Paper on govt. nursing subsidies and shortage

jjjoy, LPN · Nov 29, 2007

Thanks for the link!

I thought one line on page 10 was where this article should've gone...

How our health care system can afford to compensate nurses what they are worth is a separate but related question.

I can see the argument that subsidized nursing education isn't a magic solution to the nursing shortage. After all, there's a very high attrition rate in nursing. I don't see, though, that subsidized nursing education is anywhere at the root of the problem, though. Having paid more for one's education will only go so far in increasing their commitment to the field. Better pay and better working conditions are cited as major incentives for nurses.

lindarn · Nov 29, 2007

Thanks for the link!
I thought one line on page 10 was where this article should've gone...
I can see the argument that subsidized nursing education isn't a magic solution to the nursing shortage. After all, there's a very high attrition rate in nursing. I don't see, though, that subsidized nursing education is anywhere at the root of the problem, though. Having paid more for one's education will only go so far in increasing their commitment to the field. Better pay and better working conditions are cited as major incentives for nurses.

The root of the story, and the point of blaming subsidizing nursing education, is the it has only accomplished causing a glut of nurses to be added to the already adequate supply of nurses. The basis of this is nurses being pushed into a "quick turnaround" education system, where nurses graduate from "ABC Community College" every year, as opposed to having nurses attend four year BSN program, that forces employers to wait for the next batch of new grads.

This, in my opinion, is the root cause of most, if not all, the problems we have in nursing today. As the article pointed out, with a constant supply of new nurses, there is no incentive on the part of employers, mainly hospitals and nursing homes, to increase pay, benefits, and improve working conditions. It will never change until there is a REALLY BIG INCENTIVE for hospitals and nursing homes to have to really work at making this work attractive to nurses to want to stay in this environment. This being raising salaries, improving bebefits, and vastly improving working condition, for the bedside nurse.

Also what has to change, is allowing nurses more control of their working environment. Like limiting visiting hours, supporting nurses when they try to enforce visiting hours, allowing nurses to call the shots so they can provide patient care like it should be provided.

There was nothing more frustrating to me, than the out of control visiting policy in the hospitals. There is no reason for families to "camp out" in the patients room 24/7. Parents don't camp out in the kids classroom to "make sure that the teachers teach", do they? You would get thrown in jail if you tried to do the same thing in the public schools. Why, then do we have to put up with it in the hospitals?

That is just one aspect that nurses need to take control of. It will never happen until we take over the power to control our work environment. Change the entry into practice to a BSN, and 'grandfather in" all ADN and Diploma grads. Phase out ADN and Diploma program over five years. Increase the education of LPN/LVN to a two years Associates Degree/ Physical Therapy ASSISTANTS have an Associates Degree as entry into prectice. Recreational Therapist have a four year Bachelors Degree as entry into practice!! There will be a change in the entire nursing environment when employers have to wait for nurses to graduate. LIke they have to wait for PTs, OTs, Pharmacists, etc. And stop the revolving door of nursing employment caused by dissatisfaction of bedside nursing.

We also have to become politically active to prevent any more de skilling of our professional practice that allows hospitals and nursing homes to use "nurse extenders" to care to patients, pass medications, etc. I have been a nurse since 1975, and was originally a Diploma grad. I haved spent 30 years watching how things have come about and how nursing and the healthcare profession has changed. After observing how the nursing professions had been "molded" by hospitals and nursing homes, it is my educated guess, and strong feeling, that the goal of these institutions is to de skill nursings' professional practice as much as possible. That will allow them to function with as few RNs as possible.

They are looking at the big picture of the future of baby boomers aging, and causing a sharp increase in the number of nurses that will be needed. They are trying to "head that off at the pass", by de skilling and dis-empowering nurses now. They will not be in a position to demand sharp increases in pay, benefits, improved working conditions, etc. Which would be the logical result of a vast need for nurses.

THINK OUT SIDE THE BOX!! LOOK AT THE BIG PICTURE!!!

