Legislation to help shortage in jeopardy

The Congressional Research Service is an agency of the federal government that devotes its time to research and nonpartisan analysis on issues related to legislation that Congress is working on. Its reports are for the use of Congress and it does not post reports for public review on its Web site.

That’s just as well, because if it did, the authors of one of its most recent reports probably would be getting an earful from nurses nationwide.

In a CRS report issued May 18 and distributed only to congressional offices, the agency went on record as saying there is no nursing shortage and probably won’t be until 2008.

"It cannot be stated conclusively, based upon the available labor market indicators, that an across-the-board shortage of registered nurses currently exists," the report states. This conclusion is based on a review of data from various sources, including the U.S. Bureau of Labor Statistics and the Health Resources and Services Administration.

Using data from those sources, the report’s authors concluded that a projected shortfall in registered nurse labor supply will not occur until 2008, when they project the demand will outstrip the supply of RNs by about 15,600. The real crunch in the nursing supply won’t occur until 2020 when demand will exceed supply by 291,000 registered nurses, according to CRS.

In addition to the report, a U.S. Senate committee heard testimony June 27 from Denise Geolot, Ph.D., director of the Division of Nursing at the Bureau of Health Professions of the Health Resources and Services Administration, that a nursing shortage could occur by 2010. It isn’t until then that Geolot predicted that demand for RNs will outstrip supply.

On June 27, the U.S. General Accounting Office released its report, "Nursing Workforce: Multiple Factors Create Nurse Recruitment and Retention Problems" (GAO-01-912T).

The report is based on the testimony of Janet Heinrich, director, Health Care, Public Health Issues, given before the Subcommittee on Oversight of Government Management, Restructuring and District of Columbia, Committee on Governmental Affairs of the U.S. Senate.

Heinrich’s testimony also places the nursing shortage not in the here and now, but at some time in the future.

She told the committee that recruitment and retention problems experienced by hospitals, nursing homes, home health agencies and other entities relate to widespread dissatisfaction among nurses with the workplace, not insufficient numbers of nurses.

These conclusions all seem to fly in the face of multiple reports on the nursing shortage by a variety of groups: the American Nurses Association, the American Health Care Association, the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services), the American Hospital Association and the American Organization of Nurse Executives, to name a few.

The CRS report seems to give politicians—who may oppose any or all of the bills pending in Congress that are written to improve the nursing labor supply—the ammunition they need to delay or derail them.

The stakes are high because the combined proposed appropriations for the above bills total $266 million during the next three years and they could, if enacted, begin to improve working conditions, improve patient safety and reduce the pressure on nurses to work ever-increasing overtime hours.

Bills in jeopardy

Among the bills that could be affected by the CRSreport:

• Hutchinson-Mikulski: Their bill, the Nursing Employment and Education Development Act would create grants to health care facilities and schools of nursing to fund training and expand enrollment in nursing programs that focus on long-term care. The lawmakers also propose a National Commission on the Nursing Crisis.
• Kerry-Jeffords: Their bill increases Medicaid rates to 90 percent of state funding for five years to states that use the money to train and evaluate nurse aides.
• Capps-Kelly: Their bill provides grants to doctoral students who agree to teach at nursing schools. More than 400 nursing faculty positions now are vacant nationwide.

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