US SENATE HEARING ON NURSING SHORTAGE

[-jt]

The US Senate heard testimony from the ANA, the Maryland Dept of Health, the AONE, the AHA and a College of Nursing Re: the Importance of Nurses & the impact of the Nursing Shortage.....

Opening Statement of Senator Barbara A. Mikulski http://www.senate.gov/~mikulski/press/01/02/2001213B45.html

FOR IMMEDIATE RELEASE: February 13, 2001 CONTACT: Johanna Ramos-Boyer http://mikulski.senate.gov 202-224-4654 Opening Statement of Senator Barbara A. Mikulski

"The Nursing Shortage and its Impact on America's Health Care Delivery System" Subcommittee on Aging

"Mr. Chairman, I want to thank you for calling this timely hearing on the nursing shortage. I also want to thank Dr. Georges Benjamin, Secretary of the Maryland Department of Health and Mental Hygiene and Chair of the Maryland Statewide Commission on the Crisis in Nursing, and Kathryn Hall, Executive Director of the Maryland Nurses Association, for sharing their expertise and testimony today.

This is not the first nursing shortage that I've seen, but I'm committed to finding real solutions so that it will be our last. Because if we don't address this crisis effectively, the future is likely to be even worse due to our aging population. Today, there are about 35 million Americans aged 65 and older. This number will double to about 70 million in 2030 and be an increasingly diverse population. Older individuals have more complex health care needs and often multiple conditions that require treatment simultaneously. This means that nurses and the care they provide will be even more important than they are today.

The impact of the nursing shortage on our aging population is compounded by the fact that our nursing workforce is also aging. Fifty percent of all working nurses will reach retirement age in 15 years. Maryland and many other states across this country are experiencing nursing shortages as more nurses retire, fewer people go into nursing, and the economy offers more opportunities for nurses and higher salaries than nursing. Maryland hospitals reported that, last year, it took 68 days to fill a registered nurse vacancy.

Today's shortage is causing great distress for patients. According to a new survey by the American Nurses Association, 75 percent of nurses surveyed feel the quality of nursing care at the facility in which they work has declined over the past two years. About half of the nurses surveyed feel "exhausted and discouraged" when they leave work, and over half of those surveyed would not recommend their profession to their children or their friends.

Nurses tell me that they feel undervalued, overworked, and underpaid. In this country in 1999, a nurse with 15 or more years of experience could expect to earn on average only about $7,000 more than a nurse with three years experience or less. I asked the Maryland Higher Education Commission if there were waiting lists in Maryland for nursing scholarships or admission to nursing programs. I was not surprised to find that there are no waiting lists.

But nurses are truly the unsung heroes in health care. They are advocates, medical professionals, and healers who fight death and disease and bring compassion to the patients for whom they care. The care they give is high-tech, high-touch, and highly skilled. Nurses are at the bedside of premature infants in the neonatal intensive care unit, they are assisting in the operating room during cardiac bypass surgery, they are riding snowmobiles to provide home health care to rural seniors, and they are helping nursing home residents manage complex medications.

Why are people not coming into nursing and why aren't they staying? Because while nurses have sophisticated training and education, they get skimpy and spartan pay and respect. We need more nurses, but we as a society must get behind our nurses. That means more than just more financial aid or bigger scholarships. And it definitely means more than collecting data about the problem. Getting behind our nurses means paying them what they deserve. Because the dedication and devotion shown by countless nurses doesn't pay the mortgage! And because the best way to recruit more nurses is by having a satisfied nursing workforce that reaches out to a new generation of women and men.

I was excited about the television series "Hopkins 24/7" on ABC last year. I was proud of the doctors, but the shows provided an incomplete picture of the health care provided in hospitals. It left out the nurses and other health care professionals who work around the clock to care for patients. That's why I'm so pleased that the Discovery Health Channel "discovered" nurses. I spoke to nursing groups last month to celebrate the launch of the "Nurses" television series on the Discovery Health Channel. It is similar to "Hopkins 24/7", only it's about nurses. I think this series will be a terrific tool to educate the American public about who nurses are and what they do. I thank the Discovery Health Channel and Johns Hopkins and for sharing with us clips from this series that we'll view shortly.

