Analysis of a Discourse: The Nursing Shortage

Analysis of a Discourse: The Nursing Shortage Emily Urbanowski Northeastern University

Analysis of a Discourse: The Nursing Shortage In a video first broadcasted on October 24, 2008 (made available and popularized a year later in October 2009) called Nurses Needed, PBS delves into the busy workdays of nurses of all ages and specialties across the country. This documentary-style short film predominantly features the New York Presbyterian Hospital in New York City, including minimal focus on the Beaver Medical Center in Pittsburg and the Pennsylvania School of Nursing. It opens with a heart-wrenching anecdote of a young dancer who goes through a terrible crippling accident and the nurses that worked with her from admittance through

recovery. Highlighting the devotion and personal care shown by the nurses on several units in the hospital puts emphasis on how relationship oriented the profession is. This mood sets the scene for a broad analysis of the nursing shortage crisis and how it affects the healthcare system including workers, patients, families, and students. By completion the film efficiently evokes a sense of hopeful enthusiasm for nurses old and new to strengthen the field for the greater good. The documentary was first aired on national television via PBS, an enormous public media enterprise aimed at education and information broadcast to people of all ages, interests, and professions. For this particular piece it can be assumed that the audience PBS is trying to target is of a generation that understands the general principles of employment and acknowledge that there are reasons behind cyclic fluctuations in supply and demand of a service. Broadcasting on television attempts to reach a wide range of people within the aforementioned demographic, from those associated and within the field to those directly affected by the lack of nursing staff to any person who has simply sparked an interest in the issue and efforts to eradicate it. It is now accessible to anybody with Internet access and provides a resource for someone actively seeking the information on the topic. The

Analysis of a Discourse: The Nursing Shortage discourse is not dense with medical jargon but intended for someone with a general knowledge of the hierarchy within a hospital/healthcare setting. To summarize briefly, the film informs that there is currently a countrywide shortage of nurses (keeping in mind the production year of 2008) of 100,000. A reference to a study performed by the U.S. Department of Health and Human Services says that number could increase anywhere from five to ten-fold over the span of twelve years if a

solution is not implemented. The shortage is attributed to a number of reasons, the primary being simply an increase in demand. As the rest of the so-called baby boomers are retiring there is a spike in the number of elderly citizens needing care, as is expected of an aging population. This sudden, steady growth in people needing care is not being matched by an influx of new nurses. In fact, one factor mentioned in the video that is a contributing factor to the shortage is the unimpressive retention rate in young nurses. It is a well-known fact that nursing is an extremely high stress occupation, so much so that it drives away a national average of 25% of new nurses within their first year of working (Gentile, 2008). Although the company that produced it is not healthcare specific, PBS serves as a reputable source to get information on the topic at hand. Bill Gentile, the producer, is a long-time journalist/filmmaker famous for pioneering backpack journalism and is published in countless esteemed media formats. Mary Grace Savage is one of the spotlighted registered nurses; a veteran in her 31st year of service at New York Presbyterian provides much insight into the daily short term as well as long-term duties of a nurse with experience. Others figures that were interviewed by the narrator include a kidney transplant nurse, a former emergency room nurse, the senior vice president/chief nursing officer of New York Presbyterian, recent nursing school graduates, a senior burn

Analysis of a Discourse: The Nursing Shortage unit nurse/nursing teacher, and a professor/researcher at the Pennsylvania School of Nursing. Each of these people were of different ages, genders, had varying amounts of experience, specialized in several different areas, and played assorted roles in the overarching topic of the nursing shortage. As is common with this kind of wide-spread matter there is no single cause, effect, or solution, it is a give and take from several angles.

This wide range of views from the inside of the community combined with the informative narration create a well-rounded perspective on the kind of implications that a nursing shortage has on each facet, and the implications each facet has on the shortage. The film revolves around one main idea: nurses are integral to a properly operating medical system. Right now there is not enough of them, and if more are not integrated into the system the care-seekers (patients) will be the ones most detrimentally affected. Only four minutes into the twenty-three minute video the narration emphasizes, Nurses are the engine inside hospitals everywhere, nothing moves without them. (Gentile, 2008) Additionally the video cites the Journal of the American Medical Association in a study that showed strong correlation between high patient-nurse ratios to the likeliness of patient death, and that nursing care (not just doctor care) is a strong indicator of health in patients (Gentile, 2008). This kind of statement becomes thematic throughout the piece and it begs the question, why arent more people entering the field? The narrator inquires, I would have thought the market took care of this. If theres major significant demand for nursing talent, than youd think that thered be school across the country willing to take them in, train them up, and theyd become nurses. (Gentile, 2008)

Analysis of a Discourse: The Nursing Shortage The documentary answers this with the somewhat startling fact that the problem is not with the students or necessarily in the hospitals, but in the nursing schools. There is not enough faculty to turn out the number of reliable, well educated, experienced graduates needed to fill the void (Gentile, 2008). The source does this by interviewing a professor at the Pennsylvania School of Nursing, and this is where the argument really becomes apparent to me. The lessons to be taken away from this video is that to make progress in the right direction the basics have to be mastered and the root of the problem addressed. What this means in the real world is the people in the field need to be fostering an intense feeling of community by educating new nurses that will enter the field, stay there, develop their skills, and pass on those skills to the ones following in their footsteps. As Willie Manzano, senior vice president/chief nursing officer says in the video, At the end of the day its really the structures, systems, and support that we put in place that makes the nurses feel that this is where they belong and where they feel fulfilled personally and professionally.

(Gentile, 2008) After thorough analysis I would say that overall the video does this itself by incorporating so many different voices, making it understandable to a large audience, and broadcasting it in a medium that almost everybody has access to. Motion picture was a choice the creators of this project made, and although because of my lack of experience in a real world nursing setting I cannot speak to any other form of communication, this one was thorough and interesting. Although by now it is a little bit outdated the principles remain the same. By the way this source is produced and presented it tells me that yes, registered nurses themselves are extremely crucial to patient care, but so are all the other people that

Analysis of a Discourse: The Nursing Shortage allow that nurse to become who they are. It is such a multi-dimensional field and this source accurately depicts that in its discourse choices.

As part of the target audience of this piece I think it was very effective. It was not too dense that I felt bogged down in data points and dry information and as a nursing student I felt a connection to the keynote speakers. I soon will be the young nurse learning skills form the experienced nurses and eventually I will fill the role those mentors played for me. By following a story of a patient with her nurses you get a feeling of coming full circle seeing all that goes into competent nursing care. It is a good starting point as far as data and sets a stage for an interested person to go out and find more in depth figures if they so choose. With a foreboding start it wraps up by providing a sense of motivation and hope to those prospect of joining the field and those already in it.

Analysis of a Discourse: The Nursing Shortage References Gentile, B. (2008, October 24). PBS NOW [Television broadcast]. Arlington, VA: PBS.

Analysis of a Discourse: The Nursing Shortage Note: I dont feel completely confident that I fulfilled the prompt adequately for this assignment, and for that reason I hesitate to consider this piece as part of my final portfolio. As we continue on and write more research-based documents perhaps I will look back on it and see that it had a different effect on my writing process than I realize now. I understand

that the task of the assignment was not to summarize but I found it difficult to really separate the analysis of the discourse from a general analysis of the content.