Report on Nursing Shortage with Solutions

  1. Has anyone read "Health Care's Human Crisis: The American Nursing Shortage"? I found this report (80+ pages) to be extremely interesting, on point and thought provoking. I would appreciate any comments or discussion.
    The report was prepared by the Robert Wood Johnson Foundation and can be obtained on-line at the foundations site.

    www.rwjf.org
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  2. 21 Comments

  3. by   NRSKarenRN
    main page
    http://www.rwjf.org/newsevents/nursing.jhtml

    the american nursing shortage
    strategies and recommendations for action

    this report describes the complex and enduring nature of the nursing shortage in the united states. it provides compelling evidence that this shortage is unlike any of those in the past and thus requires bold new solutions. it calls for a re-envisioning of the nursing profession itself, so that it can emerge from this crisis stronger and in equal partnership with the profession of medicine. anything less consigns nursing, and the public that depends upon its care, to perpetual cycles of shortage and oversupply.

    the authors therefore recommend that a ]national forum to advance nursing be created. an independent body, the forum would draw together a wide range of stakeholders to address the nursing shortage and broader, related health and social issues. in an effort to build upon the vast number of activities that are already under way, and to acknowledge their critical value, the forum would focus on helping nursing achieve later evolutionary stages of the profession.

    the philanthropic sector is uniquely situated to provide crucial leadership and resources to help create and fund this forum, but it cannot act alone. the forum's success would require the active, collaborative participation of all groups that share concern about the nursing shortage, including nurses and nursing profession leaders, educators, health care industry leaders, labor unions, government, the array of collective national organizations and consumers, among others.

    the national forum to advance nursing would focus efforts in the following strategic areas:

    *creating new nursing models; developing and piloting new ideas that address both the nursing shortage and broader health and social issues; advancing the study of nursing's contribution to health care outcomes and consumer satisfaction; and creating entirely new models of health care provision.
    *reinventing nursing education and work environments to address the needs and values of, and appeal to, a new generation of nurses.
    *establishing a national nursing workforce measurement and data collection system.
    *creating a clearinghouse of effective strategies to advance cultural change within the nursing profession.

    further summary info:
    http://www.rwjf.org/newsevents/nursingstrategies.jhtml

    full report---registration required.
  4. by   fedupnurse
    BALH, BLAH, BLAH. It sounds like the crap I've been hearing from the suits where I work for years now. "Let's develop a committee to study this" really means It might be a problem for the staff but we aren't going to address the issue.
    They have renamed the "delivery of care, they have cultural diversity committees, all the rest of the stuff cited above. The problem is hospitals offer poor working conditions, lousy pay considering what we do, and a total lack of respect to nurses. That is why there is a shortage. Until there is a major shift in the mentality of hospital execs, this problem will just continue to grow. Until our compensation packages and working conditions rival those in the "business world" this trend will just continue. They should take all the millions they spend on these studies and sink it into the patient care arena and start improving the problems. Then you will see a change!
  5. by   teamrn
    Ocanke and Karen, thank you for bringing this report to my attention.

    Fedupnurse, I'm usually on board with you, but this tmie I have to disagree. We may need to take an initially apparent step backward here, one more study, etc. But RWJ is also acknowledging that this shortage is not like others; and this little known fact and its reasons can get people (consumers, suits, and legislators) to listen. Gee, do I detect that a few activists can even take note?

    I'm pretty encouraged that people listen to RWJ, and they also air specials on TV. This may be the way we need to go.
  6. by   TIREDmidnightRN
    Lack of respect is a biggie....to combat that several studies proposed pushing the professionalism..requiring BSN for entry level nursing and delegating ASN and ADN to a "technical nurse" job description. This hasn't been fully implemented and already we see new nurses unprepared for hands on care but convinced of thier superiorority over seasoned LPNs. we see doctors treat nurses with contempt because so many are new and INEXPERIENCED that they quit trusting ALL nurses.....and we see a profession where a four year degree gains you the right to empty bedpans and scrub toilets! No matter how high the degree, we are still seen as servants. Until clients are encouraged to request help appropriately (We do not ask the doctor to tie a shoe lace...why do we call for an RN to fetch fresh water?) and until administration stops expecting us to maintain the same level of servitude toward twelve seriously ill patients that we once delivered to six stable ones......ahhh I ramble on.......but respect......that's the key!
  7. by   -jt
    <(We do not ask the doctor to tie a shoe lace...why do we call for an RN to fetch fresh water?)>

