Addressing the Nursing Shortage

Published

Niko Karvounis and Maggie Mahar track the health care system for the Century Foundation. They author the increasingly influential HealthBeat blog, where this piece appeared, "Addressing the Nursing Shortage."

http://www.healthbeatblog.org/2008/09/addressing-the.html

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giving nurses a greater role on boards can help them feel valued and invested in health care organizations.

yup, that about sums it up!

great article.

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Good article (better than most on the subject), but it failed to mention the other half of the "double whammy" in nursing education -- there are two basic problems with increasing the number of nursing students accepted; one is the lack of qualified faculty, but the second is a growing lack (sounds like an oxymoron! :chuckle) of clinical sites. It's not so much of a problem for basic med-surg clinicals (yet!), but, as more and more hospitals merge into "healthcare systems" and consolidate services to save money, there are more and more nursing programs competing for fewer and fewer specialty units for specialty clinicals -- peds, psych, OB, intensive care, etc.

This is already a big problem in most nursing schools -- at the last BSN program in which I taught, arranging the specialty clinicals each semester was a nightmare, as we competed with another BSN program, two diploma programs, and six or seven ADN programs in our area for the same few units/sites, and many of the clinical opportunities ended up being of v. poor quality because of the available hours or sites. If, next month or next year, nursing programs were suddenly able to take twice as many students as they are currently because the faculty shortage was somehow ameliorated, the clinical site problem would remain and would only be worse.

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Wow, they use quotes from Allnurses in the article. Cooooool!

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Specializes in Critical Care,Recovery, ED.

Yes it is about the 3Rs RESPECT REWARD & RECOGNITION.

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RNs are increasingly scarce in emergency departments.

http://www.healthbeatblog.org/2008/09/tackling-the-cr.html

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Specializes in Hospice, Palliative Care, Gero, dementia.

i just got this info in an email, may be worth catching:

on friday, october 24, now on pbs will explore a projected nursing shortage that could impact quality of and access to care for millions of patients. the show will highlight innovative solutions in new york city and elsewhere. the production is supported in part by a grant from the barbara and donald jonas family fund and the jonas center for nursing excellence. for local viewing times, check tv schedule at www.pbs.org/now. the show can also be accessed through on-demand television, audio podcasting, video podcasting, and streaming video on the now website at www.pbs.org/now.

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Specializes in ER and family advanced nursing practice.

It was a good article and thanks for posting it. I have a few comments. People talk about nursing shortages, and an issue often discussed is better wages. The ONLY reason we have decent wages at all is because of the nursing shortage. If all of a sudden there were enough nurses then kiss the flexibility/high pay of agency, per diem, and travel nursing good bye. The nursing shortage is the only thing that gives nursing any leverage at all.

Secondly, nursing is partly to blame for the shortage as well. Nurses don't just leave for the low money. Lateral violence is very common in the work place. How many times have I heard nurses joke/gloat: We eat our young! As if that was something to be proud about. I see nurses treat each other poorly more than I have seen patients or docs do so.

On a personal note, it annoys the heck out of me that there is not a fast track for paramedics to become nurses. There are programs out there with some options, but they really don't address the skill set that the paramedic comes equipped with. I don't think paramedics should get a free ride, but there really isn't any more than a semesters difference. I find it ironic that nursing wants better acceptance of NPs and cite many good studies that indicate the successful outcomes of the NP's patients, yet won't tap the large numbers of paramedics that could help with the nursing shortage.

Just my $.02

Ivan

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Specializes in Hospice, Palliative Care, Gero, dementia.
It was a good article and thanks for posting it. I have a few comments. People talk about nursing shortages, and an issue often discussed is better wages. The ONLY reason we have decent wages at all is because of the nursing shortage. If all of a sudden there were enough nurses then kiss the flexibility/high pay of agency, per diem, and travel nursing good bye. The nursing shortage is the only thing that gives nursing any leverage at all.

Ivan

Couple of problems w/your argument: The nursing shortage is not just because nursing programs had scaled back nurses leaving the field -- there's also that good old "demographic imperative:" The number of people over the age of 65 is increasing by 2.3% annually. More people are older, frailer, & living longer in poorer health. Over 1/3 of all health care dollars are spent on older adults. No matter what else happens, there will be more people who need care -- in lots of different settings (particularly when you compare that 2.3% annual increase with the 0.8% annually of individuals who would be able to provide family caregiving.

Also, I think you can't ignore the fact that unions have had a role in helping improve wages (as well as issues like staffing ratios) for nurses. Particularly unions like CNOC.

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Specializes in ER and family advanced nursing practice.
Couple of problems w/your argument: The nursing shortage is not just because nursing programs had scaled back nurses leaving the field -- there's also that good old "demographic imperative:" The number of people over the age of 65 is increasing by 2.3% annually. More people are older, frailer, & living longer in poorer health. Over 1/3 of all health care dollars are spent on older adults. No matter what else happens, there will be more people who need care -- in lots of different settings (particularly when you compare that 2.3% annual increase with the 0.8% annually of individuals who would be able to provide family caregiving.

Also, I think you can't ignore the fact that unions have had a role in helping improve wages (as well as issues like staffing ratios) for nurses. Particularly unions like CNOC.

I agree that the shortage is not because of any one thing, but perhaps in light of the population increases you mentioned nurses ought to treat each other better. When we respect each other in the workplace it becomes a win-win situation: nurses are not as likely to leave, turn over decreases, and the constant training of new hires decreases which leads to a tighter more cohesive unit which in turn also decreases turnover. Of course the reverse is true: a nurse comes into an environment where a shortage exists, is subjected to lateral violence and consequently leaves. Then that unit must hire another employee who is not able to pull their share until they are trained. In the meantime everyone is working harder and job satisfaction decreases (which contributes to lateral violence) which makes turnover more likely, etc.

I would also agree that unions have been factorial in wage increases (where unions exist), but even unions need leverage and part of that leverage is the personnel shortage. There is no getting around the basic law of supply and demand.

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