Today's hearing will shed light on the nursing shortage and the challenges it presents, but I hope it will also be an opportunity to talk about solutions in the short and long term. We must look at what nurses, hospitals and other facilities, nursing schools, states, Congress and the federal government can do to combat this crisis. I know that my colleagues on both sides of the aisle care deeply about this issue. I look forward to today's testimony and working on this important issue with the Chairman and my other colleagues. Thank you.

Senator Barbara A. Mikulski (D. - Maryland) " Also....

"American Nurses Association Addresses Nursing Shortage at Senate Subcommittee Hearing

Washington, DC -- "America is experiencing a crisis in nurse staffing," along with "an unprecedented nursing shortage," Kathy Hall, MS, RN, executive director of the Maryland Nurses Association, told participants at a packed US Senate subcommittee hearing today.

Testifying on behalf of the American Nurses Association before the Senate Health, Education, Labor and Pensions Subcommittee on Aging, Hall noted, "Employers are having difficulty finding experienced RNs who are willing to work in health care facilities." Areas hardest hit include emergency room, critical care, labor and delivery, and long-term care units.

"One of the primary factors for nurse turnover is dissatisfaction with workload and staffing," Hall said, citing findings from ANA's Staffing Survey, the results of which were announced last week. Specifically, the survey found that 75 percent of respondents feel the quality of nursing care in their workplace has declined over the past two years. Nurses surveyed also say they have experienced increased patient care loads.

Another factor Hall cited for high nurse turnover is "the use of mandatory overtime as a staffing tool to cover staffing insufficiencies."

ANA's solutions to the nursing shortage include increasing funding for nurse loan repayment programs as well as the programs related to the Nurse Education Act (NEA). But, as Hall pointed out in her testimony, monetary solutions alone are not enough. "Improvements in the workplace environment, combined with aggressive and innovative recruitment efforts, are paramount.

"As a professional who has worked as a staff nurse, as well as a nurse administrator, I know that the current staffing problems are directly related to the reluctance of nurses to accept positions where they will not be supported by appropriate staff, [but will be] confronted by mandatory overtime, inappropriately rushed through patient-care activities, and unable to report unsafe practices," Hall added.

The Senate hearing also featured testimony from Dianne Anderson, MS, RN, president of the American Organization of Nurse Executives; Georges C. Benjamin, MD, secretary, Maryland Department of Health and Mental Hygiene; Linda Hodges, dean, College of Nursing, University of Arkansas for Medical Sciences; and Brandon Melton of Denver, CO, on behalf of the American Hospital Association.

Benjamin echoed Hall's remarks. "There are three problems," he noted. "Nurses are not coming into the profession. The ones who are there are not staying in, and those who are there are not happy."

Sen. Tim Hutchinson (R-AR), chairman of the subcommittee, led the hearing, which was designed to shed light on the national nursing shortage and its impact on the nation's health care delivery system, as well as the long-term implications of the projected shortage over the next decade. Presiding with him was Sen. Barbara Mikulski (D-MD), who noted that "real solutions" are needed to tackle the "deep systemic issues that face the health of our nation." If not, she said, "Patient care will face the crisis" brought on by "the impact of an aging population, compounded by the aging of our nurses." The issue, she added is nurse "retention."

Sen. Hillary Clinton (D-NY), who noted that the nursing shortage is particularly acute in New York state, discussed issues related to short staffing, whistleblower protections, stagnant wage growth and mandatory overtime. "There is research that demonstrates...that nursing care determines patient outcomes," Clinton said.

Other subcommittee members attending the hearing included Sen. Pat Roberts (R-KS) and John Edwards (D-NC) " http://www.ana.org/pressrel/2001/pr0214.htm

[-jt]

Originally posted by -jt:

The US Senate heard testimony from the ANA, the Maryland Dept of Health, the AONE, the AHA and a College of Nursing Re: the Importance of Nurses & the impact of the Nursing Shortage.....

WASHINGTON, DC - The most vulnerable patients in the nation's operating rooms, intensive care units and newborn wards won't have enough able caregivers in 20 years because of a shrinking pool of registered nurses, health experts warned Congress on Tuesday.......

The hearing on how much the federal government should pay for recruiting or keeping nurses came as the Health and Human Services Department prepared to release new figures Wednesday on the nursing work force.........

"Nurses tell me they feel undervalued, overworked, and underpaid," said Sen. Barbara Mikulski of Maryland, the top Democrat on the Senate panel......

