Nursing Shortage By: Jessica Klahm & Christine Nguyen
There are many reasons for nursing shortages! There is no single reason.
History of Nursing Shortages • There have been shortages of nurses in this country since the 1960's • This nursing shortage, which began in 1998, not only persists but is expected to get a lot worse • Number of NCLEX takers has declined consistently since 1994 (Fackelmann, 2001) • ICN considers this global shortage of nurses a serious crisis
Present Nursing Shortage • Registered nurses are at the top of the list in employment growth (Fox, 2009) • Shortage is lack of filling vacant spots • The Registered Nurse Safe Staffing Act H.R 1821 (Nursing Shortage, n.d) • Committees for nurse staffing • Unit by unit placement based on several factors • Place limits on “floating nurses” • Keeps RN’s in areas they are experienced in • Cut costs • Nearly $3 billion; 4 million avoided extra stay days • Keep patients safe • Adding RN’s to unit staffing eliminate nearly ⅕ of all hospital deaths
Need for more nurses in the coming years • Generation of aging nurses • Aging population • Recent Healthcare Reforms • More nurses and health professionals needed • Anticipated strengthening of the economy • Aging of nurse faculty • Impacts ability of nursing schools to accommodate sufficient numbers of students • Enrollment in nursing programs would have to increase at least 40% (Nursing Shortage, n.d) • There are fewer nurses available to replace those who retire or leave for other opportunities • Expected to get a lot worse • Bureau of Labor Statistics’ Employment Projections 2010-2020 • Employed nurses will grow from 2.74 million in 2010 to 3.45 million in 2020, an increase of 712,000 (26%) (Potera, 2009) • Need to replace 495,500 = 1.2 million by 2020 (Potera, 2009) Future Projections
So what trends have we seen throughout time that has caused or influenced nursing shortages?
Common Social Perception of Nurses • Nurses do the dirty work, they only clean people • Nurses have no autonomy - submissive helpers • Nurses are only and should only be females - male nurses are all “gay” • RN’s are MD wannabes (failed doctors) • Being a nurse is way too stressful
Nursing Stereotypes Male Nursing Stereotypes: http://www.youtube.com/watch?v=XGQhCas1Tp8 General Nursing Stereotypes: http://www.youtube.com/watch?v=hmHIioSCd8Q
Extremely Demanding Profession • Everyone knows that nursing is one of the most stressful and demanding jobs • Although it is extremely rewarding, many cannot handle it • Stress causes many people to leave the profession
Shortage of Nursing Faculty • The #1 reason why qualified students are turned away (McDermid, 2012) • The shortage of nursing school faculty is limiting the number of students able to attend nursing school • In 2011-2012, U.S. nursing schools denied 75,587 exceptional applicants from entering a baccalaureate and graduate level nursing program (McDermid, 2012) • Causes: • Aging population of faculty, reducing hiring of younger faculty • Lack of faculty, clinical sites, and inadequate education budget
Baby Boomers • The U.S. projects a massive nursing shortage as baby boomers age and the need for new health care providers grow. • Aging of Nurses • RN’s median age is 43.3 (Rosseter, 2012) • RN’s less than 30 y/o represents only 10% (Rosseter, 2012)
The Effects on Nursing • Patient health and wellness is the primary goal of a nurse. • Relationship between adequate nurse-to-patient ratios and safe patient outcomes • However, that goal is not met when a hospital is short in staffed nurses. • Research shows that patients are 10% more likely to die if there is a shortage of nurses (Buerhaus, n.d.) • It is estimated that approximately 20,000 patients die a year when brought into an understaffed hospital (Buerhaus, n.d.)
The Effects on Nursing • Ensuring sufficient staffing levels results in: • Reduce medical and medication errors • Decrease patient complications • Decrease mortality • Improve patient satisfaction • Reduce nurse fatigue • Decrease nurse burnout • Improve nurse retention and job satisfaction
The Effects on Nursing • Many studies have been done on the impact that a high nurse to patient ratio paired with working overtime has on nurses • University of Pennsylvania (West, 2007) • Overworked nurses leads to inability to provide optimal nursing care • Harvard-Vanderbilt Study (West, 2007) • ⅕ patients who developed serious complications after surgery died • With increase in nursing staff, approximately 75,000 patients could be saved from problems related to short staffing • Reduce the risk of complications by up to 12% • Reduce the risk of dying after surgery by 6% • Other studies and common findings • Health problems that resulted from inadequate nursing care tied to staffing shortages • Example: Overworked nurse might not have time to clean a urinary catheter frequently and the patient develops a urinary tract infection • Example: Nurse doesn't have time to turn a bedridden patient, secretions build up , moisture accumulates and patient develops bed ulcer
