Product Description

We are on the verge of the nation’s worst nursing shortage in history. Dedicated nurses are leaving hospitals in droves, and there are not enough new recruits to the profession to meet demand. Even hospitals that were once very highly regarded for the quality of their nursing care, such as Boston’s Beth Israel Deaconess Medical Center, now struggle to fill vacant positions. What happened? Dana Beth Weinberg argues that hospital restructuring in the 1990s is to blame.

In their attempts to retain profit margins or even just to stay afloat, hospitals adopted a common set of practices to cut costs and increase revenues. Many strategies squeezed greater productivity out of nurses and other hospital workers. Nurses’ workloads increased to the point that even the most skilled nurses questioned whether they could provide minimal, safe care to patients. As hospitals hemorrhaged money, it seemed that no one—not hospital administrators, not doctors—felt they could afford to listen to nurses.

Through a careful look at the effects of the restructuring strategies chosen and implemented by Beth Israel Deaconess Medical Center, the author examines management’s efforts to balance service and survival. By showing the effects of hospital restructuring on nurses’ ability to plan, evaluate, and deliver excellent care, Weinberg provides a stinging indictment of standard industry practices that underestimate the contribution nurses make both to hospitals and to patient care.

Product Details

• Amazon Sales Rank: #259907 in Books
• Published on: 2004-02
• Original language: English
• Number of items: 1
• Binding: Paperback
• 240 pages

Features

• ISBN13: 9780801489198
• Condition: NEW
• Notes: Brand New from Publisher. No Remainder Mark.
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From Publishers Weekly
Bad food is the least of their worries: hospital patients often feel neglected, Weinberg says, and complain that they spend hours without proper medical attention from nurses. In this thorough investigation into how the nursing profession has changed radically over the last decade, she cites hospital consolidation and 1997's Balanced Budget Act, which brought cuts to Medicare payments and severely affected hospitals' bottom line, as keys to the problem. The Brandeis University research associate uses the merger of Boston's prestigious Beth Israel Hospital with New England Deaconess as an example of how fiscal problems and consolidation are responsible for the growing shortage of nurses and rampant dissatisfaction in the field. Before the merger, Beth Israel was famous for its egalitarian policies, while the well-respected New England Deaconess was known for its "restructuring of hospital care" in the name of cost efficiency. The different philosophies behind nursing and the ensuing political struggles involved with the marriage of individual institutions contributed heavily to the drop in nurse retention and, ultimately, to a decline in patient care. Weinberg's analysis will be important to medical professionals and hospital administrators, but outsiders may find it a bit academic and dry.
Copyright 2003 Reed Business Information, Inc.

Review
"'code green' refers to the financial crisis that hospitals are facing today. . . [T]his thought-provoking book gives a uniquely personal perspective." -- Library Journal, 5/1/03

"...[a] thorough investigation into how the nursing profession has changed radically over the last decade." -- Publishers Weekly, May 1, 2003

From the Inside Flap
"Dana Beth Weinberg provides a compelling account of the dismantling of one of the few hospitals in America that specialized in care. This is a ‘must read’ for all who seek to understand the nurse shortage"—Linda H. Aiken, University of Pennsylvania

"Dana Beth Weinberg’s book is right on target, portraying how the relentless financialization of our health care system destroyed one of the finest—if not the finest—hospital nursing service in America. Code Green is a well-written demonstration of how organizational change can disrupt the work of even the most conscientious professionals, and a warning to us all of the human dangers raised by an unthinking spread of business logic."—Daniel F. Chambliss, Hamilton College, author of Beyond Caring: Hospitals, Nurses, and the Social Organization of Ethics

"Beth Israel was an international benchmark hospital which many saw as setting the nursing standards to be achieved elsewhere. This account of its recent history carries important messages about the domination of economics over the need for nursing care, the fragility of even the best nursing leadership during amalgamations, and the ease with which a reputation can be lost."—Tom Keighley, Editor, Nursing Management

"Physicians need to pay more attention to what is happening to nursing as we and our patients are critically dependent on the underappreciated activities of nurses. A good starting point is to read and heed the alarms sounding in Code Green."—Gordon Schiff, M.D., Director, Clinical Quality Research, Department of Medicine, Cook County Hospital

Customer Reviews

The "true" colour of healthcare...
Although this book is based in the U.S., so much is the same in Canada. I would highly recommend this book for nurses [who may be trying to figure out 'what it's all about Alfie'], for nursing students and no doubt, the public - so they can gain a better understanding of what it is that nurses are up against. As one wise person put it - it's a pity that these corporate entities in charge of running our healthcare, know the cost of everything...yet the value of nothing ("The Peter Principle")! So much needless suffering all for a race to the "bottom-line"/dollar. Thank you for such an intelligent book!

Well written, informative, kept me interested
I really enjoyed Code Green: Money Driven Hospitals and the Dismantling of Nursing. By telling the story of two hospitals that merged, one with a history of primary nursing and another with a team task driven approach the author speaks to the lack of a consistent role definition for nursing that caused the breakdown of service and quality at these two hospitals...also talked about the bottom line issue of money, the power issues in nursing, the importance of having nursing leadership in top hospital administration positions and so much more. Really gave me an insight into the pitfalls inherent in professional nursing practice as viewed through real problems which developed in the lives of real nurses in two prestigious medical institutions.

Great Book for Activists
this is an absolutely great read if you don't mind reading research. The book takes Weinberg's research of nurse staffing issues caused by managed care flaws, and makes it understandable- if you're an experienced, and policy-savvy nurse.

She uses the downfall of Beth-Isreal Hospital, once the best hospital in the nation (and the model for the Magnet Program), as an example of how disseminating nursing staff from the top to the bedside can result in horrendous quality failures.

A must-read for any nursing activist, or anyone who wants the low down on why there really isn't a nursing shortage, just a shortage of nurses willing to work in current conditions.