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Ailing Profession : Nurses Hurt by Recession and the Hiring of Less-Educated Medical Assistants

August 05, 1993|RENEE TAWA | TIMES STAFF WRITER

THE REGION — Registered nurse Cindy Keen loved the parts of her job at City of Hope National Medical Center that had nothing to do with taking blood or giving medication. The parts such as knowing how to take a 6-year-old cancer patient's mind off the tumor that left her tiny stomach swollen by playing her favorite video or offering her a favorite food.

Keen, who lost her job following a contentious two-week strike in June, worries that she won't find another nursing job like that. At worst, she fears, she will find no work at all.

In a dramatic change from six years ago, when a severe nursing shortage caused nationwide panic, Keen and 46 other nurses from the Duarte hospital whose jobs were filled by replacements are struggling to find steady work.

These nurses' dilemma reflects a nationwide downturn in the nursing industry, caused by twin factors: the recession and a movement by hospitals toward hiring less-educated staffs, including licensed vocational nurses and unlicensed assistants, said Arthur A. Sponseller, a senior vice president of the Hospital Council of Southern California.

In the mid- and late-1980s, frantic hospitals were flying in nursing recruits from abroad. Newspapers bulged with help-wanted ads for nurses, and competing hospitals tried to outbid each other to woo new hires.

That was a time when the percentage of unfilled slots for registered nurses averaged 21% per hospital in California. By 1991, the most recent statistics available, the vacancy rate in California was 9%, according to the American Hospital Assn., a trade group in Chicago.

At Southern California hospitals, new hires totaled 22.5% of registered nursing staffs in 1987; that figure dropped to 12.8% in 1992, according to the Hospital Council of Southern California's survey of 100 acute hospitals.

The turnaround means that, to make ends meet, some of the replaced City of Hope nurses are refinancing their homes, dipping into their children's college funds or abandoning the business for new fields.

Pediatric nurse Keen is scrambling for work as a temporary replacement nurse through a registry that hospitals notify when they are short-staffed. Every morning, she gets awakened by a 5 a.m. telephone call that usually tells her there's no work for the day. For a nurse who thrives on a human touch--she used to take home the clothes of sick children and wash them if their families weren't around--the change is jarring.

"It's degrading, to say the least," said Keen, a 25-year nursing veteran. "I do have some expertise. . . . No one seems to care. No one seems to want it."

Meanwhile, her husband, who owns a pool maintenance service, supports the family, which includes their two teen-agers.

About 80% of the City of Hope's 450 registered nurses walked off the job on June 15 after contract negotiations failed to resolve disputes over job descriptions and time off. A week later, hospital officials started hiring permanent replacements, saying that they did not want to jeopardize patient care in a potentially prolonged strike. Fifty-one of the striking nurses were replaced because the others returned to work before replacements could be hired; and four of the replaced nurses have since been rehired.

But the 47 remaining are finding that where once they could have had their pick of jobs, the pickings are now slim.

Nurse Gloria Diaz, who worked in the bone marrow oncology unit, is "waiting for the bank to write me a foreclosure note."

Her husband lost his aerospace job in March. The couple will have to pull their 11-year-old son out of private school to make ends meet. The couple also have two girls, ages 7 and 6.

"I thought this would be a lifetime place of work for me," said Diaz, 40, a 19-year nursing veteran who applied unsuccessfully for work at seven hospitals.

The nursing shortage gave her a false sense of security--and now the move toward less trained health-care workers leaves her embittered.

"I can do the work that an aide or an LVN can do, but an LVN or aide can't do what I do," she said. "It's become a business. It's just a trend of the time. Everything now comes down to how much it costs and how much will (hospitals) gain from it."

Nurse Ruby Allen, 32, is refinancing her family's La Crescenta home while she looks for work and cares for her 1-year-old daughter. She's relying on her husband's income as a manager of a door manufacturing company.

Allen feared that the hospital was trying to force registered nurses into supervisory roles.

"I didn't become a nurse to become a supervisor of LVNs and aides," she said. "The bedside nursing thing is being taken away from the RNs."

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