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Has the AONE/NURSEWEEK survey about the national nursing
shortage revealed anything different than what has been
commonly expressed among most nurses? Not really, but
it certainly confirms what is being discussed at the
state and national levels. We know that the nursing
shortage and resulting staffing problems have had a
negative effect on the quality of patient care. The
heavy workload is aggravated by much sicker patients
with shorter lengths of stay and more experienced nurses
leaving because of patient safety and work environment
safety hazards.
What is most exciting about this survey is that nurses
really "like the profession of nursing." Nurses
younger than 35 are even more likely than older nurses
to say that they would recommend nursing as a career
to a high school or college student. Even those who
say they plan to leave nursing-as well as RNs who are
not working as nurses-appear receptive to continuing
in nursing if certain conditions are met. Chief among
these conditions are better compensation and a better
work environment, followed by better hours and higher
status for nurses.
I am astonished to find many large multisystems that
still do not increase nurses' pay for demonstrated competence
and certification in a specialty field. The Magnet Hospital
Study clearly demonstrated that in settings where recognition
and economic rewards were given to those nurses who
demonstrated clinical competence, nurses would stay
and be satisfied in direct patient care.
While the study supports these indicators, it also
reinforces the challenge faced in attracting and retaining
nurses, as the original Magnet study reported. Fifty-five
percent of the respondents indicated that their job
"involved so many non-nursing tasks that little
time remains for nursing." Studies done in the
'70s and reported at the American Academy of Nursing's
annual meeting in 1979 showed the tremendous waste,
both economically and professionally, of nurses doing
non-nursing tasks.
How long will it take to support professional nurses
to engage only in clinical decision-making activities
related to patient care? Anything less than this is
unacceptable and a prostitution of the registered nurse.
If any organization wants to attract and retain nurses,
nurses need to be treated equal to the medical staff.
A self-governance model of nursing was first introduced
in the '50s at Virginia Mason Medical Center in Seattle,
with by-laws like those of the medical staff. Consultants
have been paid large sums to help develop self- or shared
governance practice settings, yet we still ignore the
obvious right of nurses to influence decisions about
workplace organization. Professional development and
advancement are sorely needed, but when is each and
every nurse going to take responsibility?
The Nurse Reinvestment Act is your chance to get on
board with advancing yourself and making the greatest
difference for your own future and the future of nursing.
If your place of employment offers tuition reimbursement,
scholarships, continuing education courses and specialty
advanced practice opportunities, say "yes."
If it does not, ask your leaders, "Why not?"
If you do nothing to advance nursing as a profession,
history will continue to repeat itself. The nursing
shortage of 2020 will be more severe than this one and
we still will be studying how to attract and retain
talented people in nursing.
Discuss this and other topics with your colleagues at
www.nurseweek.com/rnvillage.
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