True Shortage of Nurses???

Genista, BSN, RN · Sep 6, 2004

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?

VickyRN, MSN, DNP, RN · Sep 6, 2004

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

auntieflo · Sep 9, 2004

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?

lifeisbeautiful · Oct 20, 2004

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."

kcsun3 · Oct 20, 2004

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).

llg, PhD, RN · Oct 20, 2004

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?
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I won't quibble with your figures, but you made one very big mistake in interpreting the numbers you cited. You forgot to take into consideration that some of the people who are technically RN's can not be realistically expected to fill a full budgeted position.

Some of those RN's are actually elderly people who maintain their license, but of whom we can have no realistic expection of working.

Others have "retired" either permanently or semi-permanently because they have no financial need to work. They will not return unless some dramatic change in their personal life occurs (e.g. divorce.)

Many others have no intention of working full time, regardless of the pay or working conditions. They have families, husbands with sufficient income, they are attending school, etc. and choose part-time employment by choice. I keep the stats for my hospital. We have to hire approximately 550 nurses to fill 378 RN FTE's.

So ... when you compare the number of "nursing positions" (reported as FTE's) with the number of people registered as nurses within a given state or country, you have to take into consideration that it takes significantly MORE than 1 RN to fill one nursing position.

I agree with the previous poster who said that the situation was actually much more complex than it might first appear. As with most complex issues, both "extreme views" of the issue are too simplistic and therefore fail to capture the true picture. To say that there is no shortage because enough people hold licenses fails to account for the nature of the workforce, the legitimate need to balance professional life with personal life, etc. To say that the shortage is all about the numbers of recruits declining fails to acknowledge that many nurses leave because of the working conditions. Both extreme positions miss the complexity of reality.

llg

kcsun3 · Oct 20, 2004

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.

Home Health Columnist / Guide · Oct 21, 2004

[color=#330066]

[color=#606420]the registered nurse population: findings from the national sample survey of registered nurses

[color=#330066]the registered nurse population 1980 - 2000 -pg 14

the registered nurse population

as of march 2000, the total number of licensed rns in the united states was estimated to be 2,696,540, an increase of 137,666 over the 2,558,874 licensed rns reported in 1996. although this was a 5.4 percent increase in the total rn population, it was the lowest increase reported in the previous national surveys. by comparison, the highest increase in the rn population was experienced between 1992 and 1996 when the total number of rns increased by an estimated 14.2 percent or 319,058 (from 2,239,816 to 2,558,874).

of the total licensed rn population in march 2000, an estimated 58.5 percent of rns reported working full-time, 23.2 percent reported working part-time, and 18.3 percent reported not being employed in nursing (see chart 1).

[color=#330066]

[color=#330066]nursing's agenda for the future

nursing profession unveils strategic plan to ensure safe, quality patient care and address root causes of growing shortage

[color=#606420]http://nursingworld.org/naf/

nurse shortage can be hazardous to health

long working hours, safety, and health:

[color=#606420]https://allnurses.com/forums/showthread.php?t=50897&highlight=shortage+nurses

https://allnurses.com/forums/showthread.php?t=38832&highlight=shortage+nurses

https://allnurses.com/forums/showthread.php?t=35711&highlight=shortage+nurses

[color=#606420]https://allnurses.com/forums/showthread.php?t=27636&highlight=shortage+nurses

[color=#236eb5]strategies to reverse the new nursing shortage

the american association of colleges of nursing, the american nurses association, the american organization of nurse executives and the national league for nursing have issued this joint statement. they note that today's nursing shortage is different from any experienced in the past and will require a multi-faceted solution.

Home Health Columnist / Guide · Oct 21, 2004

keeping patients safe: transforming the work environment of nurses

[color=#606420]http://www.nap.edu/books/0309090679/html/

[color=#006633]new report links nurse staffing to hospital outcomes

the commonwealth fund recently released a report on hospital quality that links nurse staffing, among other factors, as a key ingredient for quality outcomes. according to the research, essential elements of a successful strategy to improve quality of care include developing the right culture, attracting and retaining the right people, devising and updating the right in-house processes and giving staff the right tools to do the job. among the hospitals studied, successful recruitment and retention of nursing staff was tied to an absolute respect for and empowerment of nurses-who must be treated as full partners in patient care and given opportunities for advancement. examples of dedication to attracting and retaining the right people include preservation of nurse-to-patient ratios (even at the expense of revenues) and a policy that results in loss of staffing privileges for physicians who do not show respect for nurses.

the report, entitled hospital quality: ingredients for success, is available at the commonwealth fund web site at www.cwmf.org.

[color=#606420]the nursing workforce shortage

the nursing shortage has profound implications for quality of care. recent studies find that in hospitals where nurses treat fewer patients at a time, patients have better health outcomes.

[color=#606420]http://www.cmwf.org/publications/publications_show.htm?doc_id=221538

llg, PhD, RN · Oct 21, 2004

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 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

VickyRN, MSN, DNP, RN · Oct 21, 2004

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.