It would be good to see more numbers out there about exactly what the lack of filled nursing and CNA positions actually reflect. How many qualified applicants were there at the facility and how many got interviewed and offered employment? What is the employee turnover like? What are the working conditions and how many qualified people would choose to not even apply there because of the conditions?
I do honestly believe that hospitals could get away with paying less for licensed nursing staff if the working conditions were better. Those nurses who don't mind the crazy conditions are reaping the profits working for high wages (travelers in particular), but overall nursing is losing out.
And while I can understand the push for bachelors' degree training for nurses, it does seem impractical given the sheer number of nurses needed. Yes, it does push the wage up, since those with more training will demand higher salary, but that also encourages hospitals to find ways to cut those expensive nursing positions.
Maybe we ought to stick to more vocational training for the majority of staff and encourage bachelors' for advancement beyond floor staff and have that extra training include a good deal of focus on management issues that nurses tend to have not had much exposure to.
Much of the same relates to CNAs. Instead of raising hourly wages to entice folks to work in otherwise unbearable conditions (overload), keep the wage lower, but make the working conditions enviable. Lots of continuing education for the staff, encouragement to advance in the field (eg flexible scheduling, assistance with school fees), and work conditions that allow the staff to feel they are making a difference and doing quality work.
That still takes money. So we also need more info about the bottom line of the healthcare business. We always hear that they are losing money, but then we hear all about these scandals, cooked books, and overpaid CEOs. We need more hard facts about the primary employers of nurses.
Finally, there are the legal issues that often create other expenses, from outrageous settlement fees to the cost of rigorous documentation. Certainly, no one wants to allow unsafe practice, but we need carefully examine all those safety (state mandates, etc) measures and ensure that they aren't unnecessarily contraining quality service while trying to ensure quality.