Shortage of Nurses Hikes Health Costs

Article excerpt

An acute shortage of nurses in hospitals and nursing homes has added billions of dollars to the nation's escalating expenditures for health care.

Of the nation's 1.9 million registered nurses, the most ever, at least 1.5 million are currently working in the profession. But hospitals and nursing homes still need at least 150,000 more nurses.

Hospitals will spend $3.1 billion this year to recruit and train nurses, said Carolyne K. Davis, head of a federal commission that is studying the situation for the secretary of health and human services, Dr. Otis R. Bowen.

In Boston, where the shortage is especially acute, employment agencies are asking hospitals to pay commissions of $8,000 to $10,000 for each nurse hired. And Southern California hospitals are paying the equivalent of $85,000 a year for temporary nurses provided by employment agencies.

For the lack of nurses, many large hospitals, especially in large cities, have had to take beds temporarily out of service, forfeiting revenues. For example, the University of Michigan Hospitals system estimated that it had lost more than $2 million in net income since October after temporarily leaving 66 beds empty.

There have been cyclical nursing shortages for years. The last one, in 1979 and 1980, was remedied when nurses' pay scales were raised, on average, 13 percent. But experts say the current shortage will be harder to solve because of changes in the health care field.

As the federal system of paying pre-set fees for Medicare patients took effect in 1983 and 1984, hospital beds were left empty and some nurses were dismissed. The hiring soon resumed as hospitals cut payrolls, eliminating medical technicians and aides while seeking to maintain standards by giving additional duties to registered nurses.

As a result, hospitals are using more registered nurses - about 80 for each 100 patients - than ever before. Nurses are helping to operate high-technology devices and to monitor the increasing proportion of patients in intensive-care units.

Davis and other experts have proposed various remedies, starting with raises, flexible benefits and child-care services for nurses.

New York-area nurses won double-digit increases in recently signed contracts, raising starting pay to $29,000 - higher than that of police officers and firefighters. The national average for beginning nurses is about $22,000.

In the past, most nurses have not received the kinds of rewards for experience and education that teachers and other professionals have. …