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NURSING SHORTAGE IN THE U.S.
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Focus on nurse dissatisfaction.... More...
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Paper Abstract:
Focus on nurse dissatisfaction. Current shortage due to dissatisfaction in the nursing profession and competition from other professions. Various reasons nurses are dissatisfied. Impact of an aging work-force couples with a smaller work-force as hospitals downsize. Issue of patient safety. High turnover among nurses. Recommendations.
Paper Introduction:
Nursing Shortage in the US
Introduction
A report from the Robert Wood Johnson Foundation, of Princeton, New Jersey, states that the current nursing shortage in the United States differs from past ones in that it is due to dissatisfaction in the nursing profession and competition from other professions (Anonymous, Current, 2002). Other contributing factors include the aging work-force coupled with a smaller young work force, failure to entice men and minorities to nursing, and women taking advantage of other professional opportunities which were not so readily available to them before. Nursing used to be one of the few professions open to women, but that is no longer the case (Yin, 2002). The National League for Nursing reports that in 2000, enrollment in nursing programs was down 33 percent, and has been declin
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(2 2). Hospital profit margins are decreasing, leaving less money tohire nurses. Other contributing factors include the aging work-force coupledwith a smaller young work force, failure to entice men and minorities tonursing, and women taking advantage of other professional opportunitieswhich were not so readily available to them before. State Legislatures, 28, 2 -23.Lee, S. Health Care Strategic Management, 2 , 8.Anonymous. Since 1995, the number ofnurses sitting for the nation license exam for RNs has dropped by 29percent. The lack of nurses at thepatients' bedsides means the nurses are not as flexible using automateddispensing units for most patient drugs. Drug Topics, 146, HSE47.Morrissey, J. (2 2). (2 2). Hospitals must supply nurses with the latest technology toallow them to work efficiently. Nurses must not be expected tofloat on services they are not familiar with. By 2 2 , there will be a 2 percent deficit in the nursingprofession. The nursing profession must be made more attractive toyoung people of both sexes. California foundation offers report on using technology to ease nursing crisis. The nursing shortage is now considered a national security concern,according to the Institute for Public Policy and Social Research andInstitute for Health Care Studies at Michigan State University (Nelson,2 2). Current shortage different from previous ones. The HHS recently announced a series offederal grants of more than $3 million for nursing education programs tohelp ease the nursing shortage (Duff, 2 2). JCAHO proposes solutions to nursing shortage. California is trying to reduce the patient load per RN down to sixfrom 1 to 2 in some places, at a cost of roughly an extra $2 perpatient. One of every five nurses is planningto leave nursing in the next five years, and half of current nurses haveconsidered leaving within the last two years. (2 2). (2 2). Patients in hospitals withfewer intensive care nurses had longer hospital stays; higher nurse-staffing levels led to a three percent to 12 percent reduction in someadverse events, such as gastrointestinal bleeding, pneumonia, shock andurinary tract infections; and hospitals with low turnover rates had lowerdeath rates and shorter stays than those with higher turnover rates. Nursing used to be oneof the few professions open to women, but that is no longer the case (Yin,2 2). Nurses complaints of excessive workloads, performing too manythankless tasks, mountains of paperwork, and being made to float indepartments where they have no experience are turning many of them awayfrom the profession (Yin, 2 2). Nursing shortage spurring changes in pharmacy operations. Nurse-staffing levels were a factor in24 percent of 1,6 9 sentinel events since 1996. (2 2). Hiringnurses from overseas can no longer fill the gap because there is a shortageworldwide. ReferencesAnonymous. (2 2). It isexpected that more than 33 , RNs will retire before 2 8 (Nelson, 2 2). Wanted: One million nurses. American Demographics, 24, 62-65. Patients are suffering becausethe pharmacy may have medication dispensed ready for a patient, but ifthere is no nurse to go and get it from the pharmacy, the patient is leftsuffering. Those in the nursingprofession must be treated with respect because of the importance of thejob they do. The California HealthCare Foundation is trying to improve the lot ofthe overly stressed nurses by employing the latest technology (Anonymous,California, 2 2). HealthcareFinancial Management, 56, 24.Anonymous. Modern Healthcare, 32, 2 .Nelson, R. Business Week, 3785, 81.Yin, S. One hospital has developed a website akin to eBay wherenurses can bid on open shifts; another gave its nurses wireless phones sothey could be contacted anywhere in the unit. Nursing: On critical List. It is predicted there will be a shortage of 51 , nurses by2 1 , the time when most baby boomers will be in their 