As soon as the seven people on the intensive care unit were transferred out, seven more critically ill patients filled the beds. It was the kind of day that made nurse Susan Kentch afraid to steal a bathroom break, afraid a patient would slip into a cardiac arrest while she was gone.
"It was like trying to stand on my head and knit. And you go home and wonder what you forgot to do," said Kentch, an intensive care nurse at Pioneer Valley Hospital. "We had patients trying to die left and right. Dang it. We wouldn't let them."This guy in room 8 was about to code. No break. No lunch. No nothing. You don't have time to chart."
Not all of a nurse's days are filled with that kind of stress. But on busy days, Kentch leaves the hospital knowing she's done something.
Downstairs, Jeanette Taylor works in Utah's second-busiest emergency room, her job punctuated by accidents that occur on the valley's suburban sprawl of freeways.
On average, Pioneer Valley's emergency room crew cares for about 100 patients per day, about 36,000 per year. During the busiest periods, like a sunny weekend day, sometimes it feels like more. Taylor says she likes her job most days for its variety. For example, she can care for a heart patient, then stabilize a trauma case behind the curtain, then provide a rubber-band tourniquet for a young patient's finger.
But sometimes she gets tired.
"I see people usually at their worst, at their sickest time. That gets to me after awhile," Taylor said.
Sometimes she thinks about a job where she could wear nice clothes and sit in a quiet office with a window. And she contrasts that with nursing, remembering one critically injured patient, who suffered broken bones all over his body. "He was in a lot of pain. It's hard hearing them say for eight hours they're hurting when you want to help them."
Kentch and Taylor are just two of Utah's 14,810 nurses, two among the state's 10,048 registered nurses with four-year degrees. While technology has changed nurses' work lives, the ongoing nurse shortage is changing the way major employers, like hospitals, do business.
Just like firefighting, nursing is the ultimate in heroic professions. Nurses routinely save lives. But ironically, the profession has claimed some status only now that there aren't enough nurses to fill the nation's hospitals.
That's because our country has sold out its caregivers, according to Suzanne Gordon's book "Prisoners of Men's Dreams." Gordon contends that professions traditionally considered "women's work" - such as teachers, social workers and day-care providers as well as nurses - have low status in a society focused on the bottomline.
In a production-oriented world, nurses, like those who work in other service-oriented fields, often provide unmeasurable care. How can you quantify the comfort provided by a floor nurse who holds a patient's hand while he or she slowly dies?
"If I were to become a nurse or an elementary school teacher, my professors and fellow students would think I was crazy," a Wellesley student told Gordon. "To them it would be like saying I wanted to be a janitor."
Gordon believes that society needs to return value to care-giving professions.
That theory makes sense when considering the nursing shortage. In Utah, nearly 2,000 nursing positions were left unfilled last year, according to the state's nursing resources study.
As a profession, nurses are still mostly female, still mostly without clout in the medical community. According to a study of national newspapers, nurses are rarely considered quotable as sources in health care stories (see accompanying box).
Then there's television. On countless soap operas, nurses are portrayed as bubble-brains, young lovelies who hang out at hospitals wearing white but who don't do much of anything. In "The Nightengales," a short-lived television series, nurses weren't trained professionals, just sexy sirens. And on "St. Elsewhere," a series considered by the medical field to be more accurate, the head nurse became addicted to prescription drugs.
Television and movies would appear more authentic, according to Kentch, if more of the actresses posing as nurses left the hospital with blood on their shoes.
Nurses are still commonly asked why they didn't become doctors, a question that implies they weren't smart enough for medical school but just settled into this lesser job. Instead, most Utah nurses say, they made the choice to have direct contact with patients and their families.
Marj Peck, a nurse and assistant administrator over LDS, Cottonwood and Alta View hospitals, said she always planned to be a nurse rather than a doctor. "I see them as different. In our world physicians have a higher status, but so do baseball players or rock stars."
And while the chronic nursing shortage is forcing hospitals to offer higher wages, a nurse's paycheck still is too small considering the amount of responsibility she shoulders, said Andrea Denton, a former intensive care nurse.
Denton is studying to become a certified public accountant. "In the ICU, you know you're the one who is there making decisions as they occur that really can determine life and death. A good nurse can prevent a complete code where the heart stops and everything."
All that responsibility while earning not much money and not much prestige is only complicated by this: hospital hours. Somebody has to pull the overnight shift. Patients still need care even after the banks close each night.
But Paula McGibbon, a pediatric nurse and clinical specialist at University Hospital, said the public perception of the profession is changing, thanks to consumerism. People in hospitals are more likely to appreciate nurses.
"I think it's getting better," said Taylor, a comment often echoed by her colleagues. "But I still think the recognition of what we do isn't there yet. We're not `The Doctor.' In reality, it's the nurse that is with the patient most of the time."