NurseWeek News

Chart a Course
Survey reveals nursing dissatisfactions-now, it's time to act for change.

By Barbara Brown, Ed.D., RN, FAAN
April 8, 2002

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.