Code Green: Money-Driven Hospitals and the Dismantling of Nursing (Culture and Politics of Health Care Work) [Paperback]

Dana Beth Weinberg (Author), Suzanne Gordon (Foreword)

Book Description

ISBN-10: 0801489199 | ISBN-13: 978-0801489198 | Publication Date: March 2004 | Edition: 1

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.

Editorial Reviews

From Publishers Weekly

Bad food is the least of their worries: hospital patients often feel neglected, Weinberg says, and complain that they spend hours without proper medical attention from nurses. In this thorough investigation into how the nursing profession has changed radically over the last decade, she cites hospital consolidation and 1997's Balanced Budget Act, which brought cuts to Medicare payments and severely affected hospitals' bottom line, as keys to the problem. The Brandeis University research associate uses the merger of Boston's prestigious Beth Israel Hospital with New England Deaconess as an example of how fiscal problems and consolidation are responsible for the growing shortage of nurses and rampant dissatisfaction in the field. Before the merger, Beth Israel was famous for its egalitarian policies, while the well-respected New England Deaconess was known for its "restructuring of hospital care" in the name of cost efficiency. The different philosophies behind nursing and the ensuing political struggles involved with the marriage of individual institutions contributed heavily to the drop in nurse retention and, ultimately, to a decline in patient care. Weinberg's analysis will be important to medical professionals and hospital administrators, but outsiders may find it a bit academic and dry.
Copyright 2003 Reed Business Information, Inc. --This text refers to the Hardcover edition.

Review

"'code green' refers to the financial crisis that hospitals are facing today. . . [T]his thought-provoking book gives a uniquely personal perspective." -- Library Journal, 5/1/03

"...[a] thorough investigation into how the nursing profession has changed radically over the last decade." -- Publishers Weekly, May 1, 2003 --This text refers to the Hardcover edition.

See all Editorial Reviews

Product Details

• Paperback: 213 pages
• Publisher: Cornell University Press; 1 edition (March 2004)
• Language: English
• ISBN-10: 0801489199
• ISBN-13: 978-0801489198
• Product Dimensions: 8.4 x 5.5 x 0.6 inches
• Shipping Weight: 9.6 ounces (View shipping rates and policies)
• Average Customer Review: 4.4 out of 5 stars  See all reviews (11 customer reviews)
• Amazon Best Sellers Rank: #204,418 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

21 of 23 people found the following review helpful:

5.0 out of 5 stars The "true" colour of healthcare..., November 7, 2004

By 

Renee V. Kennedy (British Columbia, Canada) - See all my reviews
(REAL NAME)   

This review is from: Code Green: Money-Driven Hospitals and the Dismantling of Nursing (ILR Press books) (Hardcover)

Although this book is based in the U.S., so much is the same in Canada. I would highly recommend this book for nurses [who may be trying to figure out 'what it's all about Alfie'], for nursing students and no doubt, the public - so they can gain a better understanding of what it is that nurses are up against. As one wise person put it - it's a pity that these corporate entities in charge of running our healthcare, know the cost of everything...yet the value of nothing ("The Peter Principle")! So much needless suffering all for a race to the "bottom-line"/dollar. Thank you for such an intelligent book!

7 of 7 people found the following review helpful:

5.0 out of 5 stars Well written, informative, kept me interested, March 8, 2007

By 

Dianne K. Duchesne (Fairfax, California) - See all my reviews
(REAL NAME)   

This review is from: Code Green: Money-Driven Hospitals and the Dismantling of Nursing (Culture and Politics of Health Care Work) (Paperback)

I really enjoyed Code Green: Money Driven Hospitals and the Dismantling of Nursing. By telling the story of two hospitals that merged, one with a history of primary nursing and another with a team task driven approach the author speaks to the lack of a consistent role definition for nursing that caused the breakdown of service and quality at these two hospitals...also talked about the bottom line issue of money, the power issues in nursing, the importance of having nursing leadership in top hospital administration positions and so much more. Really gave me an insight into the pitfalls inherent in professional nursing practice as viewed through real problems which developed in the lives of real nurses in two prestigious medical institutions.

5 of 5 people found the following review helpful:

4.0 out of 5 stars Great Book for Activists, July 12, 2007

By 

L. Flamini "Doctoral Nursing Student" (Louisville, KY) - See all my reviews

This review is from: Code Green: Money-Driven Hospitals and the Dismantling of Nursing (Culture and Politics of Health Care Work) (Paperback)

this is an absolutely great read if you don't mind reading research. The book takes Weinberg's research of nurse staffing issues caused by managed care flaws, and makes it understandable- if you're an experienced, and policy-savvy nurse.

She uses the downfall of Beth-Isreal Hospital, once the best hospital in the nation (and the model for the Magnet Program), as an example of how disseminating nursing staff from the top to the bedside can result in horrendous quality failures.

A must-read for any nursing activist, or anyone who wants the low down on why there really isn't a nursing shortage, just a shortage of nurses willing to work in current conditions.