True Shortage of Nurses???

Hi Vicky-

It's no wonder you can't find concrete info, since even the so-called experts disagree. I think it is a little of both (true shortage and also terrible working conditions scaring RNs away). You must know from personal experience, as I do, that RN retention is a big problem in the hospitals. I heard a statistic a few years ago about 5 year drop out rates for new RNs (I forget the number) and it was notable. It really angers me that our own peers won't recognize the multifaceted issues that contribute to the shortage.

I also think professors of nursing don't want to scare off the new "student RNs" with the grim realities of floor nursing and tales of burnout. I work in acute care & I am on the verge of burnout, and so are many of my peers. While my hourly pay has increased, working conditions have NOT improved. Many people, including myself begin to wonder if working that hard for so many years is worth the toll it takes on your mental and physical well being.

Here's an interesting article I found that might contribute to your discussion:

http://www.afscme.org/una/sns04.htm

It's important to consider all sides of the issue (including retention). I believe this topic is also being discussed currently in other threads on Allnurses, if you do a search. BTW- What are your thoughts on it?

This is great! (Just what I was looking for :)) Thank you so much!

Do you think Nurse-Patient ratio legislation would help?

Hi Vicky-

It's no wonder you can't find concrete info, since even the so-called experts disagree. I think it is a little of both (true shortage and also terrible working conditions scaring RNs away). You must know from personal experience, as I do, that RN retention is a big problem in the hospitals. I heard a statistic a few years ago about 5 year drop out rates for new RNs (I forget the number) and it was notable. It really angers me that our own peers won't recognize the multifaceted issues that contribute to the shortage.

I also think professors of nursing don't want to scare off the new "student RNs" with the grim realities of floor nursing and tales of burnout. I work in acute care & I am on the verge of burnout, and so are many of my peers. While my hourly pay has increased, working conditions have NOT improved. Many people, including myself begin to wonder if working that hard for so many years is worth the toll it takes on your mental and physical well being.

Here's an interesting article I found that might contribute to your discussion:

http://www.afscme.org/una/sns04.htm

It's important to consider all sides of the issue (including retention). I believe this topic is also being discussed currently in other threads on Allnurses, if you do a search. BTW- What are your thoughts on it?

Do you think Nurse-Patient ratio legislation would help?

Yes, but only if it is strictly enforced. I am in CA and hospitals are currently trying to reduce the patient load, but it isn't working. Why? Because there are not enough Nurses to pick up the extra patients that result from the cut. There was an article in the paper last week that said something like, "Nurses Refuse To Take Care of Patients." This was only partially true. What it should have said was, "Nurses Refuse To Take Care of 8-10 Patients At A Time Because It Is Unrealistic, Jeopardizes Patient Safety and Nurses Don't Want To Lose Their Licenses Because Of It."

Here is a short pull-out from a research paper I wrote on the nursing workforce last summer - it maybe has some of the figures you are looking for?

Current Data on the Nursing Workforce

Studies by the United American Nurses, AFL-CIO (Lake Snell Perry, 2002), the SEIU Nurse Alliance (2001), and others claim that the current nursing shortage is the biggest problem faced by the profession today. The mainstream media has been quick to concur (Pekkanen, 2003). Nurses surveyed by Peter D. Hart Research Associates (2001) on behalf of the Federation of Nurses and Health Professionals almost unanimously responded that they believed there was a current nursing shortage. 84% indicated that the shortage was moderate to severe, and 14% believed that there is at least a minor shortage; only 2% felt that there was no shortage to speak of.

The facts do not provide evidence of a shortage, however. In 1998, there were 2,221,000 active registered nurses, but only 2,078,810 nursing positions. At that time, despite cries of a shortage, there was actually an oversupply (Levine, 2001). More recently, the National Center for Health Workforce Analysis (2002), drawing on data from the 2000 National Sample Survey of Registered Nurses (Spratley et al, 2000), claimed that there was evidence of a shortage dating back to the year 2000. They cite an estimated national supply of 1.89 million employed registered nurses, with an estimated demand of 2 million. Interestingly, a review of the actual figures in the Sample Survey reveals a different picture. The survey, conducted by the Bureau of Health Professions, Division of Nursing, indicates an actual supply of 2,201,813 of active, licensed RNs employed in nursing. Rather than a shortage, this is indicative of an oversupply (Spratley et al, 2000).

Reports that the nation is currently experiencing an overall nursing shortage, then, are largely unsubstantiated. Most of these reports actually refer to shortages in specific specialty areas of nursing, certain geographic areas, or in the proportion of experienced nurses to new graduates. These are not indicative of an overall shortage, but rather point to a maldistribution of available labor (Levine, 2001).

The GAO (2001) found evidence of an emerging shortage of nurses willing to fill vacant positions in hospitals, nursing homes and home care. This was linked to poor working conditions, high staffing ratios, mandatory overtime and inadequate pay in those sectors (GAO, 2001). The sector hardest hit by the human resource distribution inequality is the hospital industry, which reports up to 126,000 unfilled registered nurse positions annually (American Hospital Association, 2001).

The SEIU (2001), concurring with the GAO, points out that this may be related to the hospitals' staffing practices; in an effort to contain costs, hospitals have long held down nurse staffing levels, despite increasing acuity. The resulting deterioration in working conditions, and increasing level of stress for staff nurses, has led to a mass exodus of nurses from the hospitals (SEIU, 2001). Even today, hospital nurses report a decline in the quality of nursing care. This they directly relate to inadequate staffing (Cornerstone, 2001).

Projected Shortfall

By the year 2008, the expected supply of registered nurses will be 2,514,000, while the demand is projected to be 2,529,674. This points to a shortfall of just 15,674 registered nurses. The margin of shortfall is so small (0.6%), "some might regard it as indicating a balance of supply and demand" (Levine, 2001, p. 12). A more significant shortfall is predicted by the year 2020, when it is estimated that the demand could exceed the supply by 20% (GAO, 2001; Levine, 2001). The projected shortage at that time will be anywhere from 400,000 to 1.5 million nurses (Bleich et al, 2003).

Hi llg,

I agree with what you are saying - the number of licensed nurses does not equate the number of nurses actually working; that said, the report I was citing gave the number of licensed nurses currently employed in nursing. The report does not, however, specify if these nurses work full-time, part-time or PRN, which is a big factor, as you mentioned. Other parts of my research paper addressed this issue, but I did not want to post the whole huge thing :) Anyway, you raise valid points - nothing is ever black and white, I agree.

Thank you all for your information and input. This discussion has been very enlightening, and especially after reading llg's input, I believe there is a true shortage.

Thank you for being so reasonable and open-minded about my response to your post. I didn't want to start a big fight or anything, but I felt that some people might misinterpret the numbers you provided. Much to my regret, I have seen some people make that mistake in looking at the numbers. I am happy to read you are not one of them and look forward to reading future posts you might right on the subject.

llg

llg, you are a gem. I always have enjoyed reading your posts and did not once feel that you wanted to start an argument. To the contrary, you had sage insights (as always) and I appreciate the point-counterpoint :) Thank you for providing good clarification and food for thought - that is what I love about this site!