Nursing Shortages Loom in Today's Hospitals

Article excerpt

If you've ever been a patient in a hospital, you probably remember a nurse who made a difference in your care. It may have been someone who was right there to meet your every need, a model of efficiency. It may have been someone who hugged you when tears were cascading down your cheeks. Nursing in this country is a wonderful combination of science and nurturing, and that's nowhere better exemplified than in our hospitals.

There's trouble on the horizon, though.

For much of the last 100 years, if a bright young woman wanted to enter a profession, she had two choices: nursing or education. That's changed. These days, the student body of almost all professional schools, including medicine, is about 50 percent women.

There's no question that society as a whole is better off to have women contributing in every field. But with women who in the past might have entered nursing now seeking careers in a variety of other professional fields, less nurses are coming out of our nation's nursing schools. And with many nurses moving into retirement or near- retirement years, the nursing profession as a group is rapidly aging. The average nurse in this country is 42 years old, and it's an average that is rising constantly.

This growing labor crunch is exacerbated by the fact that the pool of nurses is distributed in a different manner than it used to be. Last year for the first time, more nurses worked outside of hospitals than inside. The reason has to do with quality-of-life issues, which in today's world are often as important as money in attracting and retaining employees.

Hospital nursing is very difficult work. Hospitals by nature are seven-day-a-week, 24-hour-a-day operations, requiring nursing coverage around the clock. Hospital nursing also usually includes fair amounts of overtime, adding to unpredictability in nurses' lives.

Because managed care restrictions send marginally ill people home to recover, the patients who remain in hospitals have a much higher degree of acuity than in the past, making caregiving more arduous. Patients are not only more ill, but sometimes more informed, demanding and suspicious. Patients and their families have been encouraged by media to be wary of care, which often gets translated into significant demands on nursing time and attention.

Nurses get substantial demands from another direction, too. Physicians, themselves pressed by the exigencies of a changing health care environment, sometimes are quite exacting with their nursing colleagues.

In the end, we have a vicious circle. Because the work is hard and demanding, and fewer nurses are being produced, the pool of nurses is shrinking. That makes the job even more frustrating and less satisfying. And round and round we go.

For all these reasons, many nurses choose not to even get on the merry-go-round, while others are jumping off. Hospital nurses are seeking and accepting opportunities to work in physician offices, surgery centers and insurance offices. Away from a hospital setting, nursing schedules are more predictable and work pressures are less.

Given the growing crisis, what are some solutions?

Pay is probably part of the issue. Nurses in this country start at a salary of about $26,000, give or take a few thousand according to the community, the size of the hospital and the unit in which they'll be working. …