107 Congress/Report on the nursing shortage

  1. The actual report is 23 pages long.107th Congress
    'Maldistribution' of Nurses is More Likely Than Actual Shortage, Report Says
    A maldistribution of labor, rather than an actual shortage, is pinpointed as the likely culprit behind the nation's nurse staffing crisis by a new Congressional Research Service (CRS) report* (PDF).

    The report, which was released to Congress May 18, noted that available labor market indicators do not indicate "conclusively" that there is "an across-the-board shortage of RNs at the present time." The document further blames "poor personnel decisions" for any spot shortages of nurses that have occurred, rather than a simple lack of available nurse recruits.

    However, the report also warns that facilities could face a shortage of nurses by 2010 if "ameliorative actions" are not undertaken.

    Highlighting Health Resources & Services Administration (HRSA) data, the report notes that graduations from nursing education programs will increase between 1998 and 2020 by 13%, compared to 10% between 1976 and 1998. But the report also cautions that while the percentage of nursing education graduations will continue to "increase steadily," by 2020, "assuming no preemptive steps have been taken, the demand for RNs could exceed supply by 20%."

    ANA has long supported many of the remedies the report suggests, including increasing wages, improving working conditions and lowering education costs.

    Several of these remedies have been incorporated in the Nursing Employment and Education Development (NEED) Act (S 721) and the Nurse Reinvestment Act (S 706 and HR1436), which the ANA worked on closely with members of Congress.

    ANA also is working with health care leaders in the Senate and the House on a bill to ban the use of mandatory overtime, along with other number of workforce and staffing initiatives.

    Can you believe this....you work in the field, what do you think?

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  2. 10 Comments

  3. by   essarge
    . This is the site that the report can be found. Sorry, forgot to put it in the post.

    http://www.nursingworld.org/gova/fed...s/107/gcrs.htm
  4. by   Jenny P
    Essarge, after wanting to be a nurse from the age of 8 on, then working through high school and nursing school in order to fulfill that dream, I have been a nurse for 32 years and am growing tired of being the indentured servant that my hospital has made me these past few years.
    Working nights because the hospital could not grant me the schedule my family needed; being told that I could not get summer vacation (when I'd been here 20 years!) because someone else had put in their vacation request the day before (both of us requesting vacation 6 months in advance- to the day); working every other weekend and holiday for all these years; being told that we have to work short staffed AGAIN!; having your hospital make a ridiculous offer for salary and ignore patient safety issues at this time; these past 2 -3 years have really taken the joy out of the workplace for me.
    There IS a maldistribution; but until hospitals and health care corporations realize that the center of health care is the patient; more and more nurses will be leaving the bedside as the work becomes harder and harder to do. I have been seriously considering leaving the profession myself lately.
    Education, experience, skill, loyalty, and dedication are no longer valuable commodities in the health care industry. It seems that only the Almighty buck in the CEO's and upper management's pockets is the important force these days. And forget the poor sap that is sick and needs care-- just because he pays money for insurance, he thinks he should be able to be treated with expensive medical devices that the hospital administration doesn't want to fork out the money for!
    I'm being very cynical here because I feel that maybe we nurses are just as much to blame for these current problems as the money hungry managed care corporations are. We just didn't know what road we were travelling down until it was too late.
    For the past several years, we kept trying to stretch ourselves to cover whatever shortage there was in the workplace. Housekeeping can't get to the unit to clean a room before the patient would arrive? -We'd clean it.
    Dietary wasn't around after 7PM, so there wasn't any food for the patient who was admitted at 10PM? -We'd find food that would satisfy the patient.
    Pharmacy or materials couldn't deliver needed meds or supplies in a timely manner? -We'd rn and get it.... And so on.
    Then, when staffing was cut, we ignored the beginning of the problem by just knuckling down and working a little harder that day without complaints. And when upper management saw we got along without the "extra nurses"; why, they never bothered to fill the slots that started to open up-- we could just learn to "work smarter" instead. Now we are in a critical nursing shortage; and we don't know what to do about it.
    I think Congress can study the problem all they want; but it boils down to the fact that many nurses are leaving the profession; not enough are coming into it; and hospitals don't want to pay the ones that stay.
  5. by   oramar
    Jenny P, thumbs up to your reply. As usual a nurse in the trenches hits it right on the money. I know now that I was part of the problem. I saw what was happening but it was not until the last year or two that I began to protest. Managment was digging my grave and I was assisting them. How, by just doing more and more to compensate for all the deficiencies. Why? Because that was what I had always done. Used my own body and mind to make up for what ever deficiencies that exsisted to protect the patients. It resulted in a complete colaspe of my physical and mental self. Somehow I think there was a relationship between me and my employers that resembled that state of mind that an abused woman gets herself in when she protects her abuser. However, I must say that I did come to my senses eventually and take steps to save my own life. Lucky that deep down inside somewhere my own sense of self preservation kicked in.
  6. by   P_RN
    Dead on target Jenny P.