The Effects on Nursing http://www.youtube.com/watch?v=xwy-p_QJo1o&ytsession=1t2j9iVR8ks5nv7Nh46CyvueaAYarYGlJLPvEx5QSwl21b2q-davqOb6P0QmiFj8G8IinmjdyGgBHNMJ-30pqHWx5bv8xLa-CnYFmd3tRikb181fcyyKln0EDnpIKOiCZe4HeltOY0gV1RjEI2sROeeyvDmOBkilBxiZLvacwr4K3QgQ-SE-jDu-ETTTcXO4QaCp_qxf4gLylxSiDSGMZC2PDHq1wWV-YwTmajiHcwHmEyH6X1VD2tdIOGK5bQYdflKbsxqL76z3OubFPD6Bi7KsqTQjEadvXylLoKN6Pw5ddcs6zrp_xmg0cqX7UvZp4ATgpivcB6BavAEG-RByRRMGfCQ_pLaX6s3cUwBEA4hyRIWgrZhBpkbP6ay3QiT2wbQVYjLXSY6DbINWtDlb4lgTz3QbRR1H8sF4sf4UzbNcrF0ke-tfG6RBlA57imR-TFUoTYP-Fb0pDJIg2-prXl3ArOLOxeulcF1tHcIIwdHFBIEHpeaMhru_QKpnxSwo68AxPzBwQ0fuyjCReZSBjS04g5d61Jg2oM44m3-13EtamNtWJs6AXuAliNkULpyDZXlSDr9uYqKabo-yTlnyYwp6HMLwhTTj
Differing Opinions on Nursing Shortages • Many people argue that there are plenty of nurses • A survey of recent nursing grads by the National Student Nurses’ Association found that More than ⅓ of newly graduated BSN nurses cannot find a job (Nevidjon&Erickson, 2001). • “Save the Grads” program (NSNA) to help newly minted nurses find work • “We got hundreds of hundreds and hundreds of people contacting us saying we can’t find jobs, we’ve got tens and hundreds of thousands in student loans,” said Ronnie Black, a spokesman for the society. • Nurses will soon be replaced by technological advances • Graduates do not want to apply to rural areas • With the availability of experienced nurses, nurse leaders in hospitals are more cautious about employing new graduates when they do have vacancies • More than 75% of respondents said employers were filling jobs with experienced RNs, not new grads.
Differing Opinions on Nursing Shortages Let’s say there is an abundant amount of nursing graduates, why is there still a shortage? WHY?? The World Runs On Money
Differing Opinions on Nursing Shortages • Many hospitals are refusing to hire new graduates mostly because they are in debt or have a low budget • Hospitals don’t have the budget to hire the number of nurses they actually need • Healthcare is becoming more and more expensive and healthcare programs are receiving less funding by both the government and public • Growing Demand • Bad economy = population puts off getting health care • Good economy = increase in demand due to ability of people to afford getting healthcare
Strategies to Address the Nursing Shortage • Attract new people to the profession • Recruit bright young people - especially men • Recruit “inactive” nurses • In 2000, about 12% of the nations nurses were “inactive” (Nevidjon& Erickson, 2001) • Many chose a different career or were taking a career break • Educate more nursing educators • Create incentives that will attract graduates to pursue education • Increase educator salaries • Improve nursing’s image • Educate the public about the nursing profession • Eliminate inaccurate stereotypes about nurses • Improve salaries and benefits • Changes the way the government and society views nursing – support nurses more
Conclusion • The 21st century nursing shortage is more severe than any other previous nursing shortages. • We must act quickly to correct it otherwise it will cause catastrophic health care issues • Many hospitals and healthcare organizations cannot function without nurses • If the shortage worsens, more and more people will be denied access to healthcare
References • Borland, S. (2013, January 21). Shortage of nurses is 'killing thousands a year': Patients in overstretched hospitals developing fatal complications which could have been cured. Retrieved from http://www.dailymail.co.uk/health/article-2266158/Shortage-nurses-killing-thousands-patients-year-Patients-likely-develop- complications-properly-monitored.html • Buerhaus, P. (n.d.). Impact of the nursing shortage on patient care. Retrieved from http://www.aacn.nche.edu/media-relations/nursing-shortage-resources/impact • Egenes, K. J. (2012). The nursing shortage in the U.S.: A historical perspective. Chart, 110(4), 18-22. • Fackelmann, K. (2001, June 26). Nursing shortage imperils patients. USA Today. Retrieved from http://usatoday30.usatoday.com/news/health/2001-06-27-nursing-shortage.htm • Fox, R., & Abrahamson, K. (2009). A critical examination of the U.S. nursing shortage: contributing factors, public policy implications. Nursing Forum, 44(4), 235-244. doi:10.1111/j.1744-6198.2009.00149.x • Long, B. (2011). 21st century nursing shortage. Retrieved from http://www.seekingsources.com/nursing_shortage.htm • McDermid, F., Peters, K., Jackson, D., Daly, J. (2012). Factors contributing to the shortage of nurse faculty: A review of the literature. Nurse Education Today, 32(5). doi: http://dx.doi.org.lp.hscl.ufl.edu/10.1111/jnu.12030 • Nevidjon, B., Erickson, J. (January 31, 2001). "The Nursing Shortage: Solutions for the Short and Long Term". Online Journal of Issues in Nursing. Vol. 6 No. 1, Manuscript 4. Available www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume62001/No1Jan01/ NursingShortageSolutions.aspx • Nursing Shortage. (n.d.). American nurses association. Retrieved October 1, 2013, from http://nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/NursingShortage • Potera, C. (2009). The nursing shortage. American Journal of Nursing, 109(1). doi:10.1097/01.NAJ.0000344026.43038.9b • Rosseter, R. (2012, August 6). Nursing shortage. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage • West, R., Griffith, W., & Iphofen, R. (2007). A historical perspective on the nursing shortage. MEDSURG Nursing, 16(2), 124-130.