Ellen Grover

Thank you for your comment and sharing your experience. I believe there are many ways we should be valued as nurses. I agree that is what will ultimately will keep people and draw them to the profession.

Nursing shortages are almost as old as nursing itself. If we look back to the beginning of modern nursing over one hundred and fifty years ago, we find varying technological and economical reasons that the demand for nurses has often been higher than the supply. Let’s explore nursing shortages over time to get perspective on the current nursing shortage and discover if the same solutions for previous shortages can help us today or if we can find more lasting solutions this time around. The origin of modern nursing (and subsequent nursing shortages) stretches back to about the time of Florence Nightingale in the 1850s. We all learned about her in nursing school and much of the idea for formal training for nurses and advocating for their importance is due to her. In the United States, the Civil War in the 1860s demonstrated the importance of skilled nurses to care for the injured and ill. Until then, family and close friends primarily provided nursing care to people in their homes. By the 1930s, much of the nursing care in the country was provided by nurses who had trained in hospital programs. While nursing students provided most of the nursing care in hospitals during their two to three years of training, the majority of nursing graduates still worked as private duty nurses outside the hospital. It was during this time that one of the first nursing shortages came about. Throughout the 1930s the country was recovering from the Great Depression and it was very difficult to find work. So how could there be a shortage of nurses when nurses could actually get a paying job at this economically challenging time? Much of it came down to a higher demand for nurses because of more complex technology and increased use of hospitals as a place to receive nursing care. The shortage continued until WWII accentuated how important nurses were to the modern delivery of medical care. Many nurses were involved in the war and they were very important to the wartime effort. The use of nurses in the war took even more away from the civilian population at home. Once the war ended, many expected nurses to return to their pre-war jobs but the nursing shortage only got worse. This post-WWII nursing shortage is very interesting compared to the current one which has been worsened by the COVID pandemic. They are not the same, but there are many similarities: A major worldwide event calls upon nurses more than ever Technological changes continue to drive the need for skilled nurses After the worst of the crisis ends nurses do not return to their previous jobs in the numbers expected After WWII, the shortage appeared serious enough that the U.S. Department of Labor commissioned a study in 1947 to find out the cause of this nursing shortage. Results from the study indicated that poor working conditions, low salaries and long hours, especially compared to other professions at the time, discouraged people from entering and remaining in the profession. This data reinforced findings from previous similar studies earlier in the twentieth century. The solutions to try to fix this nursing shortage were not, however, to increase salaries and improve working conditions. The solutions hospitals used were similar to the ones they had used in the past. These solutions included: Increasing the number of nurses by shortening their training Increasing the supply of nurses by increasing enrollment in schools of nursing Using less educated and less trained personnel instead of or in addition to trained nurses These solutions did provide temporary relief from nursing shortages. However, nursing shortages have continued to occur periodically for various reasons since the implementation of the solutions listed. One aspect that all these nursing shortages have in common is that even if they improve for some time, the shortage returns in one way or another. Now we find ourselves in the midst of another nursing shortage, one that may be felt for many years to come. The US Bureau of Labor Statistics projects 194,000 job openings for registered nurses annually from 2020 to 2030. This is an increase of 9% and is cited as the average for other occupations. However, this data does not take into account the most recent loss of nurses from burnout, career changes, or early retirement brought about by the pandemic. Add to that a report in May 2021 that more than 40% of nurses were thinking about leaving the profession and we have many factors that show us a nursing shortage is likely to get worse. Hospitals, nursing schools, and private companies are taking some action to address the current nursing shortage. These actions include: Improving processes of applications to ensure all vacancies in nursing schools are filled Nursing schools forming strategic partnerships to increase enrollment Media campaigns promoting careers in nursing These are important and worthy goals to pursue. They do address important aspects of the nursing profession and might help improve the nursing shortage for a short period of time in a specific location. However, are they creative solutions or are they different versions of the attempts to fix nursing shortages used in the past? A simple solution these lists do not address is: compensate nurses for what they are truly worth and value the specialized, stressful, and difficult work they do every day. There have been major improvements in the profession of nursing since it was established over 150 years ago. Nursing has developed into a skilled profession that many respect. Nurses are paid better and working conditions in the hospital have improved, although some would say not to an acceptable level. Nurses also have more opportunities than ever beyond the bedside because their training and experience teach them much more than only how to care for a patient in a hospital. An encouraging fact is that applications to nursing schools increased in 2022. In order to continue to attract more to the profession and retain our very valuable experienced nurses, we have to be truly valued for what we do and be compensated well. Nurses are excellent at advocating for their patients and I hope we can advocate for ourselves and our profession in the same way. References University of Pennsylvania School of Nursing. (2011). Nursing, History, and Health Care. Winkelstein, W. (2009). Florence Nightingale, Epidemiology. 20(2), 311. doi:10.1097/EDE.0b013e3181935ad6 Buhler-Wilkerson, K. and D'Antonio, Patricia. (2022, March 1). Nursing. Encyclopedia Britannica. American Association of Colleges of Nursing. (2020, September). Fact Sheet: Nursing Shortage. American Nurses Association. Nurses in the Workforce. Retrieved May 6, 2022 Haddad LM, Annamaraju P, Toney-Butler TJ. (Updated 2022 Feb 22). Nursing Shortage. StatPearls. Bhakta, Parth. (2021, May 3).One Year In What’s Next for America’s Healthcare Workers. Vivian. US Department of Labor (1947, December 9). The Economic Status of Registered Professional Nurses. Pfeifer, G. (2022, February). Defying the Pandemic, Applications to Nursing Schools Increase. American Journal of Nursing. 122 (2), 14.

