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Topics About 'Nursing Shortage'.

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  1. Many clinicals for nursing programs have been cancelled due to COVID-19 yet nurses are needed more than ever. Delaying future nurses is not a solution to this problem and much learning is done on the job after graduating. It may help future nurses to graduate sooner rather than later to be better prepared if COVID-19 lasts longer than a few more weeks or months. Also this set-up treatment sites will need staff (aka nurses and doctors) but many states can not depart with their own. By allowing senior nursing students to graduate now they have a better chance of getting the training they need for this situation it will also help increase the number of available healthcare workers with stealing from other needed areas. Please take time to consider this petition and sign if you agreed to graduating senior nursing students..... I am not saying that these students are ready, I am saying that graduating them earlier gives them a better chance to be ready by allowing more training time. There is the possibility that they will officially graduate and enter the workforce when this situation is at its worst and there is very limited training time for them. https://www.change.org/p/michigan-governor-gretchen-whitmer-the-healthcare-system-is-in-dire-need-let-senior-nursing-students-graduate?recruiter=1060099439&utm_source=share_petition&utm_medium=facebook&utm_campaign=psf_combo_share_initial&recruited_by_id=253a9fa0-6c94-11ea-b075-cda65030bef3&utm_content=fht-20953287-en-us%3Av2
  2. A Chattanooga, Tennessee newspaper recently published an editorial analyzing the root cause of the area’s nursing shortage. Roy Exum, a local controversial opinion columnist, offered an alternative explanation that contrasted the underlying problems identified by area hospital leaders. The op-ed was written in response to a news article highlighting Chattanooga’s nursing crisis and recent events surrounding Erlanger Health Systems. Erlanger Events In May 2019, the physicians making up Erlanger’s 11 member Medical Executive Committee unanimously approved a no-confidence vote “in the structure of the current executive leadership”. The letter raised concerns about the quality of care and patient safety within Erlanger Health Systems, specifically understaffing, poor morale and policies that cause overcrowding in the emergency department and operating rooms. Chattanooga’s Nursing Shortage According to the Times Free Press, there are six different nursing programs in the Chattanooga region. Nearly 500 students graduate each year and more than 6,500 nurses live in Chattanooga’s Hamilton County. However, local hospitals are still challenged to fill critical positions. Rhonda Hatfield, chief nursing officer at the area’s CHI Memorial acknowledges Chattanooga’s supply of nurses is better than many areas. However, city is experiencing the same staffing challenges that are faced nationwide. Hospitals, insurance companies, ambulatory centers and physician practices all compete for nurses not only locally, but also in nearby Nashville and Atlanta. Local leaders attribute the challenge of recruiting and retaining nurses is related to several factors, including: Aging nurse workforce Low unemployment rates Lack of nursing faculty Patient acuity increase on hospital floors Nurses entering nurse practitioner programs Unable to maintain work-life balance Demands of nursing The greatest need is for medical-surgical bedside nurses, however, increasing patient acuity often steers nurses away from this area. Strategies for Recruitment and Retention Chattanooga hospitals have implemented a variety of strategies to attract and retain nurses. These include: Sign-on bonuses Tuition reimbursement Scholarships Student loan assistance Retention bonuses Funding of faculty positions Partnering with area nursing programs Roy Exum’s Recommendations In "Roy Exum: A Nursing Shortage?", published July 15, 2019 in the Chattanoogan, Exum shares his own controversial reasons for the shortage in Chattanooga hospitals. I admit, his reasoning does provide food for thought when considering the nation’s nursing crisis. According to Exum, the real root cause of the nursing shortage in Chattanooga is “gross mismanagement at the middle and upper levels of nursing” in the top 3 area hospitals. Other contributing factors expressed include: Poor treatment of nurses Forced overtime Off day call-in Verbal “bashings” Poor staffing and overworked No merit system for raises Lack of reward for individual excellence The Darkside of Sign-On Bonuses? Exum takes aim at a popular recruitment strategy, sign-on bonuses. After signing the contract and receiving the bonus money, Exum claims nurses are assigned to floors with “1 nurse for 24 beds”. And with the bonus money spent, the nurse is unable to pay it back and trapped working in miserable conditions. The article proposes doing away with sign-on bonuses, and instead, implement retention bonuses. Without sign-on bonuses, nurses will have a “no strings arrangement” and be in control of if and when they seek other employment opportunities. Without a sign-on bonus contract, Exum predicts hospital administrators will be forced to take “gigantic steps” in retaining nurses. Conclusion The nursing shortage in Chattanooga is not unique. And, the events at Erlanger Health Systems most likely parallel other U.S. hospitals. Factors contributing to the nursing shortage identified by Chattanooga’s hospital administrators are familiar and widely accepted. These factors are much “cleaner” and broadly brush over the harsh reality of the opinion article. Does Exum’s analysis of contributing factors have teeth and legitimacy? What do you think? Erlanger Board Approves Budget Chattanooga Hospitals Struggling With Shortage of Nurses