    EsSarge thanks for the report. I question there is not a shortage, the places are short, but if they want to politicize the jargon I guess maldistribution is as good as any. What I want is for someone to question REAL NURSES and actually get the real info out to the country at large. Yes, I have run to the Pharmacy etc, but not for the fun of it. I did it for my patients.....but then I guess that enabled the powers that be to assume we "wanted" that.
  7. by   -jt
    "but it boils down to the fact that many nurses are leaving the profession; not enough are coming into it; and hospitals don't want to pay the ones that stay. "

    and thats what the report is saying too - plus it blames the administrators for creating the situation. This report is discussed more in another thread on this BB.

    (Jenny, you hit the nail on the head.)
  8. by   -jt
    'Maldistribution' of Nurses is More Likely Than Actual Shortage, Report Says
    A maldistribution of labor, rather than an actual shortage, is pinpointed as the likely culprit behind the nation's nurse staffing crisis by a new Congressional Research Service (CRS) report*


    Essarge, yes absolutely correct! I can believe it - because its what we nurses in the trenches have been saying for a long time - there is not a shortage of availbale nurses in the country. Only a shortage of nurses who are willing to work in hospitals & LTC under the conditions they have today. The report proves that hospitals are not telling the truth when they say "there just are no nurses to be found". There ARE licensed nurses available - 500,000 of them did not work as nurses last yr - so it IS a maldistribution. Why are people so upset by the term? There is no lack of RNs in this country at this time. They just are choosing to work in other places & not in the hospitals. That is a "maldistribution" & the report blames it on poor management practices (like mandatory overtime, etc) that drive nurses away. The report is saying that the nursing "shortage" has been manufactured by the hospital administrators & much of it can be alleviated if a % of those 500,000 RNs could be brought back to the bedside by giving us what we need (better salaries, better conditions, no MOT, safer equipment, etc). The American Hospital Association is still trying to avoid that by convincing the public that there just are no nurses for them. The report proves that there are nurses - the hospitals just dont want to spend what it will take to get them to the bedside. So the nurses go to work in something else & the maldistribution of nurses perpetuates.
  9. by   rncountry
    Thank you for posting this. I printed it out and I am going to send it to someone that may be able to do something with it to get it out in front of the public. I agree with jt. What is going on with nurses has been created by those with more interest in dollars than in patient care. There are 18.3% of RNs that are licensed but not working as nurses at all. I don't mean as bedside nurses, but not in the profession. That is a fairly high number of professionals that took the time to go get their degree's and take boards to decide not to do anything with it.
    More and more is happening, we just have to keep pushing.
  10. by   oramar
    Me again. I read the whole report twice and can't see anywhere that some steps for bringing people back who are not using there licenses are outlined. The report does lay the blame at the doorstep of managment for the shortage but the recommendations for dealing with it included bringing in more foreign nurses and useing techs. She just sort of says that a lot baby boomers will retired soon and that will make the situtation worse. There is almost a good by don't let the door hit you in the ass attitutde in medicine towards older nurses and I sense it in this report also. Nursing Spectrum Mag has an excellent article that discusses how to keep older nurses at the bedside. Why are no recommendation to this effect made in this article?
  11. by   NRSKarenRN
    Congressional reports are goverment requested fact gathering reports issued on a given subject: to document verbal reports of a nursing shortage. They weren't looking for answers.

