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U.Va. Nursing deans call for improved support of field

Fontaine, White say nurses overworked, under-supplied

Nursing School Dean Dorrie Fontaine and Assoc. Dean Kenneth White published an editorial last week in the Richmond Times Dispatch expressing discontent with the public support for the field of nursing, calling for the empowerment of nurses everywhere.

“We’re not [just] talking about the U.Va. Medical Center, we’re talking about the 3.2 million nurses in the United States that face a lot of difficulty in doing the profession they love,” White said. “A lot of people leave nursing early on, because it’s hard work.”

The editorial cited stress and the lack of support, recognition and appreciation nurses feel in the workplace, in addition to “repetitive paperwork, ... inflexible schedules” and, as White said, constant “hunting-and-gathering” for supplies that are not within sight.

“It’s not the work that discourages people, it’s their jobs,” White said. “Often [nurses] work shorthanded and have to double up on patients, which means they have to work longer hours [and] overtime. Sometimes they don’t have the basic supplies they need.”

Third-year Nursing student Sydney Greenberg said nurses often feel burned out because of a feeling of isolation from being unable to share what they see.

“Nurses see things that other people do not see,” she said. “They see people at the worst times and sometimes the best times of their lives. That inability to communicate exactly what they feel and what they see is what I believe contributes to burnout.”

One of the biggest issues in health care currently is increased life expectancies — White said more patients being treated for longer periods of time. Patients who were admitted to Intensive Care Units 20 years ago are now the patients admitted to general hospital rooms, while ICU patients are much sicker, he said.

“We have not only shortages of nurses in some places, but we have much sicker patients,” he said. “People live longer but ... with more medical problems. We call them comorbidities, because they have multiple things wrong with them.”

This, combined with a general shortage of nurses, often creates a stressful environment.

“Short-staffing is definitely an important issue in nursing today,” Greenberg said. “Nurses do their best to compensate for the need for many more hands on deck, but ... their jobs really are to care for the total health of their patients. That is very difficult to do for upwards of five patients.”

In their editorial, Fontaine and White called for healthier work environments and a renewed of critical look at “how we frame our organizations’ support of nurses.”

“I’ve studied, with some colleagues, high-performing healthcare organizations,” White said. “[These] organizations seem to have happier nurses, lower turnover and higher patient satisfaction. So there is something about a ... culture that creates a preferred place for nurses to work.”

As the associate dean for strategic partnerships and innovation at the Nursing School, White is currently trying to come up with new ways to improve the nursing experience. White currently works with nurses in the Medical Center’s Innovation Unit to develop new ideas to implement in the hospital.

“It’s time for innovation,” he said. “I’m looking for new and uncopied ways to improve the patient and nurse experience. I’ve been working with [the unit] to develop some new ideas. The nurses seem very happy and the turnover is low on that unit.”

White also discussed the possibility of nursing education inadequately preparing graduates for the realities of the workplace.

“Some nurses, after they’re in school, are put through an orientation that is frankly not enough,” he said. “Just because they go to school, ... take the exam and are licensed, does not mean you really have what it takes in every situation. I think the question is, could we do more in school to prepare them better for reality?”

Many hospitals, the University included, have recently established nurse residency and fellowship programs, similar to physicians programs, to better educate nurses. The Nursing School also has programs focusing on interprofessional education.

“We have [third-year] medical and nursing students take classes together,” White said. “The more that nurses and physicians learn about each other and each other’s roles, the better it’s going to be in the future.”

Greenberg agreed miscommunication between physicians and nurses often arises in the workplace.

“The medical team sometimes lashes out at each other in an attempt to regain control,” she said. “Harsh words can be said ... to the nurses. This may come from the fact that nurses are the main advocate for the patient. When you learn in school to rely upon each other as a cohesive team, you are more likely to pursue this type of partnership in practice.”

Greenberg is the current cultural and diversity event director for Multiculturalism in Nursing Today MINT in the Nursing School, a group that is working to inspire younger people of different cultures and ethnicities to join nursing.

“I think that the most important area of nursing that needs to change is the diversification of nurses themselves,” she said. “Our number one priority is to give better patient care, and I believe the way to facilitate and successfully initiate this priority is offering patients a wider variety of culturally aware nurses. We need more Spanish-speaking nurses, more male nurses, more African American nurses and more culturally diverse nurses in general.”

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