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U.S. nursing shortage 'going into crisis'
From Dr. Sanjay Gupta
CNN Medical News
(CNN) -- The nursing shortage sweeping the United States may be worse than even the medical community expected. By the year 2008, another 450,000 nurses may be needed to meet demand, according to government projections.
More than a dozen states are considering legislation that would address mandatory overtime practices found in many hospitals. Congressman Tom Lantos, a Democrat from California, a state hit especially hard by the shortage, has just introduced national legislation.
"It gives the nurses the same kind of protection that airline crews now get," he said. "You wouldn't expect a pilot to fly 18 hours because the danger would be obvious to the passengers, but you expect workers in the medical field, specifically nurses, involuntarily on short notice, to put in unconscionable hours of work."
Irene Telarico, a nurse and supervisor at Grady Memorial Hospital, one of the busiest hospitals in Atlanta, Georgia, couldn't agree more.
"In my career, I believe I have worked at least 20 (hours), with mandatory overtime, 20 hours straight," Telarico said.
Grady now uses voluntary overtime, that is, nurses may be asked to work extra hours or shifts, but are not required to do so. However, many hospitals require overtime.
And that leaves a lot of room for error.
"It's tiring and you worry about performing," Telarico recalled. "When I'm on the 18th hour and I've got sick people I'm worried about and I'm medicating, I'm worrying."
Her voice is echoed by the thousands of nurses, many represented by the American Nurses Association.
"There are hospitals that are unable to schedule surgeries on a timely basis. There are emergency rooms that are going on diversion because they are very busy and there may not be adequate numbers of registered nurses, perhaps in emergency care where many patients may need to be admitted," said Mary Foley, the association's president.
Older nurses leaving profession
The shortage is hitting at a particularly bad time. The fastest growing segment of the population is the elderly, the group that demands the most health care. More experienced nurses, mostly middle-aged women, are leaving the profession at an alarming pace.
"This is a profession going into crisis," said Telarico.
She cites the physical stress. "I have to feed them three meals ... take care of their meds. I have to do a.m.-p.m. care ... and that's really hard when you're trying to manage all of the patients. And we can't shut our doors."
Telarico also finds the profession emotionally draining.
"We deal with a lot of stress and trauma and sometimes we might lose a child or an adult that reminds you of your daughter or your grandfather or your grandmother."
As a nurse, Telarico faces trauma on the job -- as a recruiter, she faces a similar kind of struggle.
"I think there's an easier way of earning a living. I mean, so many people will find they'll go to some other medical profession ... that won't cause you to be on your feet for 12 hours."
Lawmakers are listening to voices such as Telarico's and are taking the complaints seriously, in the wake of several nurses' strikes across the United States. Legislation has been proposed nationally to address the problem.
But they're not waiting for legislation in Walnut Creek, California. Public and private organizations, including the state's welfare-to-work program, have joined hands in a first-of-its-kind effort, dubbed the "Career Ladder," to help solve the shortage.
"It is a program that's funded by the U.S. Department of Labor, through the county, to provide training to the Kaiser workforce to help them essentially move up on a career ladder," said Elizabeth Brashers with Kaiser Hospitals, who helped start the program.
Getting paid to learn
Al Andino had a most unusual climb up the Career Ladder. He spent more than 20 years with Kaiser, mostly in the environmental service department, working in housekeeping and other related services. The father of three found the new program attractive, because it paid participants their full-time wages while they attended.
The group goes through a 10-week program of 40 hours per week that encompasses class instruction and clinical experience. Upon completion, graduates are Nursing Assistants.
Now a "Care Partner," as Kaiser calls him, Andino works in a Walnut Creek hospital, and is proud of what he's achieved.
"I enjoy it. I love it, especially over here working with kids."
The program might slowly help change the face of nursing. Joan Braconi, with the nurses' union, works closely with Kaiser and the welfare-to-work program to recruit people for the new initiative.
"The purpose of this program was to first deal with the staffing crisis, secondly to offer members career opportunities and also to help diversify the workforce," explained Braconi.
The first class of 20 graduated in March 2001.
While lawmakers and hospital officials look for answers to the looming shortage, many young people still are considering other careers.
"I think there's an easier way of earning a living. I mean, so many people will find they'll go to some other medical profession ... that won't cause you to be on your feet for 12 hours or 8 hours, or cause you to do the physical labor that this type of position takes," said Grady's Telarico.
The following CNN Medical News staffers contributed to this story: Executive Producer Susan Deutchman Lilly, Producer Jonathan Lynch and Associate Producer Stephanie Smith.
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