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In the name of cost-containment, professional nurses throughout the state of Utah are being laid off in large numbers, while top business executives are profiting at their expense, being paid $50,000 to $400,000 bonuses per year (cleverly disguised as "risk compensation").

RNs now find themselves working patient care units with fewer and less-qualified personnel. Severely understaffed, they continually run throughout the shift desperately trying to ensure that all patients receive the care to which they are entitled.Exhausted at shift's end, many RNs angrily acknowledge that patient care is too frequently compromised. In the mean and lean environment imposed by health-care executives quality of care is decreasing, and in far too many cases hospitalization is hazardous to patient health.

Executives of one regional health-care organization unabashedly declared their shift in identity as they announced themselves to be insurance executives first and health-care providers second.

Already the conflict is evident, as that organization has publicly declared it will deliver service at a lower rate than any of its competitors. Taking care of very sick patients in their hospitals is now considered a liability, a drain on corporate resources.

Embracing such values, no one should believe that subscribers (patients) to that plan could ever come first in that environment.

In the name of "managed care," regional health corporations to the tune of millions of dollars are purchasing major medical clinics and entering into closed-shop/monopoly relationships with physicians.

In this move to capture and monopolize health delivery services in the state, an enormous power base has become even more powerful and a giant debt has been incurred to be recovered on the backs of patients and nurses.

It must never be forgotten that the primary reason patients require hospitalization on a 24 hour basis is due to their need to receive hands-on, skilled, professional nursing care.

Too many local health corporations find it convenient to put the burden of cost containment upon nurses, over 98 percent of whom are women.

They've stopped treating professional nurses as members of an organizational family and now treat them as contractual, expendable commodities to work at the behest of an industry that has lost its moral roots.

Managers in many of these systems have converted all of their values to numbers that can be fed into computers to be handled with efficiency and ease.

In so doing they have lost sight of what they are doing, the very reason for why the organization exists. No longer are they able to honestly meet the needs of patients.

Mindlessly, they think little of profiting at the expense of professional nurses, inanely treating them as second class citizens.

These managers sophisticatedly flaunt their belief that investment in human capital is just no longer compatible with good business.

When so-called health organizations truly value the patient there will be no such thing as understaffing a patient care unit or staffing with marginally qualified individuals.

Nurses will not be asked to default quality patient care in favor of inanimate financial parameters. There will be no elites found whose contribution and needs are esteemed to be superior to other members of the hospital family.

The hospital corridors of fame will be representatively graced with pictures of outstanding nurses who have given their all in behalf of patients whose lives have and will continue to hang in balance.

I challenge all of the financially fixed health-care executives in Utah, all of whom verbally subscribe to Judaeo-Christian ethics, to take the higher road. Eliminate the obscene bonuses.

When there is a financial downturn in the organization let everyone, from top administrator to lowliest employee, share in the downturn together. In like manner, when there is a financial upturn let everyone together share in the upturn.

It is not compatible with the executives' "higher selves" that they should profit at the expense of nurses and suffering patients. They should do different than many of their counterparts throughout this country.

They should uphold the values that they verbally espouse in the mission statements of their institutions. They should be true to themselves, to the citizens of this state, and to those who have given them a free-will offering that must never be forgotten.

As they think of and treat patients and employees, the health care executives will either find themselves or lose themselves.