Magazine article Workforce Management

Treating the Nurse Shortage

Magazine article Workforce Management

Treating the Nurse Shortage

Article excerpt


Profession calls for a homegrown cure, not boosting visas for foreign talent

Erin McKeon still fumes when she remembers her initial reaction last spring to an amendment to the U.S. Senate immigration bill and its solution for the U.S. nursing shortage.

The amendment, proposed by Sen. Sam Brownback, R-Kansas, as part of the Comprehensive Immigration Reform Bill, lifted the annual cap on visas for qualified foreign nurses. The amendment was overlooked by those who were focusing instead on such hot-button issues as border protection. But it certainly didn't escape the notice of McKeon, associate director of government affairs for the American Nurses Association.

"We completely opposed it," McKeon says of the nursing organization's stand. "Immigration has been tried before as an answer to the nursing shortage and it has failed. We've gone down this path before and we don't want to do it again. Cynicism tells me the reason Congress is looking at this is because it is cheap."

The goal, she and others say, should be to generate a homegrown solution to the shortage, not to rely on foreign-born nurses as a quick fix for the problem.

But those who favor lifting the visa cap for nurses-including the American Hospital Association-view it as a viable short-term remedy as more permanent strategies, such as increasing nursing school faculty, are gradually implemented.

Both sides agree on one point: While the immigration bill is viewed by many as moribund, the nursing shortage is alive and well and won't be fixed any time soon. It will only deepen, perhaps reaching a deficit of more than 1 million positions by 2020, according to estimates from the Health Resources and Services Administration.

And the nursing shortage won't just impact health care industry employers, experts warn. The lack of nurses could eventually affect all employers, either directly or indirectly, McKeon and others say.

"Waiting times in the emergency rooms are getting longer," says Beth Brooks, a senior partner at JWT Employment Communications, a global recruitment, marketing and internal communications agency specializing in health care. The nursing shortage is affecting or will affect ambulatory care, longterm care and doctors' offices, she says. Sooner or later, nearly every employer will probably have workers affected by the shortage. "Nursing units are being closed," Brooks says. "In parts of the country, emergency rooms are going on diversion, sending patients to other hospitals. Elective procedures are being canceled or delayed indefinitely."

While she isn't aware of any study linking the shortage of nurses and its effect on health care with lower worker productivity or higher absenteeism, the potential for that effect is obvious.

Currently, 118,000 registered nurses are needed to fill vacancies in U.S. hospitals, according to a report released by the American Hospital Association in April. Shortages at nursing homes also are significant, according to a survey of 6,000 facilities in 2002 by the American Health Care Association. It found 15 percent of staff RN positions were vacant, and that nearly 14,000 RNs would be needed to BlI those vacancies.

From 2004 to 2014, the U.S. health care system will need more than 1.2 million new nurses, according to a 2005 Bureau of Labor Statistics report. Recruiting new nurses was viewed as more difficult in 2004 than in 2003 by 40 percent of hospitals surveyed in an American Hospital Association 2005 workforce survey.


The shortage is fueled by a number of factors, including an aging nurse population, a shortage of faculty at nursing schools and a burgeoning population of baby boomers needing more health care, including skilled nursing services.

"Some nurses are retiring earlier," McKeon notes, and applications to nursing schools began to drop in the early to mid-1990s. "At that time, hospitals were laying off nurses," she says, "and it was not seen as the best career choice. …

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