Editor's
Note
No
easy answers
Solving
the nursing shortage will require creative problem solving
Barbara
Brown, Ed.D., RN, FAAN
Editor, Mountain West Edition
April
9, 2001
The
constant concern about the nursing shortage is like a burning
bridge with no way to cross to future supply of nurses.
What has happened and why are we unable to attract and retain
nurses in the mainstream of the workforce?
If we
look at the
2000 National Sample Survey of RNs from the Bureau of Health
Professions, Division of Nursing, we can see what has
happened.
There
are more than 2.6 million RNs in the United States, with
more than 2.2 million actively working in nursing. Since
1996, nursing has gained only 137,666 nurses. Last year,
more than 71 percent of nurses worked full time, while more
than 28 percent worked part time. Why are there nurses who
are not working at all and why are there so many part-timers?
The
vacancy rate at the national level indicates that 1,754,000
nurses are needed in the United States, and we are short
at least 700,000 RNs. Hospitals report 12 percent to 25
percent increased use and have to divert or close beds because
of short staffing.
The
number of agency/traveler nurses has significantly increased.
Physicians are angry because they are unable to admit patients.
Many nurses consider the work environment to be hostile
for good practice. The nurse-to-patient ratio is unacceptable
to most conscientious professional nurses.
Mandatory
overtime adds to unsafe practices and results in patient
care mistakes, which cause more angst for nurses. Salaries
are inadequate and there is volatility with intrashift work
overload. Clearly, nursing is a troubled profession.
The
vacancy problem mandates that we seize the opportunity to
do things differently, as we did in the shortage of the
’70s. All nurses, especially those in leadership positions,
need to question which parts of our sacred spaces keep us
from seeing what needs to be done.
Our
focus and vision for family-centered patient care will return
us to advocacy for only clinical decision-making activities
being done by registered nurses and all other activities
in the care system being done by others.
We simply
cannot afford to do everything when there is no one else
there to do it or to be checker-uppers on cheaper doers
when it comes to patient care. Our united front on supporting
that every patient needs a nurse will help us to focus on
disruptive dislocations that force the issue of quality
patient care.
We can
create re-entry programs to bring nurses back into nursing
and support them, just as we have internships for new graduates
to prevent losing them at the beginning of their careers.
We need day care centers for elderly parents as well as
the children of nurses to allow freedom from care of family
members. Collaborative practice committees with doctors,
nurses and other health care providers are essential for
focusing on the patient and eliminating verbal abuse often
experienced by nurses in the work setting.
Educational
support systems to enable professional growth, whether they
are for an RNB, advanced degree or certification preparation,
enhance practice and give recognition to those who want
to rise to the next step of professionalism. Recognition
for best practice, as in the NurseWeek Nursing Excellence
Awards, reflects a belief that nurses are the essence of
health care.
We need
all kinds of partners and may need to draft young people
into health care for our future. But unless we do something
now with the vacancy/shortage, such as creating strong professional
practice environments, we cannot expect to attract students
into nursing for the future. I am proud to have been a nurse
for more than 45 years and will continue to devote myself
to advocacy for all nurses and to those who become nurses.
United,
we can make a difference and attract the best and brightest
into the profession of nursing.
~Barbara
Brown, ED.D., RN, FAAN
What
do you think?
Email us at
editor@nurseweek.com
