In Arkansas, the problem is exacerbated by a shortage of faculty at the nursing schools. And yet, according to state Rep. Jim Lendall of Little Rock, a nurse himself, the shortage is not driving up salaries in the Little Rock area, certainly not enough to attract and keep sufficient bedside nurses. And in some cases, Lendall says, nurses have lost job security in a time of shortage, another anomaly, because older, comparatively high-paid nurses have been encouraged or coerced to leave, making way for younger and cheaper nurses. If true, all this suggests that the nurses, most of whom are women, have not yet spoken loudly enough of their needs. Hospitals are constantly battered by HMOs to cut costs.
Patients are more acutely ill.
The cut in home-health reimbursement has led to a deterioration of the health of patients in the community and delayed the treatment of their conditions. These patients used to be cared for by one nurse each with close observation. A physician was usually on the intensive care unit as well. Now, a nurse typically has several similar patients in separate rooms. In a crisis, a doctor can be paged from elsewhere in the hospital or called at home.