If given a chance to vote, Utah nursing executives would overwhelmingly reject a plan proposed by the American Medical Association designed to end the worst nursing shortage in U.S. history.
The AMA, blaming nursing leaders for a "bankrupt policy" that has contributed to the severe shortage, has called for a new field of hospital workers to handle bedside chores.Specifically, the AMA's House of Delegates has recommended training "registered care technologists" who would take vital signs, bathe patients and perform other types of patient care.
Rejecting stiff arguments from nurses, the AMA's policy-making arm of the nation's largest doctors' organization (with 295,000 members) will develop pilot programs for training the technologists to help nurses care for patients. The technologists would receive 2-18 months of training and work under the direction of nurses, handling such chores as changing bandages, making beds and dispensing some medications.
The American Nurses' Association opposes the proposal, contending the answer to the nursing shortage is to raise salaries and improve working conditions, not create a new category of worker.
Local nursing executives agree.
"The AMA proposal is flawed in its conceptual approach in dealing with the issue. It's short-sided and hasn't been well-conceived and developed," said Linda K. Amos, dean of the University of Utah College of Nursing.
"The nursing profession has undertaken many steps and activities to deal with the shortage and we believe that given support from physicians and hospital administrators, we will have a better way to solve the problem," she said. "But the introduction of a new hospital worker will fragment and lower the quality of care."
And unless laws are changed, the "technologists" couldn't work under the licensure of nurses; they would have to be supervised by physicians, Amos said.
"They would be an expense to the health-care system, and particularly in Utah it's a poor plan because we have more qualified (nursing education) applicants than we can accept," she said. "We could respond better to the shortage by expanding our current (nursing education) programs at the University of Utah and Weber State College."
But AMA officials don't believe nurses need to be that well educated.
In fact, AMA leaders lashed out at nursing officials for failing to fill out their ranks and turning people away from the profession by working to require all nurses to have four-year college degrees.
Dr. William Hotchkiss, former AMA president, called it a "bankrupt policy" - a statement that angered local nursing officials.
Colleen L. Price, executive director of the Utah Nurses Association, argued that the new technologists wouldn't have enough training and would duplicate the work of nursing assistants, licensed practical nurses and technical registered nurses.
They would also be costly, she said.
"At a time when cost containment is increasingly important, a new program could add to the cost of health care," she said. "I don't know what they are planning to pay them, but if they don't pay them more, or as much as they pay nurses, I wonder if they will be able to attract technologists."
What doctors and nurses do concur on is that something needs to be done - and fast. There's a shortage of 300,000 nurses in U.S. hospitals, and that is expected to double by the turn of the century.
Like Amos, Intermountain Health Care officials believe the root problem is not lack of people who want to be nurses, but a lack of resources to train them.
Demonstrating it's commitment to solve the problem, the Salt Lake City-based non-profit health-care system has contributed $185,000 to help train nurses at seven nursing schools in Utah and Idaho.
"On any given day, IHC's 25 hospitals collectively have 100 to 125 job openings for trained nurses," said IHC Senior Vice President Steve D. Kohlert. Although IHC's 1988 contributions are $25,000 more than in 1987, Kohlert said, "We can't be viewed as a long-term source of funding. IHC urgently supports state and federal legislation that would provide more funding to train nurses and alleviate the existing shortage."