  3. The words "older adult" often produces a stereotypical image of someone who is sick, slow, frail and senile. As I age, I am guilty of thinking aging is all about decreasing... decreasing physically and decreasing mentally. The National Council of State Boards of Nursing 2015 Nursing Workforce Study reported 50% of registered nurses and 46% of licensed vocational nurses are over the age of 50. Institutions are exploring ways to retain these older nurses in a strategy to maintain the nursing workforce as nurse baby boomers retire. However, ageism is a threat to the profession's ability to maintain enough nurses in the workforce to meet the healthcare needs of our aging population. If you are in search of a lively discussion, just ask the question "At what age should a nurse retire? The conversation will most likely be divided and laced with stereotypes of older individuals. It is realistic older nurses experience more chronic disease and may find the physical demands of nursing challenging. This generation may also be less comfortable with the use of technology. However, negative stereotypes and myths of older nurses remain a threat to the nursing profession. Let's explore deeper the realities and myths surrounding aging nurses. Older Nurses Do Not Have The Physical Strength Needed For Job Role It is true the body does experience a small decrease in muscle strength from ages 40 to 65. There are many muscles in the body and they decrease in strength at different rates. Therefore, there is no one test that assesses a person's overall strength. A nurse with many years of experience has most likely developed successful strategies in meeting physical aspects of a job. In addition, nurses maintain muscle strength with the day-to-day walking, lifting and carrying that comes with the job. A benefit to a career in nursing is the diverse settings nurses, both young and older, are needed. Many jobs outside of the hospital and bedside nursing are less physically demanding. These jobs require the experience and expertise that is prevalent in older nurses. Nurse Educators- Nursing programs are currently turning away students, due to the shortage of nurse faculty, at a time when the need for nurses continue to grow. Outside of the classroom, older nurses experience is knowledge is needed to fill clinical instructor positions. Nurse educators are also hired by medical device companies, textbook publishers, community clinics and others. Public Health Nurse- These nurses focus on the health of a community, school, community organization and community health clinics. Occupational Health Nurse- Serves employees of a business to promote overall health, safety and injury prevention Older Nurses Think Slower And Are Less Productive Managers and co-workers are often concerned that older nurses have trouble meeting the mental demands of nursing. Posthuma and Campion (2009) synthesized over 100 studies on stereotypes of older workplace employees One theme that emerged is the stereotype older workers are less motivated and lack competence. It is true, especially with bedside nursing, that productivity declines with age. The Occupational Outlook Handbook (2016) reports 61% of nurses work in a hospital, however, many nurses successfully work bedside beyond age 65. In addition, the nursing profession offers jobs in a wide range of areas and settings. Older Nurses Do Not Like Change And Are Stuck In The Past. This is a myth and can easily be dispelled with 3 key points. First, baby boomers typical place a large amount of trust in leadership and in the strategies of their leaders. However, it is important to the older employee that they understand how change supports new strategies and how it will benefit or improve their ability to perform a job role. Second, older nurses bring knowledge that only years of expertise can provide. Through mentoring and informal teaching, older nurses can pass their knowledge on to newer, less experienced nurses. Third, older nurses stay informed of new standards, skills and healthcare changes through to their state board of nursing continuing education requirements and workplace training. Older Nurses Call Out And Use More Sick Time Although older individuals have more chronic illness, young and older workers actually have similar absentee rates. In addition, studies have shown younger workers have more acute illness than older workers. Consequences Of Stereotypes Ultimately, ageism in nursing negatively impacts the patient's experience. Stereotypes can make an older nurse feel unwelcomed and unappreciated. Older nurses may feel pressure to retire- leading to a staffing gap in a healthcare environment that is already understaffed. As our population continues to age, older nurses understand the aging experience. Having nurses on staff that understand their specific needs significantly improves the patient experience. Older nurses are valuable to the community and nursing profession. What you can do to address ageism in nursing Reflect on your own views about aging and the older nurse Be aware of common stereotypes and your own attitudes that reflect ageism Avoid telling or laughing at jokes with themes of ageism Avoid gossip about the performance of an older peer. Acknowledge how older nurses benefit the patients in your setting. A Final Thought Being aware of the realities and myths are the first step in supporting older nurses. Experienced nurses bring a wealth of knowledge that is valuable to younger nurses and patients. With the looming nursing shortage, it is important for the nursing community to continue identifying strategies to retain aging nurses. Resources: American Association of Colleges of Nursing, (2017). Nursing Shortage Fact Sheet, Nursing Shortage Nurse Journal (2018). 155 Super Great Non-hospital Nursing Jobs for Nurses. 15 Super Great Non-Hospital Nursing Jobs for Nurses | 218 NurseJournal.org Stokowske, L. (2008). Old but not out: the aging nurse in today's workforce. Medscape: Medscape Access The NTAR Leadership Center
