In the United States, a nursing shortage is expected to occur that will only increase as baby boomers age and require more health care services. The national nursing shortage could reach 500,000 by the year 2025 (Madkour, 2009.) The shortage is complicated by the fact that nationally, nursing colleges and universities are struggling to maintain enrollment levels that will meet the increasing demands of nursing care (Rosseter, 2011.) There is a certain irony in this shortage because it occurs at a point when Americans are sorely in need of jobs, yet the nursing profession does not have enough staff to meet the public health needs of the citizenry. This paper will discuss an article describing the problem, published in The Washington Times on June 6, 2011, called “With Nursing Shortage Looming, America Needs Shot in the Arm,” by Claire Courchain (see page 6.)
The concern about nursing shortages is compounded by the fact that many practicing nurses will be retiring within the near future, and the number of nurses who will be qualified to replace them is far below what will be needed. The problem is not that there aren’t enough students applying to nursing schools who are interested in becoming healthcare providers; rather, it is that despite increasing applications, nursing schools are not able to accept enough students because of a lack of faculty qualified to teach them (Ibid.) Nursing schools are reluctant to admit more students than they can accommodate, wishing to maintain providing a quality education that allows small class size and individual attention by faculty. A solution to this dilemma would be to fund more nurses to enroll in higher education programs, and attracting faculty by offering competitive salaries. The most worrisome result of this problem is that when hospitals don’t
have enough nurses on staff, they are forced to close beds, cutting down on the number of patients that can be admitted, thus depriving others of necessary healthcare. In addition, an insufficient number of skilled nurses in medical settings has had a measurable impact on patient outcomes, including mortality (What Is the Nursing Shortage and Why Does It Exist? 2007.)
The causes of the current shortage, which is global, include short staffing of nurses, poor working conditions in hospitals and other settings, insufficient resources for nursing education and research, the aging nursing workforce, and a tremendous gap between what professional nurses actually do and what the public thinks they do (Ibid.). In addition, nursing shortages may be due to insufficient funds to hire and maintain staff, or, at least, a perceived sense that there aren’t enough funds available. Another contributing factor to the inadequate number of nurses is the high rate of nursing students who leave the programs before they have completed them. Approximately one in five skilled nurses leave the profession within the first year, according to one national study (Madkour, 2009.)
Given the dire situation that nursing shortages present, there are many strategies that have been suggested to halt the decline in the numbers of nurses, and to replace retiring nurses with newly trained RNs, APRNs, or nurse-practitioners. Some of these strategies include: expanding NursingCAS, the national central application service to include graduate nursing programs in order to ensure that all the empty spots in nursing schools are filled; increasing the ability to educate nurses by requiring all practitioners to complete a BSN program within 10 years of
licensure; increasing grants to fund nursing student education; convening education and health care leaders to identify and develop strategies to remedy the nursing shortage; and having nursing schools partner with private sources of support to increase their ability to accept and accommodate more students (Rosseter, 2011.)
An innovation that could be developed in order to decrease the incidence of dropout from nursing programs would be to have more support for the students built into the programs, such as mentoring, peer group support, and other ways in which the stresses involved in participating in completing these programs might be minimized. In addition, the lay public could contribute their efforts to prevent or alleviate nursing shortages by contacting their representatives in both houses of Congress, as well as federal agencies, to demand that policies and legislation are enacted that will raise the number of RNs and faculty to teach them (Nursing Shortage, 2012.)
In addition, the numbers of nurses who are retiring could be lessened if work conditions improved: because nurses often have to work long hours, several days in a row, they become fatigued, experience burnout and are dissatisfied with their jobs. This increases the chances of making medical mistakes, putting patients at risk. In order to attract more skilled practitioners to the profession, it is imperative that workplace safety is a priority so that nurses feel comfortable in their work environment and are motivated to remain there.
Certainly, increases in funding to improve salaries of nursing faculty, as well as to provide students with financial assistance through loans and scholarships, could also play a central role in expanding the number of nursing students accommodated by accredited programs. To do nothing about this problem would clearly present a risk to public health and safety which will only increase because of the aging population. Nurses are absolutely essential to patient care; without enough of them, doctors cannot consistently perform their roles adequately, and the entire health system risks breaking down. The shortage of nurses demands a significant response, rapidly and effectively to avoid such a crisis.
Courchane, C. (2011, June 6). With Nurses Shortage Looming, America Needs Shot in the Arm. Retrieved February 10, 2012, from The Washington Times: http://www.washingtontimes.com/news/2011/jun/6/with-nurse-shortage-looming-america-needs-shot-in-/?page=all
Madkour, R. (2009, February 15). Nursing Shortage: One in Five Quits within First Year, Study Says. Retrieved February 10, 2012, from USA Today: http://www.usatoday.com/news/health/2009-02-15-nursing-shortage_N.html
Nursing Shortage. (2012). Retrieved February 10, 2012, from American Nursing Association: http://www.nursingworld.org/nursingshortage
Rosseter, R. (2011, July 15). Nursing Shortage. Retrieved February 10, 2012, from The American Association of Colleges of Nursing: http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage.
