Addressing the Predicted Nursing Shortage - page 6

allnurses.com staffers were recently fortunate to interview Audrey Wirth, MSN, RN-BC, CVRN-BC adjunct clinical instructor at Aurora University's School of Nursing and Allied Health. She has published... Read More

  1. by   ruby_jane
    Agree with the previous posters that what we have is a shortage of well-trained nurses who want to work with 1:7 patient ratios in Med-surg.

    We also have a substantial shortage of programs that adequately provide the hands on training that BSN-prepared nurses need in the field. Why? Because some of us (like me) went through an accelerated program that skimped on clinical hours. When we did clinicals, our school was in competition with two other schools graduating their nurses with BSNs, two graduating their nurses with ADNs, and two LVN schools. The preceptoring nurses were literally nursing student weary.

    Finally, we have a shortage of hospitals willing to invest the time it takes to train a new nurse how to operate. Part of that training is that new nurses make mistakes; most minor, some not so minor. When the culture of nursing at the hospital level changes from its current punitive state, the first problem may be resolved.
  2. by   LibraSunCNM
    Quote from Kooky Korky
    Old fashioned here

    Hospitals could go back to the old diploma style of nurses' training. A hospital ran a school of Nursing, the
    students got lots of hands-on experience in the various specialties, and many of them hired on after graduation.
    There were 3 year programs, later shortened to 2. I think there are only a couple of diploma schools left in the
    US, if any.

    I was a diploma grad, got my BSN a couple of years later, many years later got the MSN.

    The BSN did help me learn to do physical exam but only working at the bedside helped me hone my skills, time
    management abilities, leadership, and clinical knowledge.

    My employer paid for most of my tuition and gave me a raise once I had the BSN. It was quite novel at the
    time.
    Hospitals *could* go back to that "old" style of training, but there is no financial incentive for them to do so, so I wouldn't hold your breath.
  3. by   OldDude
    Just something I've often thought about; I haven't ever heard of this but...has anyone ever heard of a hospital not accepting a patient as a result of the "nursing shortage?"
  4. by   Daisy4RN
    Quote from OldDude
    Just something I've often thought about; I haven't ever heard of this but...has anyone ever heard of a hospital not accepting a patient as a result of the "nursing shortage?"
    No, its been my experience that admin will just figure out who to discharge so they can admit. This of course puts more time restraints/stress on the bedside nurse to hurry and get the patient out so you can take another one, thus a dc and admit while trying to take care of your other patients.
  5. by   lindahartford
    I totally agree that the loss of nurses is due to lack of support for new nurses and that hospital policies need to give practical bedside nursing experience before pushing them into ICU situations with poor nurse-patient ratios and little teaching available.

    When I was in my old-fashioned RN program I was taught the best nursing practices, not by my instructors but by the Head Nurses who insisted I learn them.

    When I was a young Head Nurse when of my responsibilities was to continue the training of our new nurses. Now, I see none of that. Young nurses are put into ICUs and expected to perform as if book learning is all that is needed. These youngsters are frustrated and retiring out of survival. They are in fear of making a deadly mistake and having it on their conscience for life. They work long hours and with poor nurse-patient ratios.

    Fix those things and nurses will do what they love for as long as I did.
    Last edit by lindahartford on Jan 11 : Reason: left stuff out that i wnated to say.
  6. by   lindahartford
    Hi Old Dude, you can call me Old Lady. After 53 years of nursing experience, 23 at bedside and 30 in HOme Health I agree completely that young nurses are thrown into ICU and situations over their heads with reckless abandon by hospitaladministrators.

    No patient will be turned down, providing they have some sort of insurance and hospital administra tion will rely on increased productivity by its nurses. This just means they will have more work and no relief wil incresed wages or benefits. The hospitals all expect more and more work from us for less and less consideration.
  7. by   lindahartford
    You are so right. We older nurses had the great advantage of extensive bedside experience. These young grads are taught that their BSN is everything. No wonder without support to get bedside experience these new grads are dropping out in droves.

    More respect for the vital work of bedside nurses would be a great help as well.
  8. by   lindahartford
    1:7 ? Wow! I was once hired onto an orthopedic unit with the promise of no more than 4 patients a day.

    In fact, I never had less than 8 and on weekends as many as 10. Besides that, due to outlandishly poor infection control, 2-3 of these patients were on Individual Precautions. Even at that I had to beg doctors to put on gloves for wound care or get them to at least wash their hands between infected patients.

