Future health care costs have even been a security concern — increases in health care spending are and will increasingly take money away from military readiness. Many scandalous stories about the costs of health care have been told. And while we share Americans’ outrage at the cost of health care, there is some good news on the cost front: health care spending has been leveling off in recent years.
Progress on the cost of health care notwithstanding, there is a serious scandal in health care — the toll that health care takes on the people who deliver it. The burdens of regulation, cost reductions, and quality initiatives piled onto nurses and other clinicians are undeniable. The biggest current and future risk to health care is shortages of nurses and doctors.
Especially in nursing, there is growing evidence that the job people are asked to do is unreasonable and consequently moving people out of the profession; emerging shortages are weighing down further the workload and feasibility of already overworked doctors and nurses. In a recent study of forty hospital units, more than one-third of nurses reported they intended to leave their position within the next year; sighting emotional exhaustion and lack of personal accomplishment, two key indicators of nurse burnout.
And as growing evidence has shown, nurse burnout dramatically influences how satisfied patients are with their care. The performance of nurses and their impact on quality is determined by many factors. In the end, though, all research on the quality of nursing care either concludes the absolute necessity of support departments providing nurses with what they need, or assumes that these departments will do so.
Put another way, treating nurses as customers is at the heart of all work on the quality of patient care by nurses. Efficiency — how hospitals must operate — will loom large as the Affordable Care Act is rolled out and sequestration cuts continue. Efficiency will equal profitability; without it continued financial pressures will mount. Leaving only two choices for hospitals: open or closed.