US SENATE HEARING ON NURSING SHORTAGE

Nurses General Nursing

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The US Senate heard testimony from the ANA, the Maryland Dept of Health, the AONE, the AHA and a College of Nursing Re: the Importance of Nurses & the impact of the Nursing Shortage.....

Opening Statement of Senator Barbara A. Mikulski http://www.senate.gov/~mikulski/press/01/02/2001213B45.html

FOR IMMEDIATE RELEASE: February 13, 2001 CONTACT: Johanna Ramos-Boyer http://mikulski.senate.gov 202-224-4654 Opening Statement of Senator Barbara A. Mikulski

"The Nursing Shortage and its Impact on America's Health Care Delivery System" Subcommittee on Aging

"Mr. Chairman, I want to thank you for calling this timely hearing on the nursing shortage. I also want to thank Dr. Georges Benjamin, Secretary of the Maryland Department of Health and Mental Hygiene and Chair of the Maryland Statewide Commission on the Crisis in Nursing, and Kathryn Hall, Executive Director of the Maryland Nurses Association, for sharing their expertise and testimony today.

This is not the first nursing shortage that I've seen, but I'm committed to finding real solutions so that it will be our last. Because if we don't address this crisis effectively, the future is likely to be even worse due to our aging population. Today, there are about 35 million Americans aged 65 and older. This number will double to about 70 million in 2030 and be an increasingly diverse population. Older individuals have more complex health care needs and often multiple conditions that require treatment simultaneously. This means that nurses and the care they provide will be even more important than they are today.

The impact of the nursing shortage on our aging population is compounded by the fact that our nursing workforce is also aging. Fifty percent of all working nurses will reach retirement age in 15 years. Maryland and many other states across this country are experiencing nursing shortages as more nurses retire, fewer people go into nursing, and the economy offers more opportunities for nurses and higher salaries than nursing. Maryland hospitals reported that, last year, it took 68 days to fill a registered nurse vacancy.

Today's shortage is causing great distress for patients. According to a new survey by the American Nurses Association, 75 percent of nurses surveyed feel the quality of nursing care at the facility in which they work has declined over the past two years. About half of the nurses surveyed feel "exhausted and discouraged" when they leave work, and over half of those surveyed would not recommend their profession to their children or their friends.

Nurses tell me that they feel undervalued, overworked, and underpaid. In this country in 1999, a nurse with 15 or more years of experience could expect to earn on average only about $7,000 more than a nurse with three years experience or less. I asked the Maryland Higher Education Commission if there were waiting lists in Maryland for nursing scholarships or admission to nursing programs. I was not surprised to find that there are no waiting lists.

But nurses are truly the unsung heroes in health care. They are advocates, medical professionals, and healers who fight death and disease and bring compassion to the patients for whom they care. The care they give is high-tech, high-touch, and highly skilled. Nurses are at the bedside of premature infants in the neonatal intensive care unit, they are assisting in the operating room during cardiac bypass surgery, they are riding snowmobiles to provide home health care to rural seniors, and they are helping nursing home residents manage complex medications.

Why are people not coming into nursing and why aren't they staying? Because while nurses have sophisticated training and education, they get skimpy and spartan pay and respect. We need more nurses, but we as a society must get behind our nurses. That means more than just more financial aid or bigger scholarships. And it definitely means more than collecting data about the problem. Getting behind our nurses means paying them what they deserve. Because the dedication and devotion shown by countless nurses doesn't pay the mortgage! And because the best way to recruit more nurses is by having a satisfied nursing workforce that reaches out to a new generation of women and men.

I was excited about the television series "Hopkins 24/7" on ABC last year. I was proud of the doctors, but the shows provided an incomplete picture of the health care provided in hospitals. It left out the nurses and other health care professionals who work around the clock to care for patients. That's why I'm so pleased that the Discovery Health Channel "discovered" nurses. I spoke to nursing groups last month to celebrate the launch of the "Nurses" television series on the Discovery Health Channel. It is similar to "Hopkins 24/7", only it's about nurses. I think this series will be a terrific tool to educate the American public about who nurses are and what they do. I thank the Discovery Health Channel and Johns Hopkins and for sharing with us clips from this series that we'll view shortly.

Today's hearing will shed light on the nursing shortage and the challenges it presents, but I hope it will also be an opportunity to talk about solutions in the short and long term. We must look at what nurses, hospitals and other facilities, nursing schools, states, Congress and the federal government can do to combat this crisis. I know that my colleagues on both sides of the aisle care deeply about this issue. I look forward to today's testimony and working on this important issue with the Chairman and my other colleagues. Thank you.

