Supply and demand

National | Too many patients, too few nurses; too little spinach, too few vitamins; cheap vaccine has polio almost gone

Issue: "Tax man's terror," April 14, 2001

Nursing the nurse market
There's no recession in the nursing field, where hospitals are bending over backwards to fight a shortage. The health-care industry is trying everything from career fairs where booths offer bedpans filled with candy to bonuses including cash, child care, and maid service. Scapegoats for the problem include high stress, long hours, and the managed-care bureaucracy. Many nurses today complain about forced overtime due to inadequate staffing and management. Nursing today is 94 percent female and male-dominated careers are more and more tempting. Veteran RN Patti Urbanec of the University of California, San Francisco told a gathering in Los Angeles that the increased workload could endanger critically ill patients. "These are patients with tubes in their throats and bellies," she said. "We have patients who need suctioning every hour. We have patients who need two people to assist them. They need intervention every hour to stay alive. We don't take breaks or lunches anymore in fear that they will die." Add the problem that America's nurses are getting older (an average age of 45.2, according to government figures) as baby boomers approach retirement age. And the number of new nursing graduates has dropped by 3,000 annually for the last five years, according to the American Association of Colleges of Nursing. Federal officials and nursing groups claim the problem will reach a crisis point by 2010. Some officials propose more government spending increases. Eat your spinach
Call it the Popeye diet. A group of researchers says that substituting spinach for iceberg lettuce on burgers and other food improves nutrition without hurting taste. Researchers at the University of Arkansas promote the idea as a painless way to eat better. They say people can't taste the difference and they get more vitamin C, vitamin A, and folic acid. The researchers tried substitutions because they believed convincing people to eat the green regularly as a side dish was a hard sell. So they tried a taste test. They said the volunteers rated spinach burgers and lettuce burgers equally tasty and no one suspected the difference. The same test was done with tacos. "Only one or two people mentioned that the lettuce looked very green," said Marjorie Fitch-Hilgenberg, assistant professor of nutrition. Only a memory?
Polio is almost gone, but certainly not forgotten. Only 3,500 cases of the crippling disease that terrorized earlier generations were recorded last year, according to United Nations figures. Compare that to 350,000 cases in 1988. The UN's Global Polio Eradication Initiative says the disease is virtually absent from Europe and the Americas and can be found today mainly in South Asia and sub-Saharan Africa. The group ran a massive vaccination program last year, immunizing 550 million children under 5 years old in 82 countries. Polio attacks the central nervous system with crippling and sometimes fatal results. One reason for the downturn is that the vaccine is dirt cheap, costing only about nine cents per dose. One problem is that entire population areas must be treated or else the virus can come back in a more virulent strain. But a recurrence of symptoms in thousands of polio's previous victims serves as a reminder of what a devastating virus it is. Post-polio syndrome, a weakening of muscles originally afflicted by the virus, is turning up in patients who contracted the disease as children during the 1930s, '40s, and '50s. After years of fighting off the disease, they find themselves forced back to their crutches, walkers, and wheelchairs. John Rodgers of Mays Landing, N.J., fought childhood polio and later served a stint in the Navy, plus 20 years as a mailman before returning to braces. "It's frustrating to realize you're not normal anymore," said the 58-year-old. "It's like getting really old really quickly."

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