Thanks for commenting. Great job putting in the effort and prioritizing yourself! I hope you continue and reap the benefits.

Thanks for responding. I agree that finding the time and energy to exercise can definitely be challenging, especially at different stages of our lives.

We all hear about the benefits of exercise, and for many of us as nurses, it is part of our job to encourage patients to stay active. All people are different, and therefore they all have different motivating factors. Some people might desire the more obvious benefits of exercise such as weight loss, increased muscle tone, and increased stamina. Others find the less visible changes to be more beneficial including improved sleep, decreased incidence of depression, and improved mood. The benefits can be short-term, like increased energy, or long-term, such as improved lipid levels over time. These are all excellent reasons to exercise. However, sometimes a small change in perspective can help to drive home the need for something like exercise. Nursing is a challenging profession and can take a toll on physical and mental health, so here are some extra reasons to stay healthy by including exercise as part of your regular routine. These unique benefits are just a few more reasons to help you to stay motivated. The first unique benefit is exercise gives you more time, not less One of the most common barriers is feeling like there is not enough time in the day to get everything done, much less squeeze in time to exercise. Helpful advice is to treat it like an appointment that can’t be canceled and plan ahead to make sure it is in your schedule. But consider this: exercise may give you more energy and help you focus on a task so that you can accomplish more in less time. Exercise can also prevent or delay chronic diseases – what better way to make more time than by living a longer life with less morbidity so you can enjoy those healthy years? The next unique benefit is exercise saves you money If you do some homework, such as researching your health insurance to see if they pay for gym memberships or access to exercise apps or discounts on gym equipment, then you will likely find that you have some good exercise options that are free or inexpensive. Combine those money-saving tools with the decreased incidence of diabetes, heart disease, and other conditions that would cost you lots of money for medical exams, medications, testing, etc., and there is no question that it would save you money on medical expenses down the line. (Why do you think health insurance companies provide those benefits?!) You might even be inspired to combine exercise with other healthy habits such as quitting smoking, cutting down on drinking, and cooking meals at home. All of the above saves you money! Another unique benefit is exercise can help you be more successful Exercise has been proven to improve mood and decrease stress. Investing time and energy into yourself can be empowering. Setting aside time and having reliable equipment to exercise on or joining a group that helps keep you accountable are methods that signal to yourself that you are important and you can do what you set your mind to. Your success in keeping to an exercise program could spread to other areas of your life. It could help give you the self-confidence to ask for a raise or take on a new position you’ve been considering. The final unique benefit is exercise does good for others This could be true in many different ways. For example, you inspire family members or co-workers to start their own exercise after they see the benefits you experience. It can help you stay healthy for longer and therefore better able to care for a family member or keep a job you love. Keeping yourself healthy enables you to be your best self for other people. We have at our disposal a therapy that can help us live longer, save money, be successful, and benefit others. It has no bad side effects (of course you have to exercise safely), and you have many options to find the kind of exercise that you enjoy. It may take a little bit of research, planning, and probably some trial and error to find exactly what works for you, but it will be worth it in the end. If you are working on being more active I hope some of these inspire you to continue your journey. References/Resources Real-Life Benefits of Exercise and Physical Activity Benefits of Physical Activity