"Just as the nation has made finding, training and retaining police officers and teachers a national priority, we strongly urge President Bush and Congress to elevate nursing staff to a similar status," said Dr. Charles H. Roadman, president of the American Health Care Association.

http://washingtonpost.com/wp-dyn/health/latestap/A551-2001Feb13.html

"When you visit your father after a coronary bypass or your mother in an Alzheimer's unit, you expect a competent nurse to be there," Linda Hodges, a nursing college dean from Arkansas, told the Senate Health, Education, Labor, and Pensions subcommittee on aging issues at a Tuesday hearing.........

Sen. Tim Hutchinson, R-Ark., who chairs the subcommittee, said senators would introduce a plan in the next few weeks that would include grants for nursing scholarships and training programs......"

http://www.salon.com/news/wire/2001/02/14/nurse/index.html

[oramar]

I have read these articles very carefully and everything in them sounds good to me except for one thing. What is with this business about in TEN YEARS or in TWENTY YEARS we will have problmes? We got big problems right now. Is this another version of the old "Patient care has not been compromised" load of crap.

[Lyzzard]

A THOUGHT. . .

I have been following the discussions involving the impending/current nursing shortage because throughout my schooling I have been told that I am entering the nursing career at a pivotal time and because it interests me. Though I am currently only a junior, I have a job which allows me to be in a hospital environment on a SNF floor in a local hospital. As I observe the nurses on staff about their job, I noticed they seemed very "disturbed" because they couldn't give their patients the extra TLC that they are so passionate about and that their patients deserve. This has concerned/frightened me about what I am going to have to face when I do (finally) get out of school. The whole reason I wanted to go into nursing was because I wanted to have that ability to show the patients that I care for that I truly CARE and have the knowledge to do that successfully and professionally. I wonder what I (and many friends in the major) are going to face once added to the already stressed workforce of RNs. . .

Originally posted by -jt:

Originally posted by -jt:

The US Senate heard testimony from the ANA, the Maryland Dept of Health, the AONE, the AHA and a College of Nursing Re: the Importance of Nurses & the impact of the Nursing Shortage.....

WASHINGTON, DC - The most vulnerable patients in the nation's operating rooms, intensive care units and newborn wards won't have enough able caregivers in 20 years because of a shrinking pool of registered nurses, health experts warned Congress on Tuesday.......

The hearing on how much the federal government should pay for recruiting or keeping nurses came as the Health and Human Services Department prepared to release new figures Wednesday on the nursing work force.........

"Nurses tell me they feel undervalued, overworked, and underpaid," said Sen. Barbara Mikulski of Maryland, the top Democrat on the Senate panel......

"Just as the nation has made finding, training and retaining police officers and teachers a national priority, we strongly urge President Bush and Congress to elevate nursing staff to a similar status," said Dr. Charles H. Roadman, president of the American Health Care Association.

http://washingtonpost.com/wp-dyn/health/latestap/A551-2001Feb13.html

"When you visit your father after a coronary bypass or your mother in an Alzheimer's unit, you expect a competent nurse to be there," Linda Hodges, a nursing college dean from Arkansas, told the Senate Health, Education, Labor, and Pensions subcommittee on aging issues at a Tuesday hearing.........

Sen. Tim Hutchinson, R-Ark., who chairs the subcommittee, said senators would introduce a plan in the next few weeks that would include grants for nursing scholarships and training programs......"

http://www.salon.com/news/wire/2001/02/14/nurse/index.html

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Class of 2003

[TXERRN]

This is all well and good. But we KNOW what the situation is. What are the SOLUTION? Grants for school loans and training programs are not the answer.

Proper staffing levels and appropriate pay are two things to start with. They just don't get it....

[Mijourney]

Originally posted by oramar:

I have read these articles very carefully and everything in them sounds good to me except for one thing. What is with this business about in TEN YEARS or in TWENTY YEARS we will have problmes? We got big problems right now. Is this another version of the old "Patient care has not been compromised" load of crap.

Hi oramar. You make a very good point. Over the years, nursing shortages have received bandaid treatment without any real resolution to the problem of what can be done to PREVENT a nursing shortage in the first place. It's just like a person having TIAs before that major CVA hits. The doctor looks at the patient's history and never really addresses the problem causing the TIAs. When the person has a major CVA, most of the time, it's too late. The reference to ten and 20 years I guess are related to when these public officials will retire and will need our help. Really, it probably relates to the span of time in which boomers will be retiring and the population will age.

