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may 2004: an interview with ana president barbara blakeney
susan b. yox, rn, edd
in recognition of national nurses week 2004, i spoke with barbara blakeney, ms, aprn, bc, anp, president of the american nurses association (ana), asking her some of the questions i hear most often from medscape's nurse readers.
there are 2.7 million registered nurses (rns) in the united states, and 2.2 million of them are actively employed. with the theme of nurses week 2004, "nurses: your voice, your health, your life," i asked first about the nursing shortage and nurse staffing, likely the issues at the top of everyone's list of concerns.
medscape: the number one issue is obviously the nursing shortage. how bad is it, and is this shortage any different from shortages we've seen in the past?
"to put it simply, there are certainly not enough of us to get the work done that needs to be done," blakeney said. she pointed out that although we have weathered nursing shortages in the past, this one is quite different. why? because in addition to not having enough nurses, the nurses working now are older. as a result, many aging nurses, feeling tired, overworked, and underpaid, are retiring early. in fact, estimates are that the number of rns will fall to 12% below the demand by 2010, with a 20% shortage by 2015.
medscape: what about the related concern of too few nursing faculty? is it true that many qualified applicants to nursing programs are being turned away because there are not enough faculty members to teach them?
"that is absolutely true. we don't have the academic infrastructure to accommodate the young people who would like to go into nursing as well as the older career changers, who see nursing as a viable option." blakeney went on to explain that at the bs level, 11,000 well-qualified applicants were turned away in 2003. "these are people with grade point averages of 3.7, 3.8, and 3.9, and we don't have enough room in our programs to accept them."
the aging of nursing faculty members is even more acute than the aging of the nursing population as a whole. the average age of nursing faculty is now 55 years. these experienced teachers are not paid as well as they could be; consequently, as they get older, many are moving quickly toward retirement, without enough replacements in the ranks. "some states have as many as 30% of their nursing faculty eligible to retire," blakeney pointed out. in addition, in times of financial belt-tightening, programs in the public sector often suffer cuts first. the reality is that a full two thirds of the bs education in nursing takes place in public universities, so these programs are even less able to expand and recruit faculty in the current environment.
medscape: where is ana focusing the most effort this year in dealing with the escalating nursing shortage?
blakeney described numerous legislative efforts to improve funding for nurses. ana continues to lobby congress to increase funding of the nurse reinvestment act
, legislation that targets nursing workforce development via programs designed to attract more students into nursing programs; improve the workplace for nursing; support schools
of nursing to provide faculty and updated curricula; recruit a more diverse student population; provide assistance to students to enable them to complete nursing studies; and ensure the collection and analysis of current nursing workforce data to guide the appropriate implementation of these programs. blakeney explained that $205 million is being requested this year, the fourth annual increase for this important legislation.
"because inappropriate nurse staffing is the number one concern of nurses today," blakeney continued, the ana is strongly supporting the rn safe staffing act (s. 991)
, legislation introduced by senator daniel inouye (d-hi) on the eve of national nurses week in 2003. companion legislation in the us house of representatives, the quality nursing care act
(h.r.3656), was introduced by representative lois capps (d-ca), an rn, in december 2003.
blakeney believes that this particular piece of legislation is "the smartest bill to date on staffing." rather than mandating specific patient-to-nurse ratios, the rn safe staffing act builds in some flexibility to allow for variations in various settings, nurses' experience and skills, and patient populations. in addition, the nurses practicing on a particular unit will have a big part in determining the ratios in their own setting. hospitals will need to publicize their process for both determining the needed ratios in their facility and their success in meeting them.
a safe nursing environment is essential to keep nurses working as well. a survey done in 2001 indicated that the majority of nurses report that health and safety concerns play a major role in their decision about remaining in the profession. for example, more than 80% of needlestick injuries can be prevented through the use of safer devices. the ana's safe needles save lives
campaign has been successful in passing legislation requiring hospitals to use safe needles or needleless technology where appropriate.
handle with care
is a more recent ana ergonomic initiative aimed at preventing work-related musculoskeletal disorders through greater use of assistive equipment and patient-handling devices
. "studies of back-related workers' compensation claims reveal that nursing personnel have the highest claim rates of any occupation or industry, even higher than construction workers," noted blakeney. in an ana survey, more than 59% of the nurses surveyed listed a "disabling back injury" as one of their top health and safety concerns, and nearly 84% of the nurses surveyed said they continued to work despite experiencing back pain.
using the ana position statement elimination of manual patient handling to prevent work-related musculoskeletal disorders
as a foundation, the handle with care
campaign educates nurses regarding advances in science and technology that support ana's goal of securing a nationwide "no-lifting" policy.
ana has partnered with audrey nelson, phd, rn, faan, director of the tampa veterans' health administration patient safety center of inquiry
, in implementing the goals of the campaign. nelson is a nurse researcher who designs evidence-based interventions that reduce the risk of occupational injury related to patient handling by the use of technology and equipment.
medscape: we often hear about the concerns of nurses with disabilities. these nurses explain that even though they have years of experience and expert knowledge, they are no longer considered useful in a workplace that seems to value only those with "healthy bodies and strong backs." are we perhaps overlooking a valuable resource by not offering creative workplace options for all nurses who have something to offer?
agreeing with these sentiments, blakeney emphasized, "employers need to hire rns for their brains and not brawn." she continued, "when a nurse enters a patient's room, most just see the nurse walk in, do a task, and leave. the casual observer doesn't realize all that goes on while the nurse is with a patient. the rn's biggest contribution is her assessment skills."
medscape: how can we encourage employers (and even other nurses) to work more creatively with aging nurses or nurses with disabilities?
"that is an area where we need to do a great deal of work. creating flexibility on how nurses are used on a unit or in another setting is a start," blakeney said. she continued by giving some workable examples such as using older nurses or nurses with disabilities to mentor younger, less experienced nurses, or by using staffing systems that allow nurses more control over their work hours.
medscape: as nurses consider their chosen profession this nurses week 2004, can you provide any words of wisdom or encouragement?
"there are a lot of challenges facing our profession right now," blakeney said, "but likely we all went into nursing for specific reasons." blakeney believes that nurses "have a unique chance to make a real difference every day," including the opportunity to save a life. "take pride in the importance of what you do each and every day, as patients and their families will remember all the good you have done."
the take-home message blakeney emphasized was for more nurses to get involved
in changing things. estimates are that only about 10% of nurses are actively involved in the profession. she pointed out that active involvement "can be as simple as joining a professional or specialty practice organization, or getting involved in designing or lobbying for legislation, developing standards of practice, or assisting a hospital to obtain magnet certification." just becoming a member of a professional organization is an important first step toward the need for all of us to "tend to our profession."
if you have comments or questions about this interview or about medscape nurses, you may contact the editor at firstname.lastname@example.org
susan b. yox, rn, edd
, site editor/program director, medscape nurses