Affairs Committee. She was a "tireless volunteer" while working 21 years at Maui Memorial Medical Center, working up from staff nurse to nursing director.