There is no real nurse shortage?

RN1980 · Dec 16, 2007

get rid of joint commission that should help...

marie-francoise · Dec 16, 2007

I think it is not a simple "yes" or "no" question. There are underlying population and societal factors that are putting pressures on the health care system in general to provide more care with fewer people. They include such factors as:
1. The aging population needs more health care, with relatively fewer young people to do the physical work.
2. The advances in health care possibilities and society's expectation that all services be available to everyone (even those who can't pay or who have a limited life expectancy) also adds to the demand for health care services.
3. The legal and regulatory climate that requires much more paperwork and safety controls adds burdens on the system.
4. Women now have more career options than they did in the past.
5. There are more single mothers in the work force who have problems with child care etc. while working rotating shifts.
etc. etc. etc.
These changes DO have an impact on the supply of nurses and the demands placed upon nurses. Anyone who thinks they are not an important part of the problem is wrong.
However, it is equally wrong to blame the "shortage" on ONLY these factors. Nursng needs have not been adequately considered in the planning of health facilities and in the political world that runs facilities on a day-to-day basis. Many nurses leave nursing because working conditions are so bad. That can't be ignored either.
In the end, it is a complex, multi-deminsional problem with no easy answers. The big societal forces putting strain on our health care system is moving us in the direction of a "real" shortage and the working conditions are compounding the problems. All aspects of the problem need to be addressed to have much of an impact. No one action will make much impact unless it is accompanied by other actions to move the whole system in a positive direction.

Very good post! Yup - and thank God for item 4. And I would add that managed care really ramping up in the 1990s worsened the shortage by cutting nursing jobs (oops!). And now with cost containment the order of the day, combined with all the other factors llg listed above = nursing shortage. Particularly hospital nurses.

Maybe it's my background in public health, but I really do think the feds will one day have to step in to fix the nursing situation by fixing (to the extent possible) the health care system itself - because, yes, the causes of the nursing problem are multi-factorial and rooted in the system itself.

The fact that the nursing shortage is a public health problem maybe will one day help with mandating an absolute max patient:nurse ratio for specific nursing settings (ER, med/surg, etc.), with ancillary staff not sacrificed to realize that ratio. Maybe it will mean higher taxes, or taxes reallocated towards health care instead of other, more questionable programs. But something needs to be done to improve the health care system, and the situation for nurses. Anyway, here's hoping.

P.S. The stated vacancy rate for nursing positions likely underestimates the true situation, given the unrealistic patient:nurse case loads today.

llg, PhD, RN · Dec 17, 2007

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The fact that the nursing shortage is a public health problem ...

I strongly agree that it is a public health problem, but I don't think our society sees it that way yet. It's as if people have a need to deny the seriousness of the situation because they can't handle the idea that the quality of care THEY might receive is less than desired and/or will require money to fix it.

But eventually, they won't be able to deny it. Only then will something be done. I just don't like the idea that a lot of people may be hurt in the process.

marie-francoise · Dec 17, 2007

I strongly agree that it is a public health problem, but I don't think our society sees it that way yet. It's as if people have a need to deny the seriousness of the situation because they can't handle the idea that the quality of care THEY might receive is less than desired and/or will require money to fix it.
But eventually, they won't be able to deny it. Only then will something be done. I just don't like the idea that a lot of people may be hurt in the process.

Maybe the "gray tsunami" (that's what they're calling the incoming wave of baby boomer patients that will be "breaking" soon) will force the issue, and force the feds to look at the health care situation and its related nursing problems in the face.

janettalinda · Dec 17, 2007

PRN nursing is the only way I have survived nursing. Thank God, I have that option or I would be one of those nurses not working as a nurse at all. I cannot count the young nurses I've met who worked a few years and then left nursing completely. One is stocking shelves in a grocery store! She says she prefers it to being "b..."(griped) at all day long. Sad, but true.

caminb · Nov 20, 2008

I agree with most of the posts here, and I also think we are loosing a lot of international nurses here because the process for validation it's very long and confusing.

I have heard some nurses are going back to their countries because they could not finish the process with cgfns and nclex before their visas expired