Senator Barbara A. Mikulski (D. - Maryland) " Also....

"American Nurses Association Addresses Nursing Shortage at Senate Subcommittee Hearing

Washington, DC -- "America is experiencing a crisis in nurse staffing," along with "an unprecedented nursing shortage," Kathy Hall, MS, RN, executive director of the Maryland Nurses Association, told participants at a packed US Senate subcommittee hearing today.

Testifying on behalf of the American Nurses Association before the Senate Health, Education, Labor and Pensions Subcommittee on Aging, Hall noted, "Employers are having difficulty finding experienced RNs who are willing to work in health care facilities." Areas hardest hit include emergency room, critical care, labor and delivery, and long-term care units.

"One of the primary factors for nurse turnover is dissatisfaction with workload and staffing," Hall said, citing findings from ANA's Staffing Survey, the results of which were announced last week. Specifically, the survey found that 75 percent of respondents feel the quality of nursing care in their workplace has declined over the past two years. Nurses surveyed also say they have experienced increased patient care loads.

Another factor Hall cited for high nurse turnover is "the use of mandatory overtime as a staffing tool to cover staffing insufficiencies."

ANA's solutions to the nursing shortage include increasing funding for nurse loan repayment programs as well as the programs related to the Nurse Education Act (NEA). But, as Hall pointed out in her testimony, monetary solutions alone are not enough. "Improvements in the workplace environment, combined with aggressive and innovative recruitment efforts, are paramount.

"As a professional who has worked as a staff nurse, as well as a nurse administrator, I know that the current staffing problems are directly related to the reluctance of nurses to accept positions where they will not be supported by appropriate staff, [but will be] confronted by mandatory overtime, inappropriately rushed through patient-care activities, and unable to report unsafe practices," Hall added.

The Senate hearing also featured testimony from Dianne Anderson, MS, RN, president of the American Organization of Nurse Executives; Georges C. Benjamin, MD, secretary, Maryland Department of Health and Mental Hygiene; Linda Hodges, dean, College of Nursing, University of Arkansas for Medical Sciences; and Brandon Melton of Denver, CO, on behalf of the American Hospital Association.

Benjamin echoed Hall's remarks. "There are three problems," he noted. "Nurses are not coming into the profession. The ones who are there are not staying in, and those who are there are not happy."

Sen. Tim Hutchinson (R-AR), chairman of the subcommittee, led the hearing, which was designed to shed light on the national nursing shortage and its impact on the nation's health care delivery system, as well as the long-term implications of the projected shortage over the next decade. Presiding with him was Sen. Barbara Mikulski (D-MD), who noted that "real solutions" are needed to tackle the "deep systemic issues that face the health of our nation." If not, she said, "Patient care will face the crisis" brought on by "the impact of an aging population, compounded by the aging of our nurses." The issue, she added is nurse "retention."

Sen. Hillary Clinton (D-NY), who noted that the nursing shortage is particularly acute in New York state, discussed issues related to short staffing, whistleblower protections, stagnant wage growth and mandatory overtime. "There is research that demonstrates...that nursing care determines patient outcomes," Clinton said.

Other subcommittee members attending the hearing included Sen. Pat Roberts (R-KS) and John Edwards (D-NC) " http://www.ana.org/pressrel/2001/pr0214.htm

Testifying and giving factual information is important. But, the lip service needs to translate into something I can see now. Show me the money, the resources, and the support.

A US Senate hearing being convened to address this issue is not exactly lip service. Its an incredible, important giant leap to getting what we need now. In December, at the urging of the ANA, Clinton set aside $76 million federal funds to help educate a new workforce of RNs, add additional seats to and expand nursing programs, along with another $2.2 million set aside for student RN loans. Also, there were funds allocated to increase medicare/medicaide reimbursement to hospitals so they could spend more on hiring RN staff & improving workplace conditions. Things ARE being done and the fact that U.S. Senators now recognize how important an issue this is means more will be done. But WE are the ones who are going to get it done.

So, in light of the recent Senate hearing on the nursing shortage, we might all want to take a moment to write a note to the members of the Senate Health Care Committee - many of whom are right now in the process of writing legislation involving NURSING.

http://www.senate.gov/~labor/107Members/107members.htm

[Quote the temporary solution to their problem. It is to bring the baby boom nurses like me who have left the bedside back for a few years.... .Most of us who were at the bedside two years ago would have worked another five years but they drove us out with overwork, pay freezes and other dangerous conditions. I would come back to the bedside tomorrow if they would promise to give me reasonable amts. of work, no overtime and good support. It would really help if those last few years would really count heavily toward retirment.

This is exactly what they were told at the hearing. Now they need to hear it from all of us too.

