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"Physicians need to pay more attention to what is happening to nursing as we and our patients are critically dependent on the underappreciated activities of nurses. A good starting point is to read and heed the alarms sounding in Code Green." --Gordon Schiff, M.D., Director, Clinical Quality Research, Department of Medicine, Cook County Hospital "Dana Beth Weinberg's book is right on target, portraying how the relentless financialization of our health care system destroyed one of the finest--if not the finest--hospital nursing service in America. Code Green is a well-written demonstration of how organizational change can disrupt the work of even the most conscientious professionals, and a warning to us all of the human dangers raised by an unthinking spread of business logic." --Daniel F. Chambliss, Hamilton College, author of Beyond Caring: Hospitals, Nurses, and the Social Organization of Ethics "Dana Beth Weinberg provides a compelling account of the dismantling of one of the few hospitals in America that specialized in care. This is a 'must read' for all who seek to understand the nurse shortage." --Linda H. Aiken, University of Pennsylvania "Weinberg's book is a powerful description of the issues facing both nurses and hospitals at a time when the entire health care industry is concerned with a growing shortage of nurses. Her portrayal of the impediments faced by nurses in their efforts to continue to provide quality patient care are well-documented, and, in many instances, frightening. The book makes clear nurses' contributions to patient safety and quality-even if the nurses themselves were unable to do so." --Barbara A. Mark, Ph.D., RN "Journal of the American Medical Association " "The author scrutinizes how and why hospitals, in the era of profit-driven health care, routinely exploit qualities such as empathy, dedication, and professionalism in nurses. Using human science research, she illustrates how nurses really are 'ripe for exploitation, ' in part because we internalize responsibility for patient care, patient safety and the caring-healing process." --Virginia Gillispie "Denver's Nursing Star " "Hospital restructuring has fundamentally changed nurses' work and the very meaning of nursing. It has overlooked the therapeutic value of the nurse-patient relationship and the importance of 'knowing the patient.' Is it any wonder, then, that so many nurses are leaving the profession because of frustration and disillusionment? In the end, this hurts nurses as well as patients, physicians, and hospitals. Weinberg concludes that when designers draw up cost-effective plans for hospital restructuring, they must thoughtfully include nurses in their planning. The author is to be congratulated on bringing this important topic into view." --Barbara Mann Wall "Health Affairs " "Beth Israel was an international benchmark hospital which many saw as setting the nursing standards to be achieved elsewhere. This account of its recent history carries important messages about the domination of economics over the need for nursing care, the fragility of even the best nursing leadership during amalgamations, and the ease with which a reputation can be lost." --Tom Keighley "Nursing Management "Reseña del editor:
We are on the verge of the nation's worst nursing shortage in history. Dedicated nurses are leaving hospitals in droves, and there are not enough new recruits to the profession to meet demand. Even hospitals that were once very highly regarded for the quality of their nursing care, such as Boston's Beth Israel Deaconess Medical Center, now struggle to fill vacant positions. What happened? Dana Beth Weinberg argues that hospital restructuring in the 1990s is to blame. In their attempts to retain profit margins or even just to stay afloat, hospitals adopted a common set of practices to cut costs and increase revenues. Many strategies squeezed greater productivity out of nurses and other hospital workers. Nurses' workloads increased to the point that even the most skilled nurses questioned whether they could provide minimal, safe care to patients. As hospitals hemorrhaged money, it seemed that no one-not hospital administrators, not doctors-felt they could afford to listen to nurses. Through a careful look at the effects of the restructuring strategies chosen and implemented by Beth Israel Deaconess Medical Center, the author examines management's efforts to balance service and survival. By showing the effects of hospital restructuring on nurses' ability to plan, evaluate, and deliver excellent care, Weinberg provides a stinging indictment of standard industry practices that underestimate the contribution nurses make both to hospitals and to patient care.
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