Nurses in Demand: A profession in turmoil

[Chellyse]

This report really does not say anything new, however it does point to the reality that there are nurses out there, but unwilling to work in the conditions in existence today.

Nurses in Demand: A profession in turmoil

This time, experts say, shortage is for real

BY TAMMIE SMITH

TIMES-DISPATCH STAFF

When Capitol Medical Center closed, the nurses who lost their jobs didn't have to miss a day of work, administrators said.

Survey says

The Virginia Hospital & Healthcare Association, with input from the Virginia Organization of Nurse Executives, the Virginia Partnership for Nursing and the Virginia Health Care Association, surveyed hospitals last year about the nursing work force.

The survey found there were 21,091 budgeted positions for registered nurses in Virginia hospitals. Of those, 13 percent (2,811) were vacant.

There were 2,419 positions for licensed pratical nurses in hosptials and 3,449 positions for clinical nurse aides.

Shortly after the closing was announced, Capitol human resources director Ralph G. Giannola arrived at work to find a stack of messages. The callers - human resources officials at other hospitals, nursing homes and health-care agencies - were after Capitol's kitchen and dietary staff, cleaning workers and unit managers, but especially the nurses.

A shortage of hospital nurses in the region has created almost a bidding war to get staff.

"I had HCA, Bon Secours, MCV, Southside Regional representatives calling me to find out when they could come in and talk to our associates about jobs," Giannola said.

Some longtimers were sad about the facility closing, he said, but none feared being out of work long.

"Nurses feel in demand," he said. "They know they can go out and get another job."

. . .

Every 10 years or so, there are reports of a nursing shortage. It has the ring of a broken record, of crying wolf. Nursing schools are not graduating enough nurses.

Nurses are leaving the profession faster than they can be replaced.

Hospitals are having to rely on expensive temporary help and costly signing bonuses to attract workers, while the regular nursing staff is overworked, which nurses say jeopardizes their ability to adequately care for patients.

And like clockwork, a few years into the crisis, with intensive recruiting, the situation is corrected.

But this time is different, say health-care work force experts. They see several factors converging to make the current problem of finding nurses to work in hospitals longer-lasting and more severe.

Among the factors:

An aging population. Many nurses are approaching retirement age, while the number of younger nurses is smaller and dwindling still.

At the same time, there are more older people, and with age comes illness. According to the U.S. Census Bureau, one in eight Americans is older than 65, 12 percent more than in 1990. And that number is expected to grow as baby boomers age.

Declining averages in how long patients stay in hospitals means those who are hospitalized are sicker, experts say. So a nurse will have fewer "walking and talking" patients, as one nurse described it, but more bedridden patients who need intensive nursing.

"We have had nursing shortages in the past," said Dr. P.J. Maddox, a nurse and former hospital administrator who now directs the Center for Health Policy, Research and Ethics at George Mason University.

"Before, there were always large numbers of nurses on the sidelines, employed part time or not employed," she said. "That means we had a cadre who could be enticed, through wage increases or other working conditions, to consider coming back."

The difference this time, Maddox said, is the aging nursing population.

Based on national work force data, the biggest group of working registered nurses is between the ages 40 and 49. In 10 years, many will begin retiring.

Twenty years ago, about 25 percent of the registered-nurse work force was younger than 30. Today, it is only 9 percent.

"By 2010 is when we will have this crucial gap where we believe we will have a significant national shortage of nurses," Maddox said.

Yet, at present there is some disagreement on whether there is actually a shortage of nurses. Earlier this year, a congressional report examining labor statistics suggested there are sufficient numbers of nurses and that the problem is a "maldistribution of labor."

For example, in some rural areas of Virginia, hospitals near bigger cities might have shortages, but isolated communities might not because there are fewer places to work other than hospitals.

"We are seeing more of a maldistribution at this point," said Dr. Barbara S. Brown, a registered nurse and vice president of the Virginia Hospital and Healthcare Association.

"Facilities are able to fill positions with traveler, float-pool and agency nurses. This would indicate that the number of licenses is there, but folks are choosing to work under different conditions of employment."

Dr. JoAnne Kirk Henry, co-chairwoman of the Virginia Partnership for Nursing, said reports conflict about whether there is a shortage partly because of the way data are collected.

"Some have looked at hospital nursing. Some have looked more broadly at nursing. Only 59 percent of nurses nationally are employed in hospitals. I have a friend who says nursing is a wonderful preparation for a variety of careers. Most nurses start in hospitals but have so many options for how they may practice."

The Virginia Hospital and Healthcare Association will present new survey data this fall, said Henry, who suspects based on what she hears that the situation has worsened since last fall for communities in central Virgina and the Hampton Roads area.

The Virginia Board of Nursing has undertaken a study of the nursing work force. Board records show 83,302 registered nurses licensed by the state. The work force study, due later this year, will provide answers to where these nurses work, information needed for planning.

In any event, although the federal report says no current numerical shortages can be documented, it does suggest a true shortage is looming if corrective measures are not taken.

Already there are glimpses of what a shortage could mean for patient care. Flu season is a busy time for hospitals, and some in the area periodically had to close their emergency rooms to noncritical ambulance traffic because they were full or did not have nursing staff to handle any additional patients. Ambulance patients were not necessarily taken to the nearest emergency room but to the closest one with room.