It's finally time to put all the skills you have learned in nursing school into practice - with real patients! Your first few clinicals can be exciting but also overwhelming. As a nursing instructor I love to see the energy that new students bring to clinical, and I have found that if students come in with a positive attitude and follow the tips below they are better able to keep up their enthusiasm throughout their rotation and have a good learning experience How To Have a Great Clinical Experience STEP 1: Treat the nurses you work with respectfully. Realize that some will see you as additional work on top of their already very heavy workload. Try to find a way to reduce that workload for the nurse you are paired with. Can you go check a blood sugar? Empty a foley or drain? Help a patient to the bathroom? A recent study showed that developing a positive relationship with the nursing team helped students to feel more satisfied with their clinical experience. (See article here) STEP 2: Volunteer to perform a new skill. A female patient needs a foley placed and your instructor asks who wants to do it. You may be thinking, "I've only ever practiced that in the lab, I'm not ready to try it yet." Do it! You have your instructor with you and probably several other students that want to observe that can also help - it is the BEST time to do your first foley. You never know if and when you will get another opportunity. STEP 3: Remember you are in a professional workplace. The staff and unit manager are all observing you and the other students. Students with extra time on their hands often tend to socialize which can become loud and disruptive. Here are some ideas to do instead: ask if you can answer that call light that's on, look up the medical term/medication/disease process you did not understand, go check on your patient and see if there is anything he needs. You never know if the unit you are on will be hiring after you graduate. They may remember you, and they will remember the reputation of your school during clinicals. STEP 4: Ask questions! Take advantage of the experience of your nursing instructor and the nurses you are working with. This is the time to ask "dumb" questions. As a student nurse most skills are new to you and now is the time to see in practice what you have been learning in the classroom. If you don't know how to do something, ask for help. Never, ever perform a nursing task by yourself that you are uncomfortable with. Remember the safety of your patients is of utmost importance. STEP 5: Work on your care plan. Did I hear a communal groan when I mentioned care plans? They are a part of your clinical experience and they're not going away any time soon. The best you can do is take down all the info you need from your patient's chart while you are at clinical and use it as a learning tool. It may bring up questions you hadn't thought about before (why did my patient on diuretics have such low K and Na?) and help you make connections that you otherwise may not have noticed. It also REALLY does help you learn important details about medications which will be invaluable as you continue to build your nursing skills. STEP 6: Care for a variety of patients. Did you already have a patient with heart failure and diabetes the last two weeks? Maybe your patients all had foleys but none had chest tubes or wounds or drains. Let your instructor know so that she can assign you patients with a wide variety of issues. STEP 7: Arrive on time and be ready to work. Do everything you can to avoid missing a clinical. Sometimes circumstances are out of your control but making it up in the lab is not equivalent and you are missing out on precious time with patients. STEP 8: Review the basics before your first clinical. It's OK to be nervous - I would much rather have a student be nervous than overly confident. However, you MUST know normal vital signs and how to measure them accurately. Practice skills at home AND in the lab during open lab time. Studies have shown that this kind of experiential learning, where students actively observe and participate in learning, positively affects student performance. (See article here) Follow these tips and it will help you improve your skills and develop your competence in treating real-life patients.

Has anyone worked as a virtual ATI instructor? Just wondering how the time commitment/pay is for this position. I am considering applying.

The Novo Nordisk website has great 1-sheet educational materials that you can download and print in both English and Spanish. I use them frequently in the clinic where I work. https://www.novomedlink.com

I do have IRB approval for the study. I have posted it to a few more forums with some success. I think my criteria does make it difficult to find participants, but I do not think I can change that now.

Hey everyone, I am in the middle of my research project for nursing school and am having a difficult time finding people to take my online survey. The people I am trying to target are women who: had a baby within the last six months, smoked cigarettes before or during pregnancy, and had any prenatal care. It is about a 15-minute survey. I have it posted on a couple of parenting websites, including cafemom.com, kellymom.com, and about.com, but have just not gotten a great response. Any suggestions? (Of course, if any of you fit the criteria and want to help me out, I would really appreciate it! You can find my survey here). Thanks!