Hi -jt. I guess my question should be, how will the money, resources, and support be allocated? It seems that all too often, legislated monies end up lining and padding the pockets of people who have the least need for it. If my CEO or administrator along with other administrative staff is already making 5-10-20 times more than I (I'm sorry, I'm still reviewing your info) why should he/she further increase his/her salary and benefits from additional funding when the real need is at the bedside?

I recently read a professional magazine (I can't remember the name) where one of the writers of an article wrote that we need to predict as well as prevent problems when it comes to health and patient care. I've been through several nursing shortages in my career and each time, mostly money gets thrown at the problem without any real resolution from those of us in nursing or outside of nursing. Suddenly, we're experiencing an unprecedented growth of people with acute and chronic illnesses in our nation's history and now they decide to take action after much damage has already occurred.

In my opinion, health/medical care services, like education, should not be mired in the vicious cycle of profit. I'm all for readjusting the way that we deliver care if its proven, and it was back in the early 1980's, that we're being overly wasteful with the resources. I'm all for settling for a moderate, albeit very livable wage. But, this is only if the CEOs, physicians, and various administrators and other vendors will settle for less. The pursuit of excess profits has prevented me from taking care of my clients in the way I know they would best benefit. It has taken much of the joy out of administering care. I don't necessarily long for the old days, just good days.

I still enjoy many aspects of nursing. I enjoy seeing clients/patients learn to manage on their own from my instruction or from other nurses or therapists instructions. When I first came onto this board about one year ago, I came on saying that health and medical care should be approached as a ministry and not an industry. I still stand by that.

Hi. And for those who are interested, I'm emailing some of the representatives on the list that natalie provided.

Originally posted by -jt:

[Quote the temporary solution to their problem. It is to bring the baby boom nurses like me who have left the bedside back for a few years....

This is exactly what they were told at the hearing. Now they need to hear it from all of us too.

Dear -jt, I was just posting the Barbara Mikulski site, doesn't she have a kind face.

Originally posted by Mijourney:

. I guess my question should be, how will the money, resources, and support be allocated? It seems that all too often, legislated monies end up lining and padding the pockets of people who have the least need for it.

The money is specifically earmarked and is not for the CEOs pockets. I would guess that your Congressional Representative could answer your questions in detail. When writng to your Congressman or the Senators on that Healthcare Committee, you might ask what their plans are for the Consolidated Appropriations Act (H.R. 4577)

The following is just a little info on it from December 2000....

"Billions Appropriated for Health Care Programs

Washington, DC -- The American Nurses Association (ANA) applauds the Clinton Administration and Congress for approving a major, last-minute legislative package that will address many pressing health care needs. President Clinton is currently poised to sign the bill, the Consolidated Appropriations Act (H.R. 4577), which will increase funding for a number of key health care programs supported by the ANA. The long-awaited package contains three appropriations bills as well as $35 billion in new Medicare funding.

The package will help relieve the financial pressures on America's hospitals that have exacerbated the crisis in nurse staffing by increasing Medicare's hospital payments by $14 billion over five years. Medicare funding for skilled nursing facilities is increased by $1.6 billion, including a 16.7 percent increase in payments for nursing services.........."

for more info go to http://www.ana.org/pressrel/2000/pr1220.htm

Originally posted by oramar:

I was just posting the Barbara Mikulski site, doesn't she have a kind face.

shes adorable - if you can say that about a fiesty old Senator!

Specializes in Critical Care,Recovery, ED.

-jt

Thanks for starting this thread, interesting an informative as usual. Yes we have a problem today and a diaaster facing us in a few years (10-20 doesn't seem that long anymore). Both problems must be worked on simultaneously or else everyone is spinning their wheels and will go nowhere. Without solving the "working condition/compensation" problem the Nursing profession will continue to appear unattractive and uncompetitive with other career fields. Infusions of massive amounts of capital are needed on many levels. But what is the return on this investment? The economic value of the Nursing profession has never been recognized by the American public. Though health care professionals understand nursings value they will not recognize it if it results in them losing income and access to capital themselves.

If additional funding for medicare is made avaiable and home health reimbursements are raised to provide the necessary capital for improvements in the compensation and working conditions in Nursing I still wonder how much of it would actually get passed on to the RN's? IMHO Nurses simply don't trust the administrators to do this.

Without the improvement in many of the root causes of the current shortage the money spent on increasing the supply of nurses entering the field will be wasted. A continuing revolving door will be created instead with entry and rapid exit from the profession continuing.