Hospital administrators say July and August are usually light months, but that has not been the case this year. One week in July, almost every in-patient bed was filled at Virginia Commonwealth University's Medical College of Virginia Hospitals.

"We have done everything we can to make sure whole units are not closed because of lack of staff," said Donna Katen-Bahensky, MCV Hospitals' chief operating officer. "We are doing everything we can to keep every bed open because the demand is so significant."

Physicians may figure out what is wrong with patients, but nursing care is what makes hospitals safe, said Dr. Sean P. Clarke, associate director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

"If the shortage continues, there are going to be real problems with availability of services," Clarke said. "In some hospitals, they are having to postpone or delay surgeries. Patients will notice waiting lists develop. When there is really no choice in the matter, such as with emergency admissions, there is really a difference . . . in how quickly people come to your aid."

The shortage of nurses is considered a factor in surveys that look at patient complaints about hospital experiences and reports of medical errors. By now, most everyone has heard the advice to have a family member act as an advocate during a hospital stay. It is not a bad idea, said one part-time nurse whose husband was hospitalized recently.

"Nurses have too many patients to give individual care," the woman said. "If I have too many patients, I cannot give the patient any quality of care. Sometimes you don't even know the patient's name. . . . The patient-nurse ratio is just way too high. Things are going to happen. It's a lawsuit looking for a place to happen, and it's not the nurses' fault."

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Contact Tammie Smith at [phone] or [email protected]

http://www.timesdispatch.com/vametro/MGBCWRL6UQC.html

[oramar]

Good article, glad you posted it.

[dazedandconfused]

I am in Va- every word of it is true.

[-jt]

I wrote that writer about how working conditions are mostly to blame for nurses leaving the bedside & new students refusing to choose a career where they will be subject to those same conditions that are causing experienced nurses to bolt out of there as fast as they can. I asked where the voice of staff nurses where in her article and why I didnt see too many comments from bedside nurses telling why they dont want these jobs anymore. Heres part of the reply she sent me:

depth about their working conditions........ since last year when I wrote a nursing story and heard

complaints that I had it all wrong. I asked these people could I interview them for a story on the nursing shortage. Many DECLINED, saying they would lose their jobs if they complained publicly. I understand that. I've arranged to meet nurses outside of the work only to have them NOT SHOW UP or not respond.

In the end, I included quotes from several nurses, without names. That includes a 32-year-old woman new to nursing who doesn't think she will stick with her current job because of the workload, and a part-time nurses whose husband has a major illness and who says the only reason he gets what he

needs is because she is there by his side when he is in the hospital. I also included comments from a letter writer such as your self who had many of the same complaints about working conditions.

The problem is it's hard to "get it straight" if the rank and file nurses themselves are not willing to speak openly.........>>

[suzannasue]

Greetings,

I and 2 of my co-workers requested an interview with our local newspaper, during the nursing shortage of the 1980's. We spoke with the reporter for over 2 hours and he diligently took notes,which we were allowed to read afterwords in order to guarantee accuracy....WELL...when the article was published,my friends and I had no idea where this man's printed words had come from because they certainly didn't come from us...we were misquoted...we were made to look like a bunch of "money grubbing whiners" (that became our nickname in this small community) who didn't want to work,just get the "glory" of being RN's. We were in complete shock. Certain words were deleted,others added. Statements were twisted and gnarled into anything except what we had said. One of my friends who was working at the hospital the day the newspaper hit the stands called me,woke me up from my night shift slumber and read the article to me over the phone at 2:00pm...she said the article had been posted throughout the hospital at 10:00 am by the CEO.

Hmmm...how odd that he would have access to the article hours before the paper was published. I called the newspaper office and demanded to speak to the reporter...he had "just left the building"...I reached him at home and set up a meeting with him and my friends who were involved in the original interview. He, at the meeting, told us that the editor of the paper had to proof read anything that was written and by the time the article was published,he agreed the message had been distorted and changed to the degree that even he didn't recognize his article.

I asked the inevitable question "why in the world did the editor feel he could do this?". We were then told that the editor of the paper was on the hospital board and the assistant editor was the CEO's best friend...ah ha!!!!!!! They purposely "changed "

the article because they didn't want to see their friend's hospital

in a bad light... their "friend" got a copy of the article hours before it was printed...we were not trying to even bring"his hospital" into the message...we were trying to make points about why there was a shortage of nurses in our area...but alas...I wrote a lengthy letter to the editor which proclaimed violation of our right to free speech by the over- exercising of their journalistic license and once again outlined the major points they had lost in the cutting and splicing of our words. The Letter was NEVER published and the editors refused to speak with me over the phone or in person. I called everyone I knew to verify that I was a citizen of the UNITED STATES OF AMERICA and was told I was "supposed" to have freedom of speech according to the Constitution.

I understand that fear is a major emotion elicited from those in our profession by those who are in control of our jobs,those who have no idea of what we do as nurses. We have collectively chosen to keep our voices silent due to fear of the unknown. (HOW DARE WE STAND UP FOR OURSLEVES!!!!!!!!) Are we to trust the media moguls who have the capability to deform our purpose and stance?

WE MUST DEVELOP A COLLECTIVE VOICE AND STAND OUR GROUND...BREAK THE SILENCE...THE TIME FOR ACTION IS NOW!!!!!!!!!!!!!!!!!!!

I wasn't skeert then,I sure as HELL aint skeert now.