By NurseZone Staff Writer
Dire predictions that a severe nursing shortage would cripple the nation’s healthcare system are nothing new. For years nursing leaders have claimed that without immediate intervention by the government and the healthcare industry itself, the decline in nursing staffing levels would be irreversible.
But with 78 million baby boomers facing retirement in the next decade, according to the Journal of the American Medical Association, the predictions of a nursing shortage are serious enough to get the attention of those in the healthcare industry, the U.S. Congress, and even leaders in the White House. Lawmakers and industry leaders have sounded the alarm. But is help on the way for our nation’s nurses?
Recent Report Makes Recommendations to Combat “New” Nursing Shortage
A recent study cites a combination of factors responsible for this current nursing shortage, including the aging nursing population, the aging of nurse educators, a declining number of nursing students and the need for improved working conditions for nurses. “Strategies to Reverse the New Nursing Shortage”—published by the Tri-Council, which comprises the American Colleges of Nursing, The American Nurses Association, The American Organization of Nurse Executives and the National League for Nursing—claims that changes in local customs, Medicare and Medicaid reimbursement and health delivery systems have led to an increased demand for healthcare services—a demand that cannot possibly be met without more qualified nurses. Nancy Langton, PhD, RN, president of the National League for Nursing, said that the overall requirement for nurses will continue to increase as the general population ages and treatment for chronic disease conditions increases.
The Tri-Council suggests changes aimed at motivating nurses to seek higher education through career progression initiatives; compensation tied to education; the promotion of staff development programs; and improvements in nurses’ working conditions, such as flexible scheduling programs.
Senate Subcommittee Hearings
Rep. Lois Capps, D-Calif., recently testified on the nursing crisis before the Senate Health, Education, Labor and Pensions Subcommittee on Aging. Capps, one of three nurses currently serving in the U.S. Congress, told the subcommittee that the nursing shortage must be given the same—if not more—attention as other high-profile healthcare concerns.
“Most of the public debate on health care surrounds issues like prescription drugs, a patient’s bill of rights, Medicare reform and the uninsured,” said Capps. “All of these are very important issues, but resolving them won’t do us any good if hospitals don’t have enough nurses to give quality care.”
While this current nursing shortage is seen by many as a simple case of demand overwhelming supply, there are other elements at work. The aging of the nursing population means that too few men and women are entering the workforce to offset the growing number of retiring nurses. A shortage of nurses also means a shortage of nurse educators available to train—and perhaps more importantly, recruit—young students looking for a future in healthcare. And the age-old perception that nursing is “women’s work” still exists, despite the fact that some of the doctors and administrators at many major healthcare facilities are also women.
To combat the “women’s work” stigma the healthcare industry needs to reach out to more men and minorities, Capps said. Currently less than 6 percent of the nurses are men and only 10 percent are minorities, despite the rise in the percentage of minorities in other occupations to nearly 25 percent. Capps said that the recruitment of nurses should begin at the high school level as students begin to choose their career paths.
The Department of Health and Human Services reported that there were approximately 2.7 million registered nurses in March 2000, but the increase in nurses from 1996 to 2000 was the smallest ever reported, according to a report by the department’s Bureau of Health Professions.
Meanwhile, the average age of registered nurses continued to rise, from 44.5 in 1996 to 45.2 in 2000. And the population of nurses under 30 years old dropped from more than 25 percent in 1996 to slightly above 9 percent in 2000.
“In my home state of California, the problem is even worse,” the congresswoman said. “Less than 10 percent of the RN workforce back home is under the age of 30 and nearly a third are over the age of 50.” California ranks 50th among the states in RNs per 100,000 people.
Capps told the subcommittee that some of the solutions to the nursing shortage can be addressed in the Congress. She supports legislation that improves access to nursing education, creates partnerships between healthcare providers and educational institutions and improves the collection and analysis of data about the nursing workforce. Capps also proposed increased funding for Title VIII programs, minority scholarships and loan repayment programs. She also proposed exempting nursing students from taxation on any federal assistance they receive for their education.
“My legislation [would] also provide for grants to develop public-private partnerships between hospitals, nursing schools and high schools interested in health training programs for young people,” Capps told the subcommittee.
And the nursing shortage hasn’t gone unnoticed by the White House. The shortage was acknowledged in the annual budget President Bush proposed to Congress in February. The president recommends focusing resources on the health professions’ grants that address workforce challenges such as the nursing shortage as well as improving diversity in healthcare professions.
Joint Commission Implements Pilot Program
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) recently announced a pilot program that screens healthcare organizations for potential staffing problems based on patient outcomes. While JCAHO standards require accredited healthcare facilities to staff appropriately to meet patients’ needs, many nurses still deal with understaffing, mandatory overtime and increased patient loads.
The program, which will begin in summer 2001, will determine the number and qualifications of the staff an organization hires based on patient census and acuity, correlating performance indicators such as patient falls and medication errors with human resources measures such as staff overtime, vacancy rates and patient or staff complaints.
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