  4. I had no idea, when I took a job as a nurse manager of an inpatient unit at a rural hospital that's 4 hours away from the nearest large city, that a huge portion of my job stress would come from the fact that we DO NOT HAVE ENOUGH NURSES!! Every unit at our facility has job openings. We have dozens of travelers. My department basically has just enough nurses to cover core staffing. What that means is - if there's a sick call, or a PTO request, or a medical leave of absence, we're short. Thank Dog that my unit is awesome and they are a team and a family and are invested in the unit, because when we're short, the nurses pull together and volunteer to take OT and work 16 hour shifts. The point of this post...if you're a new grad, and you can't find a job because the market is so competitive and every place is wanting a BSN...consider relocating! Look for those facilities that are in rural communities, or small towns that are >2 hours away from the nearest metro area that probably has multiple schools and a steady stream of new grad nurses to fill positions. Coming from Denver, I had no idea that there really were places in the US that had shortages, but it's true, and it sucks. For patients, for communities, and for the nurses who are working short-staffed or working 60-hour work weeks because, well, we have no other options.
  5. In our 2017 salary survey we asked nurses when they anticipate leaving the nursing workforce and factors influencing their decisions. Using data from more than 18,000 participants, projections for the future of the healthcare industry, and statistics about nurses and patient population, we can discuss ideas about what seems to be continuously driving this shortage and perhaps how a difference can be made. Nursing is one of the fastest growing occupations, yet with more than 3 million nurses in the U.S., demand for nurses is rapidly catching up with the supply. Let's take a look at where we stand right now in the shortage and where we can predict the next decade to take us. Using the 2017 allnurses salary survey, projections for the future of the healthcare industry, and statistics about nurses and patient population, we can discuss ideas about what seems to be continuously driving this shortage and perhaps how a difference can be made. A Bit of History The shortage of nurses at the bedside has been an ongoing problem for decades that has ebbed and flowed due to several factors. Looking back at the 70's you will see a large number of women entered nursing schools around the country. This is In some part due to the demand, but primarily due to the limited number of choices for women in the workforce. Shortage Postponed As we jump forward to the present, we can see how those same nurses of the 70's who are part of the largest generation in American history, the Baby Boomers, are getting ready for retirement. However, due to economic uncertainty and recession, many nurses of this age and generation who might consider retiring, have deferred doing so. As the economy begins to stabilize and is projected to continue to upswing, a very large portion of our nursing population will be leaving the full-time workforce. According to the ANA, nearly 700,000 nurses are projected to retire or leave the labor force by 2024. In a 2013 study conducted by the U.S. Health Resources and Services Administration, 187,200 nurses reported that they intend to retire or take a non-nursing job when the economy improved. Almost 82,000 intend to change to Part-time employment, which would add up to about 270,000 Registered nurses leaving full-time employment. With these retirement statistics added to other factors we will discuss, the nation will need to produce 1.13 million NEW Registered nurses by the year 2022 to fill these jobs. FIGURE 1 Ages of Nurses - 30% Age 50 and Above (Boomers) The Aging Boomers The aging Baby Boomers will present other challenges that will impact the nursing shortage and the healthcare industry in general. America has had a vast increase in the number of people over 65 with chronic medical and health issues that put a strain on the health system. As baby boomers continue to age, it is projected by the Centers for Medicare and Medicaid Services, that between 2010 and 2030 the population of senior citizens will increase by 75% to 69 million. That will make 1 in every 5 Americans a senior citizen. Approximately 80% of senior citizens have 1 chronic condition and 69% of seniors have at least 2 chronic medical conditions. As people live longer with multiple chronic diseases, demand for services will increase including hospitalizations, driving the demand for bedside nurses even higher. In addition to the aging Baby Boomers, the combination of the inundation of new patients with access to the healthcare system due to federal insurance reform (yet to be seen), plus a stronger economy will result in a flooding of the healthcare system. Shortages are expected to occur across the entire