Questions on nursing shortage

majic65 · Jul 21, 2001

Robin--there is a nursing shortage, but only in hospitals and LTC and other "bedside nursing" jobs. Other nursing jobs are filled easily.

So--why the bedside nursing shortage? In answer to your question--"All of the above!!" Every factor you listed is awful--and the age of nurses at the bedside is going up, because I suspect that new nurses have wised up and just won't do it.

Question 2--all of the above, and you could add adequate staffing on all shifts.

Question 3--the public could begin to actually payattention to and care who is providing their care. I have a theory that patients would accept Flipper in scrubs. They do not know they are getting care from non-licensed personnel, nor do they care that is they do get a "rfeal nurse" she has probably worked 60 hours that week. Once the public begins to care and ask, hositals will have to respond in order to ensure their census.

P_RN, ADN, RN · Jul 21, 2001

What majic said.

JenKatt · Jul 21, 2001

There is also a nursing shortage in the military..

Question 1: All of the above

Question 2: all of the above

Question 3: How about this: people stop looking at nurses as human pooper scoopers and instead as professionals.

Huganurse · Jul 21, 2001

Questions 1, 2 and 3: All of the above. And add tuition reimbursment.

puzzler · Jul 21, 2001

To all the questions I feel the answer is "all the above" plus better Nurse to patient ratio.

To work very, very hard and go home knowing you have not given the patient all that they need is very demoralizing.

As far as pay goes let me give one example that we have encountered today. A position was posted for a "Maintenance Apprentice" the requirement was "no experience necessary". The upper end of the pay range was 13.59/hr (this is more than many of our nurses make). Why would a young person chose to enter into nursing when the pay range for other less physically exhausting, less emotionally draining, less dangerous (exposure to many diseases) areas of employment is as good or even better?

I have been a nurse for 25 years and I do love it but would I do it again? I really do not know if I would.

-jt · Jul 21, 2001

There is no nursing shortage in the numbers of nurses yet. There are 500,000 licensed nurses in this country who did not work in nursing at all last year. There is only a "shortage" of nurses who want hospital/nursing home jobs. Its not a shortage of nurses - its a mas defection of nurses away from the bedside.

A recent congressional report, studies done by the ANA & data from nurses themselves show that the reason for this is primarily that the nurses are unwilling to work in hospital/nursing home working environment, under the unsafe, abusive & punitive conditions (forced OT, too high a pt ratio, no support staff or services, unsafe equipment, etc) & for the low compensation/ benefits that these places offer. There is also a shortage of nurses who are willing to work as educators because of the dismal pay they are given.

Word gets around & students are not choosing to put themselves into the same situation we are running from, so they are choosing other careers. By the time we all retire within the next 10-20 yrs, there really will be a shortage of nurses in numbers, but right now we are out there - just not at the bedside. We keep telling employers what they need to do to make the job worthwhile & entice us to come back to it but they keep resisting that & living in denial.

Nursing organizations, nursing unions, nurses, local legislators & Congress have told employers that unless they repair the working environment & compensations, no amount of funding education & recruiting new students will alleviate the problem because if the workplace conditions are not changed, those new students will leave the bedside too. Experienced nurses today are fighting tooth & nail to make it a better place for all of us - especially for the new nurses of the tomorrow. Hopefully new nurses & students will be pro-active from the beginning & join the fight instead of just accepting things as they are. You can find out more info on this topic at:

https://allnurses.com/forums/forumdisplay.php?s=&forumid=100

-jt · Jul 21, 2001

I hope you mean HEALTHCARE profession because if we leave it up to the MEDICAL profession (MDs) we'll all be replaced with UAPS & dead as a profession.

What the healthcare profession can do is:

(Nursing Crisis Solutions - legislation developed & presented by the New York State Nurses Assoc to the NYS legislature:)

RN Solutions to the Nursing Care Crisis:

"Improve workplace conditions

Create enforceable guidelines to ensure safe staffing

End mandatory overtime

Strategies to resolve the immediate need for nurses must include improved working conditions. If practices such as short staffing and mandatory overtime were eliminated, nurses that have left direct care could be enticed to return. If facilities had respect for the principles of nursing practice, the current erosion of the nursing workforce would be stopped. Improved ergonomic standards would help retain older nurses. To retain nurses, the workplace must be safe - safe from violence, safe from pathogens, safe from occupational hazards.

