America's hospital staff nurses need immediate relief from both within and outside a Utah health official told members of the U.S. Commission on Nursing at a regional hearing in New Orleans Tuesday.

"We have taken an entire generation of caring, dedicated, very responsible nurses, created artificial expectations about their function in relationship to what we know to be true about current and expected health care trends, downgraded the importance of their role in patient care and insulted their sensibilities about how health care should be rendered, " Mary Anne Lappin Graf told the committee.Graf, a nurse herself, is president of Health Care Innovations, Inc., Salt Lake-based consultants providing program services to 200 hospitals in 25 states.

The Commission on Nursing was established early this year by the secretary of the of the Department of Health and Human Services to hear recommendations for improved recruiting and retention of registered nurses in America's health care facilities. The commission's final report is expected next December.

Graf emphasized that many hospital staff nurses, who entered the field committed to service or mission, perceive that today's health care has little to do with that commitment. "The way many hospitals operate today looks like a horror show of shortcomings," she said.

Among the problems Graf cited were:

Active nurses working outside of hospitals; more and more hired away by non-hospital health care industries.

Nurses available but hospital pay too low, considering hours and risk.

Fewer young people entering nursing schools, because of seemingly better opportunities elsewhere.

Loss of federal funding for nursing education.

Lack of programs to keep nurses abreast of health care advances.

Fear of AIDS.

Aggravating the situation, Graf said, are economic pressures on hospitals the worst in history because of rising costs, shorter length of stay by patients and declining admissions.

Nurses must work longer hours with less help, they are "sued with impunity, they are paid 30 percent to 50 percent less than they might make in a related industry, and many share the problems facing women who work outside their home," she said.

However, Graf observed that the issue is not so much pay as satisfaction with what they can do as nurses and with how other professionals treat them. To keep more people in the nursing force, hospital management must help nurses grow professionally, recognize the need for nurses to control their own destinies, and allow nurses and physicians to work for common goals, instead of "offensive and defensive posturing."