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Education
Continuing education for hospital nurses has been one more casualty of downsizing in the 1990s. As a result, nurses have been hard-pressed to keep up with changes in treatment or technology and have had fewer opportunities for professional growth to expand their job skills. On average, new nurses now get 30 days' training, compared with three months of hands-on training just five years ago.135 As JCAHO President Dennis O'Leary explains:
Today, with many shifts short-staffed, managers are reluctant to pull experienced nurses away from patient care activities to serve as trainers and mentors. New nurses start on patient care units feeling unprepared, and, in fact, too often they are. ... Another fall-out of the budget constraints and hospital restructuring of the 1990s has been the reduction of educational budgets for in-service training and continuing education of nursing staffs. The continuing pace at which new drugs, procedures and technologies are being introduced makes the inadequacy of in-service and continuing education support a major factor in the persistent high frequency of health care errors and adverse events.136
Along with the obvious problems for patient care and nurses' ability to get professional satisfaction from their jobs, cutbacks in continuing education have also stunted the traditional paths for career advancement. Only 32 percent of current nurses say they have advancement opportunities in their jobs.137
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