What Is the Nursing Shortage and Why Does It Exist? (2007, October 18). Retrieved February 10, 2012, from Truth about Nursing: http://www.truthaboutnursing.org/faq/nursing_shortage.html
With Nurse Shortage Looming, America Needs Shot In The Arm
By Claire Courchane
-The Washington Times
Monday, June 6, 2011
At a time when many Americans are in desperate need of a job, the field of nursing will soon be in desperate need of Americans.
The economic downturn of the past few years has temporarily eased the nation’s shortage of nurses, but university nursing schools say they are struggling to keep up with what is expected to be soaring demand and chronic shortfalls in years to come.
Employment services routinely list nursing as one of the hot hiring professions of the next decade, but supply never seems to catch up with demand – even as the national unemployment rate tops 9 percent.
The need for more nurses in the coming years stems mainly from an aging baby boomer population as well as a generation of aging nurses who will retire. Although the nursing shortage of the early 21st century has been helped temporarily by the economy, many are predicting a shortage in the next several years.
“I look at it like a double helix. When the economy is up, the nursing supply goes down. And when the economy tanks, the supply goes back up,” said Karen Haller, vice president of nursing at Johns Hopkins Hospital. “What we’re seeing right now is an aging of the workforce. Many nurses in their 50s are going to be retiring soon. … There is a silver tsunami of retirements coming. You can’t delay retirement forever.”
Most labor shortages tend to be self-correcting – workers flock to jobs as wages rise.
The problem, however, is not a lack of Americans who want to be nurses. It’s finding the schools that can teach them.
“There’s definitely a lot of people interested in nursing,” said Robert Rosseter, spokesman for the American Association of Colleges of Nursing.
“The number of students who met all the requirements but weren’t admitted was over 67,000 students last year [in U.S. nursing programs],” he said. “People do want in, but there just aren’t enough seats.”
The No. 1 reason why qualified students are turned away from nursing programs: a lack of faculty.
While the number of applicants to undergraduate nursing programs is climbing, the number of students accepted remains low. At the University of Minnesota at Twin Cities, 64 of 324 total applicants were admitted in 2011. The numbers are also low at the University of Washington at Seattle, which admitted 95 out of 455 total applicants, and the University of Pittsburgh, which admitted 120 students out of 1,050 total applicants in 2010. All three schools have highly ranked nursing programs.
Ethan Nowaczyk, a student from UM-Twin Cities, said he feels he was wrongly denied admission into the nursing program last spring.
“This is the thing I want to do. I want to help people. I feel like I’m definitely qualified but I wasn’t accepted, and that’s a lot of people’s problem,” Mr. Nowaczyk said. “I have good grades. But the school only has so many spots. It’s just frustrating that they have a shortage, but I want to do this and I can’t.”
Kristen Swanson, dean of the School of Nursing at the University of North Carolina at Chapel Hill, said a lack of funding is to blame. UNC reduced its undergraduate program by 25 percent this year because of cuts in state funding.
Ms. Swanson said the resulting faculty layoffs meant that the school simply was unable to accept more applicants.
“The bottom line is, it’s not like we could get by with less faculty teaching the same number of students. We still always have to have [a certain] ratio in the clinical settings. We can have a large number of students in the big lectures, but that’s only a portion of nursing education. And that’s where I have clinical faculty that I’ve had to let go in order to sustain my budget, and once I let them go I have to reduce my number of students,” Ms. Swanson said.
“I felt I could decrease the quantity of students, but I would not compromise the quality of our education program,” Ms. Swanson added. UNC-Chapel Hill’s nursing program accepted 258 out of 551 “qualified” applicants in 2011.
Joanne Spetz, an associate professor at the University of California at San Francisco and a specialist in health economics, said she feared that the lull in the nursing shortage could produce a false sense of security among policymakers and legislators.
“My worry is that because of our current economic conditions, the legislature will say, ‘Oh, we’re done with the shortage and we’re going to pull all this money back out of nursing programs.’ Then we’ve lost all our progress.”
She added, “If we don’t take our eyes off the ball, then the shortage may not resume with the kind of ferocity that it had before. But if we do allow the current economic situation to influence our decisions, then we’re going to be in a position where the shortage will come back really strong.”
UNC’s Ms. Swanson stressed the importance of funding more nurses to go for higher education and giving nursing school faculty members competitive wages. She also said raising wages would not be helpful in this situation because nurses already get paid a “decent amount.”
“Nurses already get paid an amount that reflects the important work they do, and getting people to want to be nurses is not the problem. Plenty of people still want to be nurses,” Ms. Swanson said.
Ms. Haller of Johns Hopkins said the shortage will have disastrous effects without more trained nurses.
“When we don’t have enough nurses, we close beds. There’s less access to health care for the public. We can’t put a patient in a hospital bed if we don’t have the nurses to take care of him,” Ms. Haller said. “[That will] not be a good situation for the public to be in.”