    because all the support staff have been laid off.
  8. by   fedupnurse
    OK I read the summaries. I still don't see anything in there about changing the working conditions which is one of the primary reasons why there is a shortage! Until nursing executives take this seriously and REALLY address the issues of wages and working conditions, this shortage will continue. You can do a million studies. If no one acts on these studies, what is the point? It is then just a waste of money.
    We raise issues on a regular basis with our nursing executives. They play the game of answer their questions with a question rather than give us a straight answer. They also blame us for the problem rather than acknowledge that they are a part of the problem.
    We have enough studies to support that there is a nursing shortage. If the executives are serious about addressing this problem come and talk to your staff and ask us how to improve working conditions and then ACT ON OUR INPUT!! We know what the problems are and want them to be corrected. We are not just healthcare providers, we are also consumers!!
  9. by   TIREDmidnightRN
    In Michigan the support staff are not laid off..the nurses are....or rather, lost through "attrition" which means they get rid of you, but let you think it was your idea...so one RN will have 11 to 17 patients, and the patients still say , "I need a NURSE" when someone answers the call light..when asked WHAT they need, or if the need an AIDE, they invariably refuse to answer, or say "I need a nurse", or "I need help" , so the Aide sits at the desk while the RN leaves another patient to see what the emergency is, only to find the client wants a pencil sharpened, water fetched, a bedpan emptied....and to suggest that an aide would be able to do that job is unthinkable...might be seen as laziness!!!!! Somehow, someway it needs to be encouraged...if hospitals insist on cutting costs by replacing RNs with USP they need to let the CLIENTS know that some needs and wants will HAVE TO BE directed to those USP's!!!!
  10. by   Furball
    Originally posted by TIREDmidnightRN
    Lack of respect is a biggie....to combat that several studies proposed pushing the professionalism..requiring BSN for entry level nursing and delegating ASN and ADN to a "technical nurse" job description. This hasn't been fully implemented and already we see new nurses unprepared for hands on care but convinced of thier superiorority over seasoned LPNs. we see doctors treat nurses with contempt because so many are new and INEXPERIENCED that they quit trusting ALL nurses.....and we see a profession where a four year degree gains you the right to empty bedpans and scrub toilets! No matter how high the degree, we are still seen as servants. Until clients are encouraged to request help appropriately (We do not ask the doctor to tie a shoe lace...why do we call for an RN to fetch fresh water?) and until administration stops expecting us to maintain the same level of servitude toward twelve seriously ill patients that we once delivered to six stable ones......ahhh I ramble on.......but respect......that's the key!

    Several months ago I had my head blown off by other nurses here because I said that I didn't have time to do housekeeping chores. I had expressed how irritated I got when I'm asked to fetch water, empty an overflowing garbage can ect ect ect ect ect ect while trying to deal with other pressing issues like resp failure, active bleeders and cardiac rhythm prob's, ect ect ect ect. These other opinions basically stated that a "good nurse" would see to these things without complaint. We have too many expectations placed on us that it's IMPOSSIBLE to get everything done. Many of these expectations are misplaced. I can't stand it anymore. I am going back to college for another degree. (computers) Another one bites the dust.
  11. by   fedupnurse
    Furball, it sounds like your colleagues are the oppressed types that tow the company line even though they are falling for doing the nonnursing things you stated that take us away from what we should be doing. I'm fortunate in that respect. Most of the nurses I work with will speak up and not go along with it because mgmt or admin said so. The things you mentioned make me sick too!
  12. by   OC_An Khe
    Because of our training and always being present, hospital administrators know that if they leave a job undone, or eliminate those who were doing the job, the nurse will eventually do it.
    This has been termed the fatal availability of the nursing profession. If our profession is to survive and grow it must get rid of the hospitals administrators belief that the nurses will eventually do any task placed in front of them. No matter how menial that task is.
  13. by   TIREDmidnightRN
    I agree with the last post. I once tried to "call off" due to wrist tendonitis.....the boss insisted I show up, and that the other nurse on the unit would do my charting (I was in a SNF at the time)...the other nurse REFUSED to help me at all...she said, "If we get all of your work done tonight they will decide that one nurse for 150 patients is doable! I will do my work, you do what you can,,,,,what is undone is undone....maybe they will let you have the leave you need!" They did.
  14. by   fedupnurse
    Well siad Ocankhe! It is like putting a bandaid on a hemorrhaging wound as one of my colleagues put it. This idea that we are super human, never get sick and have no personal lives has got to stop. We must have the resources necessary to provide care and the most important resource is ourselves.

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