Nursing News

Other Health Care Personnel Shortages Affect Nurses, Patient Care

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By Jennifer Larson, NurseZone feature writer 

A 2000 study released by the federal Health and Human Services’ Bureau of Health Professions noted the following: “Consequences of the shortage include a negative impact upon the profession and the public resulting in…job stress, inadequate working conditions, and reduced professional satisfaction due to longer working hours and lesser flexibility in scheduling, and introducing fatigue-related factors that increase the potential for medication error.”

Sound familiar? All of these factors are oft-cited effects of the nursing shortage, but this particular report referred to a shortage of another important group of health care workers: pharmacists.

The nursing shortage has become well-documented over the last few years. The American Hospital Association has reported that there are at least 125,000 nursing positions currently unfilled in U.S. hospitals. But other health care professions, like pharmacists and radiology technicians, are experiencing severe shortages, too. And those shortages can and do have a direct impact on nurses.

“It’s a critical issue,” said Cheryl Peterson, MSN, RN, of the American Nurses Association. Anytime you don’t have the full complement of providers and support personnel, it’s going to impact nursing.”

According to the 2000 HHS report, “The Pharmacist Workforce: A Study of the Supply and Demand for Pharmacists,” the 196,000 active pharmacists in 2000 represented the third largest health professional group in the nation. And while the profession did grow over the course of the 1990s, the demand for pharmaceutical services grew more rapidly. Some of the increase in demand has been attributed to the increased use of prescription medications, especially as the population has aged, along with the need for pharmacists to work at retail organizations.

What’s more, a recent report from Modern Healthcare, Peterson reported, showed that the turnover rate for some technicians is even higher than that of nurses. The turnover rate for nurses is around 18 percent, while radiology technicians’ turnover rate is closer to 25 percent.

The Charleston Gazette in West Virginia recently wrote that the shortage of radiology technicians may be the worst health care worker shortage of all in the United States. The U.S. Bureau of Labor estimates that the U.S. will need at least 75,000 more radiology techs by 2010.

The technology has expanded so rapidly in recent years that a shortage of techs means a shortage of people to conduct vital diagnostic tests such as ultrasounds, mammograms and CAT scans.

“We keep adding equipment, but who’s going to run it?” asked Peterson.

With vacancies adding up in hospitals, nurses are bound to feel the effects of the missing health care workers. The shortages, especially of pharmacists, makes it hard for nurses to deliver care as they have in the past, said Pam Thompson, executive director of the American Organization of Nurse Executives.

“It impacts the ability for efficiency of that care and the ability to have those colleagues available to consult with,” she said.

Health care is multidisciplinary, and everyone is affected by missing personnel, said Thompson, comparing staff vacancies to missing puzzle pieces.

When there aren’t enough pharmacists to go around, the delivery of medications can slow down. Without an adequate number of pharmacists to handle a hospital’s needs, nurses may find themselves waiting longer to obtain and administer medications to their patients. Pharmacy technicians can help, but they cannot replace the pharmacists.

Nurses should still be able to consult with pharmacists, despite the shortage, Thompson said.

“The question is, will they get [a consultation] as quickly as they would like to…so that care is delivered more quickly?” she asked.

A similar phenomenon can occur with a shortage of technicians.

“You’re missing some pretty critical members of the team,” Peterson said. “And the reality is, when you’re missing that member, the work doesn’t go away. You still have to have the patient’s blood drawn.”

The nurse may have to pick up the slack by doing more support tasks when other health care personnel are not available. This can slow down the delivery of patient care, and it may contribute to the already growing dissatisfaction that many nurses are expressing over their working conditions, Peterson said.

Also, patients can be affected by these personnel shortages. For example, with a shortage of radiology technicians, patients may have to wait longer for X-rays or procedures may take longer.

Thompson doesn’t forecast a slowdown in the shortage of hospital workers. Citing the aging Baby Boomers as one reason for the growing number of patients who will need to be treated, she also noted that there are not as many young people to fill the vacancies in hospital staffs.

The American Nurses Association is trying to express the need for better workforce planning across the board for the health care field, Peterson said.

“We’ve tried to broaden our language and say, “Look, nurses aren’t the only shortage; we’ve got shortages across the whole of the health care profession,’” she said. “We really need to be having a discussion on…the workforce.”

Thompson agreed, saying that the design of the delivery of care needs to be carefully examined to take these shortages’ causes and effects into account. Otherwise, the situation could continue to worsen.

“We need all the players on the team,” Peterson said.

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