Testifying and giving factual information is important. But, the lip service needs to translate into something I can see now. Show me the money, the resources, and the support.

[natalie]

jt-

I always liked that gal, Barbara Mikulski.

If anyone would like to address any input into this, here is the link to the committee members. Have no doubt they know the problem exists TODAY and not just the future. To have the nursing shortage dilemma addressed by the senate committee speaks volumes.

Over the next few weeks, Jeffords, Hutchinson and probably others will be putting forth bills to address the problem.

http://www.senate.gov/~labor/107Members/107members.htm

[whistlestop 7]

Last night I received in my email at work a notice that in the next 8 days there are 232 unfilled slots for nurses, as well as 153 slots for assistants. Nowhere in this notice was any incentive given for staffing to fill these slots. Of course many nurses will be glad to work for standard overtime pay, but many like myself will not. This is a medium sized hospital in an urban area. The public must somehow be made to understand the nursing shortage has already hit, and hospitals must realize their paternalistic attitudes toward nursing no longer will guarantee their profits.

[oramar]

Originally posted by natalie:

to address any input into this, here is the link to the committee members. Have no doubt they know the problem exists TODAY and not just the futurehttp://www.senate.gov/~labor/107Members/107members.htm

Thanks for that link. I am going to email them to tell them the temporary solution to their problem. It is to bring the baby boom nurses like me who have left the bedside back for a few years until they can get nursing education moving to bring new nurses in to the field. This will take at least five years. Most of us who were at the bedside two years ago would have worked another five years but they drove us out with overwork, pay freezes and other dangerous conditions. I would come back to the bedside tomorrow if they would promise to give me reasonable amts. of work, no overtime and good support. It would really help if those last few years would really count heavily toward retirment. There are a few things that I would like to see that might sound a little wild like running all the bad managers out of town wearing tar and feathers. I would very much like to be present for that.

[LaurieCRNP2002, MSN, RN, APRN]

Glad to hear that this problem is getting some attention at the national level. Oramar, you are 100% on the money when you say bringing back "baby boomer" nurses will help...but who would want to come back with conditions the way they are now? I am currently enrolled in an NP program--I love what I do but I do not love being overworked and underappreciated! It just drives me up the wall that many of those in upper level management just don't "get it" about the day-to-day problems bedside nurses face. If I weren't already enrolled in a grad program,I'd be looking for something else to do--I'm utterly exhausted many days when I get home from work (as are many other nurses I'm sure). I can't see myself being a bedside nurse over the long term under the present conditions.

Thanks for letting me chip in my $.02 worth!

Laurie

[-jt]

What is with this business about in TEN YEARS or in TWENTY YEARS we will have problmes? We got big problems right now.

We do but nothing like we will have in 10 - 20 years if things dont change now. the point was that right now there are still RNs out there who can work. Getting them back to the bedside is the problem because unless working conditions change there, AND there are incentives in place to make it worth their while, they will continue to leave direct-care nursing, or work in other fields. But right now we still have those RNs & if the game was played right, the facilities could draw them back to work at the bedside & retain them there, while concentrating on recruiting & educating the new RN workforce, because in 10 - 20 years those RN we have now here & in other fields will be retiring & there will be no one to replace them. Right now they are out there. If the hospitals would bring them back, there is enough of them to tide us over until the new workforce is built up to replace us when we retire. If this isnt done, we will be retiring anyway in 10 - 20 years & there will be NO nurses. So we do have problems now but there IS a workforce to work with.... the hospitals just dont seem to be doing anything meaningful to get them back. In 10 - 20 years, there will be no workforce to speak of. The problems we have now will pale in comparison then.

[-jt]

Grants for school loans and training programs are not the answer.

Proper staffing levels and appropriate pay are two things to start with.

If you read the entire articles, this was part of the answer not the whole answer. But it IS part of the answer because you can't build proper staffing levels without a workforce that has the numbers you need. Bringing in new students, recruiting the under-represented minorities into the profession, making their education affordable, offering grants and other funds to schools to entice them to expand their programs to allow for more students is all part of the answer to recruiting a new workforce for the future to replace us when we all retire. But we also need to retain the nurses we have right now & to do that we need improved workplace conditions and compensation. The rest of the articles go into more detail & explain that the answers all go together.