Introduction
United States has been experiencing a problem in the shortage of nurse staff, a problem which has been projected in by experts to go on for a long time. The lowest increase in the number of professional nurses since the beginning of national surveys was recorded in the year 2001 in the year’s national survey, which was 5.4% since 1996. Out of the over 2.2 million employed in nursing, those working on full time basis was 1.5 million, representing 71%. In a 2001 estimate by the National Sample Survey of Registered Nurses, US would require 2.6 million nurses working on a full time basis and it was estimated that the need for the registered nurses in all US occupations, would go higher above the average through this year.
A national trend similar to that in New York State is indicative of low increment of 6% in the number of Licensed Practicing Nurses between 1997 and 1998, then going down by 7% in the 2000 and 2001. Between 1997 and 2001, this number, including the Registered Nurses, increased by an overall of only 3% with a peak in 1999. The number of nurses employed per 100,000 people was indicated to be 843 in New York State which ranked next to the last in this category according to the National Sample Survey of Registered Nurses (“The Registered Nurse Population”, 2001). There was a projection that the demand of New York for registered would exceed supply with over 17000 nurses, and this would go to almost twice by 2015. Peri-operative units, critical care units and emergency departments in hospitals were among the reported areas of shortage of nurses in 2001, and also there was reported uneven distribution of nurses in the same year. In the year 2000, 71% of the statewide hospitals reported vacant position in the Licensed Practicing Nurse and 92% Registered Nurses. The situation may be worsened by the requirements of experienced and highest specialized education in the field which causes a delay in filling the vacancies.
A shortage such as the one predicted in the year 2001 was aggravated by factors like an overall decline in population, shortage of nursing faculty, low employment, containment measures including managed care, profession image, expanded women career opportunities, and a work force that was ageing.
Latest data this year still show that there will be continued shortage of the nurse staff. New and replacement nurses exceeding one million would be needed according to US Bureau of Labor Statistics (2007). According to a March 2008 report by Buerhaus, Auerbach and Staiger, the nurse shortage could go as high as a half a million by the year 2025. There is the expectation for the growth of nurse demand by 2-3% every year according to this report (“Recent reports”, 2008).
Effects of shortage
Shortage of nurses in hospitals in the US has been reported to have caused hospitals to close some departments or abandon part of their operations. For example, 10% of John Hopkins Hospital’s beds in Baltimore were left unfilled and a delay or cancellation of surgery was realized due to shortage of nursing in November 2000. Closer of hospital facilities may end up causing a burden to the next hospital. Staffing demands has been reported to cause agencies apply mandatory overtime. Nurses may be forced into circumstances where they may not be competent enough to avail quality services because of threat over their licenses, if employers, for example, threaten to consider their refusal to work at the additional hours as being patient abandonment.
According to a summary given by George Benjamin on a testimony given before the US Senate subcommittee hearing on February 2001, three problems namely; lack of entrance into the nursing profession, lack of “staying in” by the nurses in the profession, and unhappiness of those in the profession, were the three problems. According to the testimony staffing problems were attributed as being the result of hesitancy of acceptance of position by nurses where no appropriate staff support would be availed, and instead nurses would be required to hurry patient care activities, overlook practices that are unsafe which are carried by others, and work compulsory extra time (“American Nurses Association Addresses Nursing Shortage at Senate Subcommittee Hearing”, 2001). In addition to affecting the staff nurses, working on compulsory overtime is reported to result in reduced patient care (“Staff Nurses”).
Remedies to insufficient staffing
Increment of wages and benefits which are not wages like paying for vacation and club membership has been traditionally used to provide short term solution to the shortage of staffing but it fails to provide a solution for the future supply of nursing for enough medical care. According to Buerhaus (278-284), being ergonomically sound is needed to ensure that the health of nurses is assured. Nurses may depart from the profession or seek employment from agencies if their ergonomic needs are ignored. The author gives 40% of working Registered Nurses to be more than 50 years by 2010. the author recommends enhancement of application of technology that saves labor to enable better use of the scarce Registered Nurses, and making the unlicensed personnel who assists nurses to care for the patients, to be more competent and improving their training. He is of the opinion that if men entered nursing profession with the same rate as women, shortages in future would be covered. There is therefore the need to study and remove the barrier of men’s entrance to this profession. Another remedy is through preparation for enrollments of smaller Registered Nurse and modifying of the curriculum to fit future student needs while continual changes are occurring in the workplace. The Board of Regents recommends provision of public service by professionals who are qualified and ethical and who are up to date with the best and current practice in their fields “Leadership & Learning”, 2000.
Although creation of new health care personnel and care-fragmentation efforts, pressure to lowering the established requirements and standards in order to offer license to people who have not shown competence in the practice of nursing, and allowing the non-nursing profession who aren’t supervised by a licensed RN and/or LPN to deliver nursing care; have been proposed, they have been indicated to lead to unsafe and a times illegal delivery of these services.
There is need to have the students reached upon to increase or generate more opportunities for them to learn about the profession is also necessary. Nurses’ speaker bureau, as reported for the case of New York Members of the State Board for nursing strategy, can be used to provide a field for students to learn early about the diverse and good opportunity in the nursing profession.
It is necessary to ensure proper working conditions for the nurses, in addition to the checking of application of professionalism by the same nurses. For example, allowing nurses to handle two jobs at a go may lead to compromise in the offering of quality service and patient being not satisfied by the service provided. Approximately 20% of nurses who were disciplined for medication errors have been shown by an internal research study conducted by the State Board for Nursing and the Education Department in 1995 as having held three or more jobs concurrently. According to this study, 21.5% of those punished surveyed nurses indicated that they had graduated within the previous five years. This can be compared to only 7.5% of the general Registered Nurses population.
Work Cited
“American Nurses Association Addresses Nursing Shortage at Senate Subcommittee Hearing”. 2008. Web.
Buerhaus, P., Straiger, D., and Auerbach, D. Policy Responses to an Aging Registered Nurse Workforce (2000). Nursing Economics, Vol.18, 6, pp. 278-284.
Leadership & Learning. New York State Board of Regents Strategic Plan, Goal 3, 2000. “Recent reports”. 2008. Web.
“Staff Nurses”. 2008. Web.
“The Nursing Shortage”. 2008. Web.
“The Registered Nurse Population”. National Sample Survey of Registered Nurses-2000. Preliminary Findings. Bureau of Health Professions, Division of Nursing.