    See the post re nursing shortage and solutions: http://allnurses.com/bb/cgi/ultimate...&f=93&t=000029
    Has some good suggestions proposed by national educational and administrative RN's.


    WHEN CARE BECOMES A BURDEN:
    Diminishing Access to Adequate Nursing
    By Claire M. Fagin http://www.milbank.org/010216fagin.html

    EXECUTIVE SUMMARY

    This report synthesizes research studies, recent journalism, and the author's personal experience to address the problem of the increasing burden of care placed on nurses, patients, and families. The author drew the following conclusions from this work:

    The burden of care for nurses, patients, and families has demonstrably increased since 1990.
    Pressures on families are particularly severe when a patient has been sent home from the hospital after a shortened stay or has received outpatient care for problems that were formerly dealt with in hospitals.
    There is considerable evidence that nurses and families are very concerned about the erosion of care and fearful about hospital safety.
    Nurses report increasing dissatisfaction with their work in hospitals that have cut staff, that require frequent overtime, and that have replaced nurses with assistive personnel. Research has shown that these phenomena are related to adverse nurse and patient outcomes.
    The supply of nurses is tightening, and a severe shortage will occur should present conditions persist. Supply is tightening because the nursing workforce is aging, and the number of students enrolling in nursing programs in 1999 declined for the fifth straight year. Moreover, there is currently a shortage of faculty in nursing schools, leading to an inability to accept enough qualified and interested students. In addition, the average age of full-time nursing faculty has increased. The graying of the nursing workforce, coupled with the declines in enrollment in nursing schools, makes a serious shortage inevitable.
    Experts in nursing reviewed a draft of the analytic section of this report. These experts then convened in conference calls to answer the major question raised by the analysis in this report: What can be done to alleviate the actual or potential harm to patients as a result of lack of access to adequate nursing care?

    The experts' recommendations for policy initiatives designed to prevent harm by improving patients' access to nursing care fell into six broad categories:

    Regulation and licensing
    Financing
    Organization of nursing services in hospitals
    Role of governing boards
    Recruiting and educating nurses
    The experts addressed their recommendations to a variety of audiences. The principal audiences for the recommended strategies are within the health care sector and include administrators of health services, physicians, nurses themselves, and hospital trustees as well as members of state boards of nursing. Other important audiences are state legislators and members of the U.S. Congress, public- and private-sector collective purchasers of health services, leaders of education in nursing and medicine, foundation executives, and officials of the federal agencies that subsidize higher education for the health professions as well as clinical and health services research. Some of the recommendations may also be of interest to journalists.

    The experts' recommendations for action in the six categories can be found on pages 27–31.
  12. by   Norbert Holz
    God Help you if you ever make what is percieved by administration as a mistake! You'll be put on the "DO NOT USE LIST!" That means even if you are willing to work - you can't work there FOREVER!

    The "monday morning quarterbacks" in administration have looked over my work and decided that my solution to the patient's problems - no matter how satisfactory they were to the patient - or how "less harmful" they were given the circumstances at the time were not the "most desireable ones." We now disagree with you and because we are your superiors will BLACK BALL YOU!

    I must rely on my clinical judgement of the entire situation and complete circumstances at the time I am careing for my patients. I once thought that was why I was there working. Not so! I'm merely there to blindly follow the illegible orders, policy and procidures and perform the other "additional duties" delegated to me by the true professionals in housekeeping, dietary, and pharmacy!

    Shortage!!!!!!!!!!!!!!!!! MALDISTRIBUTION???????????????
    Not really, just administrators who truthfully do not give a rats a** about the "professional" nurse.

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