What physicians should know about the nursing shortage

Article Abstract:

The shortage of nurses has resulted in vacancies at all institutions that employ nurses, and may compromise the ability of hospitals to provide safe, effective patient care. It has been predicted that a decline in the number of nursing students will result in the deterioration of hospital care. In February 1988, the American Medical Association proposed a new type of health care professional called the registered care technologist (RCT), but this option was opposed by nursing organizations. A study of the extent and nature of the nursing shortage indicated that the percentage of vacant registered nurse positions ranged from six to 14 percent. Most registered nurses were employed, although many were only working part-time. The nursing shortage has caused many hospital administrators to close hospital beds, delay non-emergency surgery, float or transfer nurses between departments, rely on nurse registries and recruit overseas, and develop various approaches to meeting their nursing needs. Other changes made by administrators include increases in salaries and shift differentials, and benefits such as child care, further education, and career advancement. Nurses have often complained that much of their dissatisfaction with their occupation stems from the authoritarian and demeaning attitudes and behavior of physicians. The current shortage of nurses is not due to a transient problem in nursing salaries, but may result from the explosive growth in the demand for nurses due to new medical technologies and the aging of the population. Various recommendations for solving the nursing shortage problem are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Economic aspects, Supply and demand, Nurses, Nursing, Nurse and physician, Nurse-physician relationship, editorial

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Nutritional issues in nursing home care

Article Abstract:

Diagnosing the causes of malnutrition in nursing home patients and aggressively treating nutritional deficiencies may improve the quality-of-life and health of these patients. Increasing calorie intake is the primary treatment for weight loss. Loss of appetite, paranoia, difficulty swallowing, tooth loss, dementia, hyperthyroidism, digestive problems, inability to feed oneself, tasteless diets, and social factors are all treatable causes of malnutrition in nursing home patients. Drug side effects and depression are treatable causes of protein energy under-nutrition. Tube feeding may be successful when used soon after illness or surgery. Appetite stimulants and vitamins may facilitate weight gain and prevent complications of malnutrition such as infection and bone loss.

Diagnosis, Food and nutrition, Nursing home patients, Malnutrition

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I've been where it's gone, so I know what I got...an American Fulbright lecturer in Albania, 1994-1995

Article Abstract:

Many questions remain in how best to help the Albanian medical community. A Fulbright Lecturer in the medical sciences reports his experiences and insights gained during a 10-month stay in Albania. Albanian medical students and trainees are eager and capable but access to current medical knowledge is limited by the impoverished economy as well as by controlling division chiefs and government officials. The learning curve in becoming familiar with and trusted within the Albanian system for teachers sent there may be long but eventually fruitful. This lengthy time requirement may limit the number of willing teachers.

Social aspects, Medical students, Training, Medical colleges, Medical schools, Albania

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