Facilities should follow the example of hospitals recognized *under the Magnet Nursing Services Recognition Program for Excellence in Nursing Service, sponsored by the American Nurses Credentialing Center. At these facilities, which excel both in patient care and in recruitment and retention of nurses (and frequently have waiting lists of nurses who want to work there):

*Nursing professionals' knowledge is respected in the development of policies.

*Nurse practice committees that include direct-care nurses are involved in establishing staffing plans based on patient acuity and need.

*Nurses do not face retaliation or intimidation for questioning policies or working to change practices that negatively impact on patient care.

*Nurses are not forced to work overtime to fill gaps in staffing schedules.

*To encourage nurses to enter or remain in the work force, there must be sufficient nursing care hours to meet patient needs.

Offer competitive salaries and benefits.

Lower the high turnover rates of nursing staff ie:

Provide competitive wage and benefit packages for registered nurses and support personnel.

Improve working conditions to ensure safe staffing.

Wage increases alone will not solve the shortage, but it is important to ensure fair compensation for nurses and salary parity throughout the healthcare industry. For example, compensation for a nurse in long term health should be comparable to that of a nurse in the hospital setting.

Staff competency can be supported through reinstatement of in-house educational services, which have been decimated over the past five years, and a commitment to lifelong learning through continuing education.

What the community & State can do:

Establish reimbursement rates for health care facilities to reflect costs of recruiting and retaining staff:

*Tie funding to evidence of improvements in recruitment and retention.

*Enhance the funding to the NURSING DEPARTMENT, not to a facility's general operating costs.

Develop a stable RN workforce

Collect data on the demographics of the nurse workforce.

Adopt funding and education policies to meet the projected need for nurses.

Fund nursing education

*Establish a conditional scholarship program for nursing education.

*Fund up to $15,000 per year per individual for tuition and other expenses

*Require work in a designated need area for 18 months for every year of scholarship

*Fund 2000 scholarships in the first year

*Include scholarship opportunity for nurses preparing for faculty positions

*Provide funding for expansion of nursing education programs.

*Fund up to $250,000 per school to start-up or expand educational slots for bachelor'sand graduate degree and specialty certificate programs

*Support expansion of baccalaureate completion programs for Associate Degrees RNs

*Encourage increased capacity of CUNY bachelors in science of nursing programs

*Fund enhanced salaries to support faculty recruitment

Support nursing students, present and future

Outreach must be directed toward students and guidance counselors in elementary, middle and high schools. Support must be available for students who need assistance in improving their academic performance, especially in math and science. Merit scholarships should be reinstated to enhance recruitment of high school seniors.

Access to affordable college programs in nursing is essential, through scholarships to offset tuition and other expenses and through increased government aid to nursing programs. We must begin to address this problem now-scholarships created this year will not result in nurses prepared to enter the workforce for three to five years.

Experienced clinicians in facilities must be given the time in their schedules needed to adequately precept students. Mentoring of new licensees and recent hires must be valued as a component of nursing education and orientation.

Support nursing education programs

Nursing education programs must be expanded to accommodate new students and make higher education more accessible in every part of the state. RN baccalaureate completion courses are needed for nurses with associate degrees, as the National Advisory Council on Nursing Education and Practice has identified a need for higher educational preparation due to changes in practice and in patient needs.

The current supply of RNs does not reflect the ethnic, cultural, and racial diversity of New Yorkers. Efforts must be made to provide supports for students and to increase access to urban, public schools of nursing that offer bachelor's degrees.

Teachers of nursing are needed to replace those who are nearing retirement. Support for graduate education will assist nurses in preparing to teach. Faculty salaries must become competitive with clinical practice wages. Faculty-run clinical practices can be used to enhance salaries and maintain clinical skills.

Prevent future shortages and crises of care

Healthcare consumers, policymakers, and researchers need information about the relationship between quality care and hours of nursing care. Facilities should collect and disclose information on staffing mix, staffing ratios, and patient outcomes that indicate the quality of nursing care provided.

Information on the nurse workforce needs to be collected regularly and consistently to avert shortages in the future. Early identification and intervention will help ensure a stable RN workforce.

