But I think it will have all the problems inherent to the character of our people. We're all concerned with our own financial security, and I think it needs to be weighed with the whole ethics of the process. I think the priorities need to be evaluated by people who are really versed in the ethics of the whole system, and that relates to the impact on the community, the individual, the family, the whole picture. Most hospitals currently are restructuring nursing units. This is a process that takes a variety of forms specific to a given hospital and which targets specific nursing units, said Jacobson of the Seattle Area Hospital Council.
Some examples are team approaches, involuntary transfers, unit merging and skill mix changes.
In many cases, such as with skill mix changes and team approaches, the idea is to put RNs in the role of managing, planning and assessing, leaving other jobs requiring less skill and training to be handled by less-trained nurses, aides or orderlies. A team might consist of a mix of RNs, clinical nurse practitioners, licensed practical nurses and certified nurse assistants, Jacobson said. Ironically, hospitals moved away from such models years ago in order to favor a primary care approach-giving RNs the responsibility for the direct care of the patients. And the reason we can is because of the efficiency of technology. All of this is done to get the most appropriate person doing the most appropriate care in the most appropriate setting.