Background Registered nurses are the backbone of America's acute health care delivery system. Increasingly hospitals are changing their services, levels of care and staff mix in what they assert is a necessary response to impending state and federal health care financing reforms, other expected changes in reimbursement methodologies, and relocation of delivery of services into new and alternative settings. Currently, registered nurses are experiencing the consequences of these changes through downsizing, restructuring of nursing services, and layoffs. Others are increasing the work responsibilities of registered nurses and simultaneously increasing their substitution with lesser skilled workers. The impact of this profit-driven health care is alarming.
Collective action is essential to any strategy for job and career security for registered nurses.
Whether at the negotiating table, in the federal or state legislatures, or at the job site, registered nurses must increase their involvement with their state nurses associations. ANA encourages organized nursing and all registered nurses to work together toward their common goals of safe, quality care and job and career security. Collaborating with other nursing organizations, ANA is working with the Institute of Medicine, numerous federal agencies, and the private sector to address the key issues and to develop a national infrastructure fortifying local and state collective action. ANA opposes work redesign programs which delegate professional nursing responsibilities to unlicensed assistive personnel and other non-RN personnel. ANA believes such inappropriate substitution, along with inappropriate discharge and transfer of patients to less regulated areas, will lead to deterioration in the quality and safety of health care.