Nursing Economic Reforms

Great discussion everyone! This far we have discussed and learned how economic reforms in healthcare system affect nurse’s ability to provide care. Weiss article challenges us to think how high turnover rates, increased float staff, increased workload and a move to a more supervisory role over non-licensed personnel creates difficulties in providing the ‘basic nursing care’ that ensures a space for ‘meaningful human interaction’. Austin’s article discusses the impact of economic reforms on nursing in a different manner. Austin contends that nursing is a ‘humanly fulfilling moral mission’ that revolves around ‘caring’. She claims that the meaning of ‘nurse’ ceases when the nature of nursing changes from moral practice to routinized activity.

It was a pleasure to be part of this discussion and watch how this topic directly impacts many of us today, and has the potential to shape our future practice. Specifically, Yangchun brought idea of unanimous voice for nursing in pursuit of a safe and competent care. Rida developed on the same idea and felt more determined to bring a positive change. Laura asserted that ‘genuine engagement’ to acknowledge patient as a human being can have positive impact in care regimen. Overall, it was a very fruitful discussion.
Now I would like to move on and facilitate further discussion on week’s other article, which is conceived by Shores. Shore provides us a different perspective of healthcare reforms as they pose challenges to nursing.

Summary of Shore’s

In regards to hospital institutions, targets such as hospital waiting time, operating time, and league table (measures a range of criteria to rank different hospitals) are different means to quantify efficiency. Author further argues that audit system is not a “response to problem of governance or accountability”; rather, it is about “politics of regulation and managerial control”. One of the effects of the managerialism in health services is that a practitioner must be “subversive” and act according to the structures and interests that have been forged by the audit system. This entails corrosive effects on practitioner’s sense of autonomy and professionalism. The effects of audit system and managerialism are subtle and irreversible. As public professionals, we need to speak openly about the risks produced by the audit and managerial