Courage To Make A Change
Advocates say the Partners-in-Practice system frees nurses from routine tasks to concentrate on the patient's medical care while under medical assistant training. Critics say hospitals are skimping on registered nurses and forcing the remaining ones to spend little time with patients -- time that they use to pick up subtle changes in breathing, skin color and other red flags that unlicensed workers are not trained to notice.
A bill pending before the state Assembly would limit the role of unlicensed hospital workers in patient care to work that requires no medical knowledge of medical assistant training. The California Nurses Assn. has lobbied for the bill. But some nurses embrace the trend toward using less-educated aides.
"It makes my job so much easier," said Lee Ann Bruhn, a UCLA Medical Center pediatrics nurse, who heads a partnership team. "I can concentrate more on patient care . . . I can have time to do teaching and discharge planning and making the patient stay the best possible without having to worry about getting all the beds changed and baths done."
The move is toward efficiency, not an underhanded scheme to show registered nurses the door, said Dr. Ben Shwachman, president of the Los Angeles County Medical Assn. and a Covina anesthesiologist. "There is no goal to phase out nurses or RNs," he said. "That simply is not so." Nancy Miner, 56, is the mother of three grown children, including a son, Kenny, who still lives at home because of his developmental disabilities. A little more than a year ago, after 30 years as a homemaker, she sought work outside the home. Now she has a job at the Syracuse Home Association, a nursing home in Baldwinsville. She's a medical assistant there, and a model one: The Metropolitan Commission on Aging recently gave her its senior career development award. When Miner first called the agency, looking for training, she had vague visions of doing office work; that's all she felt prepared for. Closer to heart, she dreamed of medical work but felt she'd never qualify. It took help from the commission, encouragement from friends and a six-month course at BOCES to change her mind. "My first reaction was, 'No, I can't do that,"' she recalled. "'I can't go to school again. I've never done these things.' I was petrified. I didn't know what to expect. The people at BOCES, most of them, were so much younger. I just didn't know if I could do this." A former resident of Eastwood and North Syracuse, Miner now lives in Liverpool, on Sudbury Drive. What I like about my neighborhood: I have very nice neighbors. It's a "Hello, How are you? My name is ... " and that's just great." The accomplishment I'm proudest of: What I've accomplished in the last two years. Realizing that I can do things. Having the courage to go forward and try them.
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