Nurses
more
than
ever

August 1, 2015 -- In this video interview with Pam Cipriano entitled Why Nurses Matter More than Ever, Ms Cipriano -- an old guard union booster -- makes an important point. But it's based on nursing's traditional battle about staffing levels. This pits us directly against management that seeks to hold down costs. Recall, payroll is a hospital's single largest expense. Nurses are often its largest component.

Ms Cipriano is right but for reasons other than what she states. Now reimbursements -- thanks to the ACA -- are partly based on quality measures and, most importantly, on outcomes. In its central role, the quality of nursing care has risen to what is perhaps the most essential factor in determining outcomes.

Our union does an important job in enabling us to work well but we need to move beyond those tired formulae and focus on how we deliver the high quality health care that America demands. What we nurses need to enable us to deliver these ever-better results should be the goal for which our union contends. Ms Cipriano fights a good fight but could do better by enlarging her goals. Adequate staffing is necessary but not sufficient. We also need tools (especially mobile ones such as NurseMind), participation in decision-making, representation in the C-suite (every substantial health care organization should have a CNIO), evidence-based protocols, and much more.

In Nursing: Essential to Healthcare Value in Nurse Leader, a model begins to emerge. Authors Pappas and Welton propose to "...define nursing value as the function of outcomes divided by costs." The model is rudimentary but it's a good start. What you can't measure you can't manage. The model begins to tell us what to measure.

The point is that, with reimbursements tied more than ever to outcomes and perceptions of quality, nurses are essential to health care revenue. Hospitals, make sure your nurses have what they need to deliver the results you need. When we do our work well, you are reimbursed well and -- most importantly -- patients get good care.

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