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 in the Journal of Nursing Administration and Nursing.com as well as a presentation training the trainer for end of life care. We discussed the predicted nursing shortage.
According to the latest (2017) HRSA report regarding supply and demand:
- Looking at each state's 2030 RN supply minus its 2030 demand reveals both shortages and surpluses in RN workforce in 2030 across the United States. Projected differences between each state's 2030 supply and demand range from a shortage of 44,500 FTEs in California to a surplus of 53,700 FTEs in Florida.
- If the current level of health care is maintained, seven states are projected to have a shortage of RNs in 2030, with four of these states having a deficit of 10,000 or more FTEs, including California (44,500 FTEs), Texas (15,900 FTEs), New Jersey (11,400 FTEs) and South Carolina (10,400 FTEs).
- States projected to experience the largest excess supply compared to demand in 2030 include Florida (53,700 FTEs) followed by Ohio (49,100 FTEs), Virginia (22,700 FTEs) and New York (18,200 FTEs).
With the ever increasing costs of college, how would you convince a young just graduated from high school person to commit to a nursing education?
A college education is an investment. It is an investment in oneself and in one's future. A simple ROI (return on investment) conversation would quickly silence this concern. With diligent financial planning and discipline post-graduation, student loans can be paid off rather quickly. I would also discourage a student's parents from paying for their child's education, as this can delay their own retirement. An education can be financed, a retirement cannot.
As for committing to nursing specifically, first of all, I believe nursing is a calling. Nursing is not a profession for everyone. The student must show true and compassionate interest in the field. Once this was evident, I would vouch for what a career in nursing has to offer. Some benefits include a very flexible schedule, opportunity to pick up extra shifts for extra money, and later on the possibility of advancing into the business and management side of nursing if desired. There are also nursing positions such as school nurses, which would match schedules with the nurse's children, allowing for optimal family balance and avoidance of childcare costs. Furthermore, there are even work at home opportunities in nursing that may prove ideal for some individuals throughout various stages in their life.
Above all, the best reason to go into nursing is making a difference for your patients and having an impact on their health, comfort, and well-being. The reward of helping fellow humans through some of the best and worst times in their life is one that cannot be quantified. Personally, I choose to continue having a bedside presence while teaching nursing for this very reason. The positive humanistic reward is immensely indescribable.
AN recently reported on this topic in our Student Survey: Demographics
As the nursing population ages, many nurses are not BSN-prepared. What do you see as incentives that hospitals could offer in order to "grow their own" BSN nurses?
In my experience, there are two main barriers for ADN (Associate Degree in Nursing) nurses to continue on to their BSN, the first being the cost of the degree and the second being the time to complete it. Many nurses have home life commitments such as children, spouses, adult parents they may be caring for etc. Hospitals can offer a salary incentive to their nurses if they hold a BSN degree or higher. They can also offer tuition reimbursement to their employees predicated on their completion of the degree and a defined employment retention period. If hospitals considered not only paying for the degree but offering to pay the nurses their hourly wage for their classroom time, they would likely have more interest. If the degree was integrated into their nurses' normal weekly schedule, then there would be virtually no reason for the nurses not to complete the degree. It could fall under an education budget.
Above all, hospitals need to convey the reasoning and rationale for encouraging nurses to continue their education. The WIIFM (What's In It For Me) factor of a BSN degree could include gaining knowledge of research article interpretation and leading, disseminating, and integrating evidence-based best practices to their area of nursing. Another would be acquiring knowledge specific to nursing leadership and management. Some nurses may disclose having no interest in climbing the management ladder, however, understanding the avenues of leadership and the organizational structure is still important if one wants to influence change.
If nurses want to have an impact, they need to understand the processes behind the scenes of a hospital. For example, if a unit manager brings a change to his/her staff, part of gaining the staff's buy-in is helping them to understand why the change is being brought upon them. If a nurse has an understanding of how a nursing unit is managed, funded, staffed, etc. then the nurse will likely see the proposed change as making sense and will have a true understanding of the "Why".
Along that same line, what steps could hospitals take to engage and retain older, more experienced nurses that perhaps would like to continue working bedside but on a part-time or PRN basis?
Bedside nursing can be quite demanding, both physically and mentally. Oftentimes, aging nurses may struggle to meet the physical demands of bedside nursing. Offering shorter and less frequent shifts may help with this. Developing clinical nurse specialist roles where senior nurses can mentor and guide younger nurses through chart reviews, bedside assessments, etc. is a way to keep them and their expertise at the bedside, but also pass it along to novice nurses.
With the ever-increasing physician shortage, NPs are becoming the primary care provider in many areas, especially the rural ones. How would you propose to keep BSN nurses at the bedside versus continuing their education?
In all honesty, I would never encourage any nurse not to advance their education. I believe this would be shooting our profession in the foot. Mid-level providers are an excellent avenue for healthcare and when partnered with a physician practice they have proven to have better patient outcomes. Instead, I would encourage young nurses to pursue their BSN degree from the start of their college education. Many nursing schools are turning away qualified applicants because they do not have the faculty capacity to teach more students. So, I believe we should be looking here, at the potential student nurse population to grow the number of bedside nurses. If we want to grow the population of nurses, we need more nursing faculty.
What are you seeing in your area? Is it easy to get a nursing job? Difficult? Have you thought about furthering your education?
