States Tackle the Nursing Shortage: The Lack of Qualified Nurses Is Reaching Epidemic Proportions. States, Universities and Hospitals All Are Trying to Do Something about It
Goodwin, Kristine, State Legislatures
It's an impending disaster that may, ultimately, touch the lives of everyone. The growing shortage of qualified nurses has already hit some states and threatens just about everyone in the coming years.
Today, America's hospitals have 126,000 unfilled nursing positions, and that number is expected to rise to 400,000 by 2020, according to an August report from the Joint commission on Accreditation of Healthcare Organizations. "It's critical, not only in our state, but in the whole country," says Maryland Delegate Marilyn Goldwater, a registered nurse.
The shortages have been blamed on demographics, hospital restructuring in the 1990s and a waning interest in nursing as a career.
Going up against demographics is no easy battle as public and private players try to find ways to entice more bright minds to join the nursing ranks and change the culture that some say has driven them away.
And bright young people are needed. The average age of nurses is 45.2, and there aren't enough new nursing school graduates to replace those who will soon retire. Add to this the fact that the U.S. population is getting older (the 65 and older numbers are expected to double in the next 30 years), which means greater need for medical care and nursing.
To make matters worse, many states are struggling with budget shortfalls--situations that further challenge legislators to favor low or no-cost solutions. The bleak budget picture "has hampered us," Goldwater says. "There are lots of things we'd like to do, but can't because of a lack of resources."
At the heart of the problem, say many, are concerns over difficult working conditions and a general lack of respect. In addition to taking care of more and sicker patients, nurses point to such issues as mandatory overtime, disrespect from patients and doctors, an ill-defined promotion ladder, arid other practices as evidence of a culture that doesn't value them.
GETTING AT THE PROBLEM
There are myriad ideas for correcting the problem. Although "this is no simple problem," Pam Thompson, CEO of the American Organization of Nurse Executives, says it is best addressed as a system. We need to focus on all the system's parts, says Thompson, like improving the work environment, bringing enough young people into the profession--and making sure that there are enough faculty to teach them--and changing the way providers deliver care, among others.
For their part, states have enacted a broad range of legislative plans to ad dress the problem. In their arsenal: forgiving loans in exchange for working in a shortage area, boosting the capacity of state schools to admit and train nurses, and collecting data to aid in state and regional workforce planning, to name a few.
IMPROVING WORK CONDITIONS
Recent studies suggest that nurses are not satisfied in their jobs. About 30 percent of nurses say they are dissatisfied in their current position, according to the 2000 National Sample Survey of Registered Nurses. This is higher than levels seen in other kinds of jobs. Nurses working in hospitals and nursing homes have an even lower job satisfaction than all nurses.
A 2001 American Nurses Association survey of nurses found that 75 percent of those surveyed believed that the quality of nursing where they work had declined in the past two years, and 56 percent said that the time they have for patients has decreased.
Senator Bob Hagedorn in Colorado sees working conditions, and specifically, forced overtime as "the single most important issue here." Six states have enacted legislation to prohibit or limit mandatory overtime. Policies like mandatory overtime, argues Hagedorn, turn young people who are considering having a family away from the nursing profession, Mandatory overtime "does not work if a parent wants to be home with small kids. Something has to be done," Hagedorn says. …