Nursing Shortage Raises Concerns About Patient Care

The current nursing shortage is becoming so severe that it is threatening the quality of patient care, according to nurses, hospital executives, and health-care experts across the country. "The nursing shortage is one of the dominant issues in health care today," says Peter Buerhaus, associate dean at the Vanderbilt University School of Nursing. "In some cases the problem is so severe that hospitals have had to shut down nursing floors and cancel surgeries. This crisis has the potential to create a disaster scenario in terms of the quality of care."

Because of staffing shortages, nurses are being asked to work longer and longer shifts-leading to exhaustion, burnout, and bitterness. As a result, many nurses are leaving the profession entirely or joining unions. In addition, efforts to attract new recruits to the field are falling short. The year 2000 saw the sixth annual drop in nursing school enrollments. Meanwhile, the average age of nurses is 45.2 years and rising. As a result, increasing numbers of nurses are unwilling and physically unable to work double shifts or mandatory overtime. "We've burned out an entire generation of caregivers," says Jeff Goldsmith, president of Health Futures, a hospital consulting firm.

This burnout has led to increasing numbers of nurses leaving the profession. According to the Bureau of Health Professions, 494,000 registered nurses are not using their licenses-up from 443,000 in 1996 and 387,000 in 1992. In addition, a recent survey revealed that 22% of nurses planned to quit their job in the next year.

According to Susan Blanchi-Sand, director of the United American Nurses, the labor union affiliate of the American Nursing Association, "Wages are always an issue, but they are not the principal issue. Safe staffing and the quality of patient care are higher priorities." In response to these concerns, federal and state legislators are introducing legislation to prohibit forced overtime, mandate appropriate staffing ratios, and offer incentives to enter the profession. California, Kentucky, and Virginia are settings standards for appropriate staffing, and 15 states-including New York, Connecticut, California, and Illinois-are considering bills that would prohibit mandatory overtime. Maine has already passed such as bill, and New Jersey is currently drafting overtime regulations.

"Mandatory overtime is a huge issue," says Stephanie Reed, a lobbyist for the American Nurses Association. "Nurses have to work overtime when they are exhausted. The nurses have a tremendous fear of making mistakes. It's a patient safety issue."

Hospitals are also taking steps to make nursing more attractive-offering perks such as babysitting services, health club and spa memberships, Hawaiian vacations, and discount purchasing programs. However, recruiting efforts have only been moderately successful, and the demand for bedside nurses continues to outpace additions to the workforce. According to Cross Country Travcorps-one of the largest temporary nurse staffing companies in the nation-there are currently 100,000 openings for RNs.

From the April 8, 2001 New York Times article by Milt Freudenheim and Linda Villarosa entitled "Nursing Shortage Is Raising Worries on Patients' Care."