healthcare field, but nurses will take the biggest hit. According to the US Department of Labor Statistics (BLS), employment projections for nurses between 2012 and 2022, total employment rates for Registered Nurses and Advanced Practice Nurses will need to increase by 575,000 to meet the demands of all of the factors influencing healthcare today. You would think that this means an increase in the number of students entering into nursing programs, however, that is not the case. The BLS mentions that "US nursing schools turned away almost 80,000 qualified applicants from BSN and graduate nursing programs in 2012 due to insufficient faculty, clinical sites, class space, clinical preceptors and budget constraints." While there have been some strides in several states and national programs in offering incentives for students to attend nursing school, aging faculty leaving the workforce again becomes a barrier. Some universities are providing fellowships and loan forgiveness for nurses who agree to teach after graduation in the university's state. Also, some companies associated with healthcare have jumped on the bandwagon of support for nurses during this shortage. Where is the Nursing Shortage Today? The top 5 states that are feeling the nursing shortage the most in 2017 are: California Florida New York Ohio North Carolina There are several others close behind due to either aging population in that state, decrease in nursing school graduates, or nurses leaving the bedside due to various reasons. Nurses also want to practice to the fullest scope of practice and some states limit what nurses can do legally. South Dakota, for example, limits the scope of how Advanced Practice Nurses can practice clinically. Therefore those states may have lower desirability for nurses looking to practice healthcare to the fullest extent of their license. Why & When are Nurses Leaving? FIGURE 2 Factors Affecting Leaving Nursing FIGURE 3 When nurses age 50 and above will leave The 2017 allnurses Salary Survey results show the bulk of nurses from all levels of education, experience, specialty, locations, etc. plan to leave the nursing profession due to retirement and age as we would expect. While the statistics for all respondents show almost 54% leaving in more than 16 years, Figure 3 above shows statistics for those 50 years of age and above. 61.78% of nurses in that age group will leave the workforce within 10 years, 39.46 leaving before 7 years. That will account for more than one million nurses across the U.S. This will definitely impact the timing and severity of the nursing shortage. Job dissatisfaction is the next primary reason nurses report leaving. All of the reasons come back to the nursing shortage in some way. Nurses are leaving due to nurse/ patient ratios being unsafe. This may be one of the most discussed topics in nursing today. Groups have been formed to put pressure on the legislature to improve these ratios. Many feel (and studies support) that caring for too many patients leads to increase in medical errors, low patient satisfaction, decreased quality of care. Having poor staffing numbers also increases the amount of overtime that nurses are required to work; which increases fatigue and high burnout rates. Nurses do not feel safe in caring for their patients when they are stretched so thin. As nursing is a profession that incorporates technology, critical thinking, and emotional connection with patients and families, you can see where these factors would lead to job dissatisfaction. Nurses feel unable to give what patients deserve and this can take an emotional toll on individuals and alter the tone of the work environment. Increased patient loads equal high turnover which is costly, disruptive and potentially harmful to patient safety. Overall the nursing shortage is a circular problem. Nurses are leaving the bedside faster than they can be replaced. The patient population will continue to increase which will make the nursing shortage that much more dramatic. As nurses are dissatisfied and feel unsafe and under supported, they are either choosing to leave healthcare altogether, advance their degree, or continue nursing but in a non-bedside capacity. Although nurses from all areas, levels and specialties will be exiting in great numbers, the bedside exodus will be felt the greatest. This shortage is projected to worsen as baby boomers retire from nursing and create a larger patient volume to be absorbed into the healthcare system. Several states are already feeling the effects of the "nursing shortage tsunami" as it has been called and the trend will continue unless we can make changes. What Do You Think? Take a look at the interactive graphs below to see why and when nurses are leaving the workforce. Do you see anything surprising? How does your thinking about the why and when of leaving the nursing workforce compare with the results? Let us know your thoughts. Are you feeling the shortage in your area already? What other factors go into the shortage? How do we make a positive impact? Nurses Leaving the Workforce FIGURE 4 When Do You Anticipate Leaving the Workforce FIGURE 5 When Do You Anticipate Leaving the Workforce Why Do You Plan to Leave the Nursing Workforce? FIGURE 6 Be sure to view the 2017 allnurses Salary Survey Results Part 1 References: BHW.HRSA - The Future of the Nursing Workforce: National and State Level Projections, 2012-2025 NursingWorld.org Nursing Shortage Bureau of Labor Statistics Employment Projections: 2014-24 Summary TheAtlantic.com/The U.S. Is Running Out of Nurses/Feb 3, 2016

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