The Nursing Shortage: According to the National Sample Survey of RN's, 500,000 nurses with active licenses are not practicing. Another 500,000 are practicing only part time. These numbers represent over one third of the entire nursing profession. How do we solve this problem?

Hospital Mistakes: 15,000 to 100,000 fatal medical mistakes occur each year. (The number depends on how one defines a medical error.) How do nursing practice conditions affect patient care quality?

Patient Outcomes: The quality of nurse/physician teamwork has been shown to have a significant impact on patient outcomes. What system lends itself to the best professional collaboration?

ASK ANY HOSPITAL BEDSIDE NURSE.

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The nursing systems and working conditions with which nurses are presented in many of our community hospitals prevent even the most excellent nurses from practicing well. Like physicians, registered nurses are finding that the commercialization of their practice may be placing them at the dictates of non-professional managers who view their practice, not as a professional process, but as a string of disjointed tasks. Nurses who would otherwise find personal enrichment in the practice of their profession may instead dread to report for duty and may practice under constant worry.

Nurses are convinced of the value of their profession, one that may have a richer history of altruism than any other profession has. Their complicity in poor systems of practice may be more from a sense of powerlessness than apathy or agreement. CREATING HOSPITALS WE CAN TRUST offers guidance and sustenance to those nurses who would make it clear that the intergrity of their practice and the noble history of their profession are not for sale.

This book helps nurses, physicians, executives and the public understand nursing practice in a new light. It reveals the "hallmarks of quality" in any hospital, and it offers guidance to those who must reconcile both professional and economic imperatives of today's hospitals.

From the Foreword: "We can create hospitals that will serve their patients well and at the same time retain the profitability necessary for growth and modernization. This is today's task of health professionals, executives, legislators and community leaders with integrity and courage."

Excerpt from Chapter 10, "Reconciling Power, Profit and Service"

Nightingale set an example few nurses have followed. Her lesson for us was that power does not have to be delegated; it must be seized. ...Nightingale's principles drove her actions. At a time when women supposedly had no way to bring about change, she did not accept that women or nurses were powerless. She did not wait for permission to act. When persuasion alone failed, she developed a strategy, and she used imaginination. She has thus left a clear message for each individual nurse at the bedside today.