Orne R M, Garland D, O'Hara M, Perfetto L, Stielau J
University of Connecticut School of Nursing, Storrs 06269, USA.
Appl Nurs Res. 1998 Aug;11(3):101-10. doi: 10.1016/s0897-1897(98)80092-x.
Under tremendous pressure to contain costs, most U.S. hospitals are radically altering the composition and skill mix of their staff, thinning their skilled registered nurse (RN) ranks, and often substituting them with minimally trained, lower paid, unlicensed assistive personnel (UAP). Twelve staff nurses were interviewed to illuminate the experience of working with UAP, who function largely in untested, expanded roles. Only two nurses viewed this experience positively; the rest were either opposed to or had strong reservations about UAP use. Confusion and emotional turmoil predominated as these nurses struggled to maintain safe, comprehensive care with the assistance of UAP who were often ambivalent and sometimes dangerously inept.
在控制成本的巨大压力下，大多数美国医院正在彻底改变其员工的构成和技能组合，削减熟练注册护士（RN）的数量，并且常常以培训不足、薪酬较低的无执照辅助人员（UAP）取而代之。采访了12名在职护士，以了解与UAP合作的经历，UAP在很大程度上承担着未经检验的、扩大了的职责。只有两名护士对这种经历持积极看法；其余的护士要么反对使用UAP，要么对此有很大保留意见。当这些护士在常常态度矛盾、有时甚至危险地不称职的UAP的协助下努力维持安全、全面的护理时，混乱和情绪波动占了上风。