Without the improvement in many of the root causes of the current shortage the money spent on increasing the supply of nurses entering the field will be wasted. A continuing revolving door will be created instead with entry and rapid exit from the profession continuing.

yes - That is the very point that was made at this hearing. Everyone finally seems to be on the same page so I think that Senate hearing was very important first step in correcting the problem. I'm encouraged.

From American Hospital Assoc. http://www.ahanews.com/asp/ArticleDisplay.asp?PubID=2&ArticleID=13744

AHA News Monday, February 19, 2001

Senate panel told nursing demand will outpace supply by 20% in 2020

by Che Parker

Debate surrounding the nation's worsening nursing shortage heated up last week in several quarters, with experts telling a Senate subcommittee that by 2020 the demand for nursing services is expected to exceed supply by 20% as just one chilling highlight of that debate.

Witnesses at the Feb. 13 hearing of the Senate Health, Education, Labor and Pensions subcommittee on aging warned Senators of a pending major health care crisis in America if action isn't taken now.

Senators on the subcommittee on aging were unanimous about the need for immediate action to address the shortage. Subcommittee Chairman Tim Hutchinson, R-AR, stated that in nine years more than 40% of registered nurses would be over the age of 50.

"What if our military was aging and everyone over the rank of corporal would retire in 10 years?" asked Sen. Barbara Mikulski, D-MD. "This is like the military. The safety and health of our nation depends on our nurses."

Sen. Pat Roberts, D-KS, agreed. He compared the nursing shortage and the conditions nurses face to a national security issue that needs prompt solutions.

A panel of expert witnesses testified that 78 million aging baby-boomers, along with a shrinking number of nurses, will have a grave effect on the health and well being of the nation.

George Benjamin, M.D. and secretary of the Maryland Department of Health and Mental Hygiene, testified that nurses are "not coming in, they're not staying in, and while they're there, they're not happy."

Sen. Hillary Rodham Clinton, D-NY, said that nurses, not physicians, determine patients' outcome physically and emotionally.

"They love their work, they love their patients," explained Clinton, "but they can't continue to work under the conditions that exist today."

Panelist urged that recruiting programs for students years before reaching high school, higher wages with better incentives, and more flexible hours be instituted as soon as possible.

Brandon Melton, vice president for human resources at Catholic Health Initiatives, testified on behalf of AHA that "the nation will need 1.7 million nurses by 2020, but just more than 600,000 will be available. We realize the severity of the situation and understand that unless we all work cooperatively now, we will face increasingly critical situations in the future," he said.

When asked, representatives of the American Organization of Nurse Executives (AONE) and the American Nurses Association (ANA) said they don't support mandated staffing ratios. (ANA later clarified that it supports "upwardly adjustable" minimums.) They stated that it was difficult to determine proper ratios because health care settings in general are constantly in a state of perpetual motion.

Hutchinson said he plans to introduce legislation soon to focus on nursing recruitment, training and education incentives, and faculty development.

This article first appeared in the February 19 2001 issue of AHA News

Also-

http://www.ahanews.com/asp/ArticleDisplay.asp?PubID=2&ArticleID=13747

AHA News Monday, February 19, 2001

Planned bill aimed at nurse shortage

by Che Parker

Sens. Jim Jeffords, R-VT, and John Kerry, D-MA, announced last week they plan to introduce legislation in just over a week they believe will ease the nationwide nursing shortage following the release of a national government survey that puts some alarming numbers to the issue.

The Senators met with health care professionals in Washington on Feb. 14 to discuss immediate solutions to the nation's nurse shortage upon the release of the 2000 National Sample Survey of Registered Nurses (RNs).

The survey, conducted by the Bureau of Health Professions' Division of Nursing, reports educational backgrounds and specialty areas, employment status, geographic location, and demographic makeup of nearly 2.7 million RNs.

Among the findings: the share of the RN population below age 30 dropped from 25.1% in 1980 to 9.1% in 2000, while the average age of all RNs today is over 45 years old.

Jeffords, chairman of the Health, Education, Labor and Pensions Committee, said the survey showed alarming trends that reinforce fears of a looming health care crisis.

Kerry said the multi-tiered plan he and Jeffords plan to introduce is meant to attract quality men and women to the field while providing better hours and pay to those already in it.

For more on the survey, visit http://www.bhpr.hrsa.gov.-- Che Parker

This article first appeared in the February 19 2001 issue of AHA News

I think nurses act more as independent contractors than they did in the past. I feel no loyalty to my employer who hires agency nurses to fill gaps then lays off their own full time personnel in order to pay the agency nurse a full week's pay. I am looking into agency work myself. If all nurses were agency nurses then the hospitals would be screaming for answers to staffing issues. Right now it is YOUR problem, not theirs.

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