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
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
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.