Imagine being admitted to a hospital for major surgery only to find out that while the surgeon and anesthesiologist are poised to do their jobs, the nurses are somewhere else.

That situation is analogous to why the New Jersey hospitals crisis, the worst in the U.S. and a harbinger of things to come elsewhere as the nation’s health-career system slowly collapses, is not going to get better anytime soon. The crisis in the Garden State is being addressed in a politically expedient and piecemeal way that neither recognizes the impact that the crisis in nursing itself is having on the situation nor have nurses been consulted or empowered.

When we last visited the situation in April, it was dire:

New Jersey, the most densely populated and second wealthiest state, had 112 hospitals 20 years ago. Today it has 74 after six closed in the last 18 months. Meanwhile, four others have announced plans to close and five filed for bankruptcy protection, with about half of the others losing money like an ER patient hemorrhaging blood because of gunshot wounds.

Hospitals should be no more immune to the effects of bad business practices than any other enterprise, and indeed some of the closings are the result of lousy management, including a failure to remain competitive as the industry lurches away from community-based facilities to those where making profits for shareholders trump all other concerns.

So what has happened in the intervening four months?

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