    It was scary personnally, exhausting and frustrating. The worst 6 months of my 53 years of practice.
  9. by   CaffeinePOQ4HPRN
    Quote from OldDude
    Just something I've often thought about; I haven't ever heard of this but...has anyone ever heard of a hospital not accepting a patient as a result of the "nursing shortage?"
    Not in Canada. Our coveted "universal healthcare" system is good, but not the unicorn everyone seems to think it is. In the acute care hospital where I worked, some units were consistently over-capacity. For example, ALC and rehab were at 120-135% capacity on-and-off for years. The hospitals here literally admit patients to the hallways if we run out of space in rooms. To address all the (valid) upset patients/families were voicing the hospital CEO issued a letter for nurses to pass out to anyone with an inquiry that just glossed over their PR-friendly reason for compromising patient privacy and safety by stacking bodies wherever they can. Sigh.
    Last edit by CaffeinePOQ4HPRN on Jan 11
  10. by   morelostthanfound
    From my perspective, this problem was heralded in when modern healthcare organizations began assuming a corporate business model. This model, regardless if it's McDonalds, Boeing, or Holy Cross Hospital that we're talking about, dictates increasing production while holding (or trimming) operating costs. It effectively eliminates any humanism, compassion, or charity, and strictly adheres to the 'bottom line'-i.e.$$$. How does this translate for health care? It has been my experience, that it manifest as the revolving door for staff, critical nursing shortages, and often, marginal or unsafe patient care. I'm not knowledgeable enough to know if this changing paradigm was necessary to allow these enterprises to remain competitive amidst increasing market pressures, or instead, was to appease shareholders and/or the often bloated senior administrations. Like OldDude RN, I remember when hospitals had far better benefits: Christmas bonuses, significant cafeteria discount, pensions, good medical/dental...in addition to reasonable expectations of their nurses. As others have suggested, who wants to enter a profession to be overworked, poorly compensated, and treated like a commodity? In a nutshell, I think this is the problem
  11. by   AutumnApple
    It's odd to me how the "Does the BSN make you a better bedside nurse?" debate always comes up when shortages and/or education are discussed.

    It's the wrong question to ask. Even if you have a valid, well researched answer to the question (few do, we just pick the answer the suits our personal preferences) it's not applicable. The goal of furthering our education is not to insert IV's more quickly or document better. It's about being in a better position to further nursing away from the bedside.

    It's like being a pizza delivery person, taking safe driving courses and then complaining that "This didn't help me bake pizzas any faster." It wasn't designed to do that anyway so................sorry for you not connecting the dots and all.

    I got my BSN to be more employable. I followed an educational pathway that didn't make me bankrupt. Along the way, in part due to my education, I became more aware of the bigger picture *away from the bedside*. Sure, a lot of the classes seemed to be boiling over with "filler" intended to justify course credit requirements. The classes were not completely barren of value though.
    Last edit by AutumnApple on Jan 13
  12. by   AutumnApple
    Forgot to add (and this is the topic anyway): Signs of a shortage are in full bloom in my area.

    Sign on bonuses are back, travel agencies that know me from my days of travel nursing are contacting me again (I went years without hearing a whisper from them, not I get weekly emails), facilities (hospitals in particular) are getting creative with reimbursement...............

    For example, I am looking to move into a nicer apartment. There are five apartment complexes in the area of my hospital that offer reduced rent to hospital employees. This sort of thing was not available two years ago.

    When I graduated, most facilities put heavy emphasis on retaining nurses. That went away for a long time due to the recession. It seems to be back now. That's just my observations though.
  13. by   SpankedInPittsburgh
    Yeah, despite my criticisms of BSN programs for their low quality and downright silliness at times I think that if nurses are going to be considered "professionals" they must have and educational qualification that folks will respect. Simply put, my 13 months at Community College won't fulfill that. So what do we do? First, I think we have to make it worth it for the individual nurse economically. Now it's not if a nurse can invest $10K at a community college to get hired at a $60K job why would she invest $150K. That makes no sense economically and I would never advise that. Perhaps BSN trained nurses should get a robust bump in pay or the places they work should make significant contributions to their efforts. The whole "you are going to have to have a BSN to be a nurse" argument rings hollow. My ex was a nurse and I remember her telling me that nonsense back in 1983. A close second is more regulation and standardization of BSN programs. Lets face it many of these programs are a joke. Stop with the group projects involving silly topics and arts & crafts. They are simply time killers and fillers for lazy professors who want to eat up class time so they don't have to teach. In short we have to make the BSN something it is not & that's economically valuable, important to a career that proportionate to time and money invested, educationally pertinent and interesting and many other things that it is not now. We need to stop pretending that what we have now is as it should be or even close.

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