Condition: Critical; Long Hours, Burnoutcontribute to Nursing Shortage in hospitals.(PAGE ONE)(SPECIAL REPORT)
Byline: Joyce Howard Price, THE WASHINGTON TIMES
Hospitals competing for registered nurses amid a nationwide shortage are offering inducements ranging from signing bonuses - some as high as $15,000 on top of $60,000 starting salaries - to free child care and a free continuing education.
One advertisement in a nursing trade publication offered a new car for any nurse who agreed to work for at least two years.
Patricia S. Yoder-Wise, first vice president of the American Nurses Association, said such an enticement isn't a wise investment for hospitals.
"When the two years are up, the nurse will take the car, leave the hospital" and find another job with better perks, Ms. Yoder-Wise said.
Still, she recognizes that hospitals are desperate to recruit and retain nurses. In fact, some hospitals have begun offering $1,000 to $3,000 "retention bonuses."
"The nursing shortage is pretty dramatic, it's probably the worst we've ever seen," and no one expects it to ease anytime soon, Ms. Yoder-Wise said.
National surveys, including one by the American Hospital Association, indicate hospitals are averaging 11 percent to 14 percent vacancy rates in nursing positions, about 120,000 vacancies nationwide. The federal government predicts the number of vacancies will surpass 800,000 by 2020.
"The projected shortage in 2020 results from a projected 40 percent increase in demand between 2000 and 2020, compared to a projected 6 percent growth in supply," said a report released last summer by various agencies of the U.S. Department of Health and Human Services.
Nurses and physicians say hospital nurse staffing levels are already inadequate for safe and effective care, says a University of Pennsylvania study recently published in the Journal of the American Medical Association.
It found that the "difference from 4 to 6 patients and from 4 to 8 patients per nurse would be accompanied by 14 percent and 31 percent increases in mortality, respectively."
Key factors in the shortfall, health officials say, are the aging of the nursing population and professional "burnout." Many nurses are reaching retirement, as are faculty members in nursing schools, and not enough people are replacing them. Enrollments in nursing schools are down, and some schools are closing.
"Hospital nursing is heavy sledding. It's very hard work. It's a 24/7 operation," said Molly Billingsley, assistant vice president for operations support at Georgetown University Hospital.
"Nurses have to give up parts of their lives that lawyers, accountants and those in other professions don't have to," said Mrs. Billingsley, whose division is responsible for nurse recruiting.
In New York, thousands of registered nurses don't use their licenses because of working conditions, said Anne Schott, spokeswoman for the New York State Nurses Association.
Miss Schott said nurse retention would improve greatly if hospitals didn't overwork the ones they had, especially by forcing them to work overtime shifts without prior notification.
"The use of overtime as a staffing shortage 'solution' is pervasive. On average, nurses work an extra eight-and-a-half weeks of overtime per year," said a report by the Joint Commission on Accreditation of Healthcare Organizations.
Fed up with overtime and night and weekend work, many nurses have left the rigors of direct patient care services in hospitals and nursing homes for less-demanding nursing career options.
Leaving the hospital
Seeking "more regular hours, many nurses now work for managed care plans and insurance companies, pharmaceutical firms, health care technology and medical device vendors, and consulting firms, among others," said the joint commission report released in September.
"Years ago, most women [looking for jobs outside the home] either became teachers or nurses, but today they have so many other options," said Gaurdia Banister, vice president of nursing at the 408-bed Providence Hospital in Northeast Washington. …