Nurses Pick Rich, Elderly

Amid a shortage of health care professionals, some nurses have returned to the hospitals — this time in private-duty roles.

The attraction of one-on-one interaction between patients and nurses has drawn some employees out of hospital settings and into nursing registries and home-health offices.

In 1992, about 66 percent of the nation’s registered nurses worked in hospitals, according to the American Nurses Association. By 2000, 59 percent were in hospitals. In 2000, 16 percent of R.N.s worked in non-hospital based home-health agencies and community public health settings, which include nursing registries.

By leaving the hospital setting, nurses and nurses aides often take a reduction of benefits and a cut in pay.

According to the U.S. Department of Health and Human Services, the average annual earnings for RNs working full time in a hospital totaled $47,759. RNs in public health environments, including private nurses, averaged $45,150 per year.

Joyce Mader, director of professional services at Care IV Home Health Services in Springdale, said the assurance that a nurse won’t have to care for “50 patients at once” is worth it.

Most of a home-health clinician’s time is spent in private residences rather than in the hospital, but Mader said Care IV sends private-duty nurses or certified nursing assistants on hospital visits 10-15 times a year, and they often take the place of family members who are unable to stay with the patient around the clock.

Legally, when patients are admitted to a hospital, their privately hired nurses take a back seat to the “primary care” nurses employed by the facility.

For a hospital setting, nursing agencies and home-health providers sell assurance.

Personal nurses essentially become bedside sitters on ice-chip duty. While they give assistance for nighttime bathroom visits and such, it is companionship that aids patients the most, Mader said.

About 99.9 percent of the requests made to Care IV for private-duty nurses are from the families of elderly people who suffer from mental illnesses, Mader said. A hired bedside nurse can help keep a patient from having to be physically restrained in bed, an action that often aggravates the patient and disturbs hospital staff.

Occasionally, an affluent patient will hire a bedside nurse during a hospital stay, because they prefer private and personal interaction and have the money to pay for it, Mader said.

Privately hired certified nursing assistants and nurses from an agency cost $13-$35 per hour, Mader said. Patients pay for the bedside nurses privately, because insurance, Medicaid and Medicare only reimburse for care given by hospital-employed nurses.

Teresa Wilson worked at Butterfield Trail Village for nearly 13 years before she opened 1-to-1 Home Services Inc. At a patient’s request, she and any of her eight certified nursing assistants will follow a regular patient into the hospital for bedside monitoring.

Wilson said she has been well received within the hospitals.

“Nurses can’t be everywhere at once,” Wilson said. “It actually takes a load off of them.”

Mader agreed, “It helps [hospital nurses] to know that someone’s sitting there with [the patient]. They don’t worry as much.”

She joined Care IV more than a year ago, after her job with Washington Regional Medical Center’s private-duty nursing department was terminated when the ward closed in March 2001.