HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Respond to This Article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Stock, C. Search for Related Content PubMed PubMed Citation Articles by Stock, C.

I have been a nurse for 30 years. Most of that time has been at the bedside in critical care. Much to my dismay, I have watched nurses, hospital administrators, and nursing models come and go. The saddest thing I have seen die is altruism as a component of professional nursing. The causes of this demise are many. First and foremost, an increase in technical knowledge, increased responsibilities and decision making, and increased performance expectations of the professional nurse have not been accompanied by a commensurate increase in pay or recognition.

I have seen nurses who are taking care of patients on left ventricular assist devices and also on continuous renal replacement therapy asked to provide coffee cups for the waiting room. The public has yet to realize that nurses provide the steel infrastructure that enables a hospital and critical care patients to survive.

Sign-on bonuses of $10 000 and more have created a mobile, transient group of nurses, who work for the money, not for the quality of care or the reputation of an institution. The lure of the flexibility of 12-hour shifts has fragmented care, as nurses tend not to work more than two 12-hour shifts in a row because of the labor intensity of those shifts. This means that for 24 of 48 hours, a patient may have the same nurse, a family may bond with that nurse, and the nurse has assimilated the nuances of both, and then that nurse is off for 3 days.

As for unions, contrary to your editorial, other journals have recognized that staffing and patient care are often issues advanced by union activities. If the Fair Labor Act is changed and overtime pay is curtailed, does it make a nurse more professional to work overtime without being reimbursed? Having worked in a law office, I know that legal professionals bill for every hour they work.

Finally, in the current economic maelstrom, economic survival of families has superseded altruism and, to a degree, professionalism. What can be done about this? Discourse at all levels, in education, in hospital staff meetings, in orientations, and at meetings of professional organizations must occur to illuminate what is missing in terms of altruism and the benefits that a return to this concept will provide. Today, as bedside nurses, we are challenged to look at improving outcomes. If altruism and professionalism are to be nurtured, their effects on outcomes, not only for the patient, but also for the nurse, must be clearly illustrated.

Cynthia Stock, RN, BSN, MSN, CCRN
Garland, Tex

This Article Full Text (PDF) Respond to This Article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Stock, C. Search for Related Content PubMed PubMed Citation Articles by Stock, C.