This article is from the EMU News Archive. Current EMU new is available at www.emu.edu/news

Can We Reverse the Nursing Shortage Trend?

A great deal of alarm exists in health care circles about the current nursing shortage.

From 1995 to 2000, the number of registered nurse (RN) graduates in the U.S. decreased by 26 percent. In 2000 there were just over 2.2 million RNs even as the Bureau of Labor Statistics cites the need for one million new and replacement nurses by the year 2010.

This is a challenge, considering that over the past five years the average annual number of RNs entering the workplace was 85,193.

Registered nursing shortages are not new. This is the third nursing shortage cycle since 1950.

RN shortages are due to a set of complex factors. These include the amount of federal assistance for health care, hospital demand for nurses (more than 50 percent of nurses are still employed in hospitals), and the degree of federal assistance for nursing education.

The national ethos is another important factor in people choosing nursing as a vocation. Nursing wages are good, but when the national ethos is more materialistic than altruistic, the interest in service professions, such as nursing, declines. Many perceive nursing as unpleasant work. In addition, nursing has had a hard time attracting men and persons of color.

In addition to wages, working conditions for nurses are a major concern. As federal support for health care decreased and health care moved to "for-profit" in the last decade, nurses have been asked to do "more with less". This naturally has had a profound effect on nursing morale.

There is finally some recognition that RNs affect patient outcomes in hospitals. A portion of the federally passed Nurse Reinvestment Act, signed into law in August 2002 by President Bush, deals with "retention priority" and interventions that will improve patient care so nurses will be retained.

JACHO, an agency that accredits hospitals, also has recently mandated that hospitals must tie patient outcomes to their nursing staffing. Studies done by the American Nurses’ Association have shown that infection rates and patient injuries increase when fewer RNs are providing care.

This being said, this present shortage is unique and will most likely be at its worst by the year 2010 if something is not done. The average age of registered nurses in 2010 will be over 50. Aging baby boomers is making this shortage worse, along with a decline in nursing school enrollments over the last decade. The boomers will be reaching retirement age at the same time that more nurses are needed. Included in the retiring baby boomers are also many nurse faculties. Consequently, there is also a shortage of nursing faculty.

Why is nursing important? What will we lose without RNs? In the hospital, nurses make a difference in whether one lives or dies. Nurses catch the subtle nuances that indicate deterioration in a patient’s condition or detect early adverse reactions to treatments. "Nurses do" for persons what they are unable to do for themselves when they are sick. Nurses see themselves as partners in the health journey of their patients or clients.

Nursing services also include working together in disease prevention. This is most obvious in community health nursing. Public health nurses work with disease detection, prevention and surveillance. They also offer clinics to those with fewer resources.

Other nurses visit sick people in their homes and provide care. They help their clients to find resources to meet all their health needs.

Nurses also work in churches, schools, factories, the armed forces, prisons, mental hospitals, nursing homes and retirement communities, forensics, as coroners, as teachers, flight nurses and in physician offices. Other nurses with advanced degrees work as hospital specialists or some have their own practice in the community.

Eastern Mennonite University's nursing department, working with our Adult Degree Completion Program, offers an accelerated program for working registered nurses. RNs who attend class one night a week for about 16 months can complete a BS degree in nursing. Enrollment has grown in the program, as well as in the traditional day program that prepares students for the RN licensure exam.

I serve as a member of the Virginia Partnership for Nursing and am a member of a task force that prepared a report for the General Assembly about the shortage in Virginia and developed recommendations. The Partnership is developing a marketing campaign to attract more young people to nursing. We are also working on a statewide plan to make it easier for LPNs to become RNs and for associate degree RNs to earn their BS degree.

What will happen without more RNs? More of us will be sicker and we will die earlier. The quality of health care will continue to deteriorate. The complexity of health care and the technical advances in health care have made it difficult to use substitute providers.

Nurses are a crucial part of the health care team and a national resource. We need more of them.

Arlene G. Wiens, RN, Ph.D., is chair of the nursing department at Eastern Mennonite University. She volunteers as a nurse practitioner at the Harrisonburg Free Clinic.

— article by: Arlene G. Wiens, EMU nursing department chair; posted August 30, 2002