Fuszard B, Slocum L I, Wiggers D E
Medical College of Georgia, Augusta.
J Nurs Adm. 1990 May;20(5):41-6.
Cost containment and the nurse shortage have impacted rural hospitals and their nursing staffs. This impact did not appreciably affect burnout levels among the rural nurses, but did evidence itself in the reports of the directors of nursing and their nurses. Cost containment brought with it layoffs of colleagues in the work setting who were neighbors or relatives. This occurred while the rural areas were already filled with the unemployed and underemployed. Unfamiliar recordkeeping increased two- and three-fold, and the 23-hour admit caused unequal work flow. Downsizing, elimination of some services and reports of rural hospital closings were threatening to the nurses, who were often the sole support of their families. The rural nurse shortage was seen to be different from the national nurse shortage in significant ways. Except for the few study hospitals that were close to population centers, nurses could not be recruited from outside the geographic area. Suggestions from the Secretary's Commission on Nursing are not all appropriate for the rural hospital nurse shortage. Rural hospitals changed in the face of cost containment, and nursing personnel also worked to contain costs. However the nurses have worked within cost and salary constraints for so long that they predict loyalty to their community hospitals can be coming to an end. The nurse shortage is being approached by minor alterations in staffing and mode of care delivery. Federal support is desperately needed by the rural hospitals to permit equitable salaries, and to support financial aid to permanent residents of the rural areas for entrance into or advancement in nursing education.(ABSTRACT TRUNCATED AT 250 WORDS)
成本控制和护士短缺对农村医院及其护理人员产生了影响。这种影响并未明显影响农村护士的职业倦怠程度，但在护理主任及其护士的报告中有所体现。成本控制导致工作场所的同事被裁员，而这些人是邻居或亲戚。此时农村地区已经充斥着失业和就业不足的人群。不熟悉的记录保存工作增加了两到三倍，23小时住院制导致工作流程不均衡。医院规模缩小、一些服务的取消以及农村医院关闭的报道让护士们感到担忧，因为他们往往是家庭的唯一支柱。农村护士短缺在很多方面被认为与全国护士短缺不同。除了少数靠近人口中心的研究医院外，无法从地理区域外招募护士。秘书护理委员会的建议并非都适用于农村医院护士短缺的情况。面对成本控制，农村医院发生了变化，护理人员也努力控制成本。然而，护士们在成本和薪资限制下工作了很长时间，他们预计对社区医院的忠诚可能即将结束。目前通过对人员配置和护理提供方式进行微小调整来应对护士短缺问题。农村医院迫切需要联邦支持，以实现公平的薪资，并为农村地区的永久居民提供经济援助，帮助他们进入护理教育或在护理教育中取得进步。（摘要截取自250字）