7 s and in need ofmore hospital care. The study believes that by 2 2 , 44 states plus the Districtof Columbia will have nursing shortages. Nursing Shortage in the USIntroduction A report from the Robert Wood Johnson Foundation, of Princeton, NewJersey, states that the current nursing shortage in the United Statesdiffers from past ones in that it is due to dissatisfaction in the nursingprofession and competition from other professions (Anonymous, Current,2 2). US nursing shortage a "national security concern." Lancet, 36 , 855.Weintraub, A. HHS predicts growing nurse shortage. Other suggestions to ease theshortage include: new models of nursing and health care provisions;reinventing work environments and nursing education to address currentneeds; establishing a national nursing workforce to collect data; creatinga clearinghouse of effective strategies; and forming a national independentbody to work on these reforms (Anonymous, Current, 2 2). Healthcare Financial Management, 56, 11.Duff, S. While many of these solutions are alreadybeing implemented separately in various places, there must be a nationaleffort to address the reasons why so many nurses are leaving theprofession, and national standards set for nurses' working conditions whichwill attract future nurses, and keep those already in the profession. The Bureau of Labor and Statistics predictsthat by 2 1 , there will be more vacancies in nursing than in any otherprofession.Discussion Nurses are dissatisfied for a host of reasons: soaring drug costs anddecreasing insurance reimbursements have led to hospitals cutting down onemploying RNs to the point that patient safety is threatened; demographictrends are changing; cultural shifts occur in inner cities and elsewhere;and image problems are rising now there are so many other opportunitiesavailable to women (Weintraub, 2 2; Yin, 2 2). The National League for Nursing reports that in 2 , enrollment innursing programs was down 33 percent, and has been declining at a rate of4.2 percent a year since 1993. States tackle the nursing shortage. States are eachenacting programs in an attempt to address the shortage, from financialincentives, to forgiving loans in exchange for working in areas withnursing shortages, reducing patient-nurse ratios, and boosting the capacityof nursing schools (Goodwin, 2 2).Conclusion There is no simple answer to the nursing shortage, but somethingneeds to be done. (2 2). With such a wide range of professions open to women now, nursing isnot an attractive profession. The JCAHO has recommended providing management training to nurses;setting staffing levels based on nurse competency and skill mix; increasingfunding for nursing education; establishing a standard postgraduate nursingresidency program; and establishing financial incentives for investing innursing (Anonymous, JCAHO, 2 2). (2 2). Even when medications reach the floor, there is often not anurse available to administer them to the patient at the right time, againto the detriment of the patient. Salaries must be competitive with work outsidenursing. The mean age of nurses in 2 1,according to the Bureau of Labor and Statistics was 45; the percentage ofRNs under 35 dropped to 24 percent; and the percentage of young nursesunder 25 was down to three percent. The dropout rate for nurses only four years after graduationhad risen to 4.1 percent in 2 . Patient/nurse ratios must be set at levels which assure patientsof safe nursing care when hospitalized. (2 2). Thenursing shortage is a national emergency and should be addressed as such. Modern Healthcare, 32, 13.Goodwin, K. A study by the American Nurses Associationin 2 1 found that 55 percent of 7,3 nurses surveyed would not recommendthe profession to others (Yin, 2 2). (2 2). Salaries are low, and workloads are high for the remainingnurses. There is currently a 26 percent turnover rate among nurses - thehighest in decades - and hospitals are resorting to sign-on bonuses as highas $15, to attract qualified nursing staff (Weintraub, 2 2). For male nurses the rate was 7.5percent. Not only that, but newly licensed nurses are also leaving the professionin droves. The nursing shortage is so bad in some places that pharmacists areadministering drugs to patients (Lee, 2 2). Technology information isavailable to help hospitals schedule nurses, provide mobile communications,educate patients, administer medications, and to computerize patientrecords, physicians' orders and nurses' documentation. An even more dire prediction comes from an Health and HumanServices (HHS) study which expects the shortage to reach 12 percent by2 1 , 2 percent by 2 15, and a whopping 29 percent by 2 2 (Anonymous,HHS, 2 2). The American Hospital Associationestimated American hospitals are currently short by 126, nurses. Nurses are necessary. The situation is such that hospitals are not able to deal withcurrent health care needs, and if a bioterrorism attack were to occur, theywould be swamped and unable to cope.Impact on Nursing A report issued by the Joint Commission on Accreditation ofHealthcare Organizations (JCAHO) showed that nursing shortages wereresponsible for one in four unexpected deaths and injuries caused byhospital errors (Morrissey, 2 2). Nursing Management, 33, 7.Anonymous. Nurses get funds to ease shortage.
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