Lindarn, RN, BSN, CCRN

Spokane, Washington

elkpark · Nov 29, 2007

The root of the story, and the point of blaming subsidizing nursing education, is the it has only accomplished causing a glut of nurses to be added to the already adequate supply of nurses. The basis of this is nurses being pushed into a "quick turnaround" education system, where nurses graduate from "ABC Community College" every year, as opposed to having nurses attend four year BSN program, that forces employers to wait for the next batch of new grads.
This, in my opinion, is the root cause of most, if not all, the problems we have in nursing today. As the article pointed out, with a constant supply of new nurses, there is no incentive on the part of employers, mainly hospitals and nursing homes, to increase pay, benefits, and improve working conditions. It will never change until there is a REALLY BIG INCENTIVE for hospitals and nursing homes to have to really work at making this work attractive to nurses to want to stay in this environment. This being raising salaries, improving bebefits, and vastly improving working condition, for the bedside nurse.
Also what has to change, is allowing nurses more control of their working environment. Like limiting visiting hours, supporting nurses when they try to enforce visiting hours, allowing nurses to call the shots so they can provide patient care like it should be provided.
There was nothing more frustrating to me, than the out of control visiting policy in the hospitals. There is no reason for families to "camp out" in the patients room 24/7. Parents don't camp out in the kids classroom to "make sure that the teachers teach", do they? You would get thrown in jail if you tried to do the same thing in the public schools. Why, then do we have to put up with it in the hospitals?
That is just one aspect that nurses need to take control of. It will never happen until we take over the power to control our work environment. Change the entry into practice to a BSN, and 'grandfather in" all ADN and Diploma grads. Phase out ADN and Diploma program over five years. Increase the education of LPN/LVN to a two years Associates Degree/ Physical Therapy ASSISTANTS have an Associates Degree as entry into prectice. Recreational Therapist have a four year Bachelors Degree as entry into practice!! There will be a change in the entire nursing environment when employers have to wait for nurses to graduate. LIke they have to wait for PTs, OTs, Pharmacists, etc. And stop the revolving door of nursing employment caused by dissatisfaction of bedside nursing.
We also have to become politically active to prevent any more de skilling of our professional practice that allows hospitals and nursing homes to use "nurse extenders" to care to patients, pass medications, etc. I have been a nurse since 1975, and was originally a Diploma grad. I haved spent 30 years watching how things have come about and how nursing and the healthcare profession has changed. After observing how the nursing professions had been "molded" by hospitals and nursing homes, it is my educated guess, and strong feeling, that the goal of these institutions is to de skill nursings' professional practice as much as possible. That will allow them to function with as few RNs as possible.
They are looking at the big picture of the future of baby boomers aging, and causing a sharp increase in the number of nurses that will be needed. They are trying to "head that off at the pass", by de skilling and dis-empowering nurses now. They will not be in a position to demand sharp increases in pay, benefits, improved working conditions, etc. Which would be the logical result of a vast need for nurses.
THINK OUT SIDE THE BOX!! LOOK AT THE BIG PICTURE!!!
Lindarn, RN, BSN, CCRN
Spokane, Washington

I'm not saying that I disagree with most of what you have to say here, but I'm puzzled by your statement that eliminating ADN programs would force employers to "wait" for BSN students to graduate. Every BSN program I'm aware of graduates students every year (just like the community colleges) -- in fact, the last BSN program in which I taught (a state university program) graduated two cohorts a year, one in December and one in May. Also, if ADN programs were eliminated (not that I believe for a moment that that's going to happen!), all the BSN programs would enlarge their programs to accomodate larger numbers of students each year.

I certainly agree with you that increasing the number of new graduates being cranked out each year is not the answer to the so-called (but non-existent) "nursing shortage." Unfortunately, the current model of turning out large numbers of minimally-prepared new nurses every year suits the interests of both hospitals (no need to increase salaries and/or improve conditions) and colleges/universities (increasing numbers of nursing students = increased revenues). Even if nursing did try to make an organized effort to change the status quo, we're facing stiff opposition from a number of powerful, well-organized, well-funded fronts, and we all know that trying to organize nurses on anything, even our own professional interests, is about as productive as herding cats. (I'm not saying it's not worth trying -- just that the odds are not good.)

As for the increased (open) visiting hours in hospitals, the difference between that and your example of parents attending school with their kids is that attending school is a routine, ordinary experience, whereas having a family member with a health problem severe enough to require hospitalization is, by definition, a family crisis. I've been a nurse since Hector was a pup, too, and I agree with you that visiting hours are often abused (and can be frustrating for nurses) but, on the other hand, if anyone tried to tell me that I couldn't visit a hospitalized family member whenever and as much as I wanted, there would be all kinds of heck to pay! So why wouldn't other families feel the same way? It would be nice, though, if hospitals would back up nurses in intervening with visitors who are intrustive or disruptive on units ...

jjjoy, LPN · Nov 30, 2007

I just don't see the argument that hospitals count on the new grads to meet their nursing needs. New grads are expensive to get up and running and if the hospital doesn't provide support to new grads, there's a great risk of their new grads quitting completely after a few months.

I could see how admistrators might encourage the hiring of less experienced nurses with lower wage demands but that's just bad policy - period - whether or not there is a study supply of newbies available or not. It's not safe for facilities to have a high percentage of inexperienced nurses. It's as bad a policy chronic understaffing (when the census is low and there actually could be decent nurse/patient ratios - the floors still feel understaffed - so that's not a shortage of nurses, it's a shortage of funding). It's as bad a policy as HR not following up on qualified applicants even while bemoaning their inability to find enough qualified staff. It's as bad a policy as not increasing wages, benefits and improving working conditions and then saying it's a shortage of personnel as opposed to a shortage of people willing to work under the current conditions.

llg, PhD, RN · Nov 30, 2007

Thanks for the link. I'm bumping the thread so that it will be easy to find if I want to add a comment after I read it. :specs:

elkpark · Dec 1, 2007

I just don't see the argument that hospitals count on the new grads to meet their nursing needs. New grads are expensive to get up and running and if the hospital doesn't provide support to new grads, there's a great risk of their new grads quitting completely after a few months.
I could see how admistrators might encourage the hiring of less experienced nurses with lower wage demands but that's just bad policy - period - whether or not there is a study supply of newbies available or not. It's not safe for facilities to have a high percentage of inexperienced nurses. It's as bad a policy chronic understaffing (when the census is low and there actually could be decent nurse/patient ratios - the floors still feel understaffed - so that's not a shortage of nurses, it's a shortage of funding). It's as bad a policy as HR not following up on qualified applicants even while bemoaning their inability to find enough qualified staff. It's as bad a policy as not increasing wages, benefits and improving working conditions and then saying it's a shortage of personnel as opposed to a shortage of people willing to work under the current conditions.

As we all know, though, the fact that all of these things are "bad policy" (and I agree with you that they are) does not for one moment stop hospitals from doing them ...