Legislative Recommendations for 2001

Connect funding enhancements to improved staffing:

State reimbursements for health care should reward facilities that are using their resources to provide quality nursing care. Enhanced funding for health care institutions should be tied to the evidence of increased recruitment and retention, rather than be provided as a rate adjustment that goes to facilities' overall operating costs.

Establish safe staffing guidelines:

Consistent, enforceable guidelines must be developed to support the state's goal of sufficient nursing care. Such a proposal should be flexible enough to apply to various settings, shifts, and levels of patient acuity. Guidelines also must reflect the experience and skill of the nurses delivering the care.

Protect nurses from retaliation:

Existing whistleblower protection laws are not enough to protect healthcare professionals who report violations of their professional standards when they are forced to provide care in an unsafe environment. The state should be responsible for investigating claims of unfair retaliation against employees.

Ban mandatory overtime:

The routine use of mandatory overtime is a danger to both nurses and patients. Overworked, exhausted nurses are unable to provide quality care and are likely to leave the workforce.

Create a conditional scholarship program:

Conditional scholarships will require recipients to make a commitment to work in New York in return for assistance with tuition and other expenses. Scholarships are better than loan forgiveness programs, especially for older nursing students who have difficulty getting loans due to their family incomes and outstanding debt.

Provide financial support for nursing schools:

Grants should be available to nursing schools to either start up or expand nursing education programs, particularly those that will meet the growing need for nurses with bachelor's degrees and from diverse populations.

Collect and disclose quality-related data:

Healthcare facilities should be required to collect data that reflects the quality of nursing care: patient-to-staff ratios, staffing mix, patient complications such as pressure ulcers, in-hospital infections, and medication errors. This information should be part of "hospital report cards" and be made available to the public.

Require continuing education:

Lifelong education is essential to ensure professional competency. Nurses should meet continuing education requirements with each re-registration. "

http://www.nysna.org/PROGRAMS/LEG/points/solutions.htm

oramar · Jul 21, 2001

To the first question I would add: F. bad managment. My niece, a fairly new nurse, was a bar maid before she became a nurse. She said she was stunned when she first experienced managment abuse as a nurse. Most bar owners are lucky if they have a high school education and not once did she ever have one of them tell her to shut up or that she was easily replaced. She was not in nusring very long when she was told both those things.

Home Health Columnist / Guide · Jul 21, 2001

Check out the links I've posted to re the nursing shortage:

WHEN CARE BECOMES A BURDEN: Diminishing Access to Adequate Nursing

https://allnurses.com/forums/showthread.php?s=&threadid=7878

ANA Capital testimony re shortage

https://allnurses.com/forums/showthread.php?s=&threadid=8096

107 Congress/Report on the nursing shortage

https://allnurses.com/forums/showthread.php?s=&threadid=1988

AHA says Hospital staff shortages already serious

https://allnurses.com/forums/showthread.php?s=&threadid=1256

5/17/01Senate Hearings on Nursing Shortagehttps://allnurses.com/forums/showthread.php?s=&threadid=417

Good article: A medical crisis: Who'll care for your patients?

https://allnurses.com/forums/showthread.php?s=&threadid=1936

PSNA Testimony re Nursing Shortage to PA House Licensure Committee

https://allnurses.com/forums/showthread.php?s=&threadid=2392

ANA Commends Institute of Medicine for 21st Century Health System Recommendations

https://allnurses.com/forums/showthread.php?s=&threadid=2698

Good Nursing Shortage Article

https://allnurses.com/forums/showthread.php?s=&threadid=1775

Other info:

NLN Update Newsletter & CEO Letter

Vol. IV, Issue No. 6, March 27 - April 9 , 2001

http://www.nln.org/newsletter/index.htm

Online Journal of Issues in Nursing---THE NURSING SHORTAGE: Solutions for the Short and Long Term

http://www.nursingworld.org/ojin/topic14/tpc14_4.htm

STRATEGIES TO REVERSE THE NEW NURSING SHORTAGE

A policy statement from Tri-Council members:

The American Association of Colleges of Nursing (AACN)

The American Nurses Association (ANA)

The American Organization of Nurse Executives (AONE)

The National League for Nursing (NLN)

http://www.nursingworld.org/pressrel/2001/sta0205.htm

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You can also do a search here (button located next to allnurses logo) , type in nursing shortage, will bring up all posts re this issue, with multiple posters opinions.

Good luck.