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A Nursing Crisis Fact Sheet

Written by LeAnn Thieman, CSP, October 7th, 2008

by LeAnn Thieman

Most nurses didn’t choose their career because of the great hours, pay, and working conditions! They were called by a need to serve – to give of their hearts and hands, compassionate and thorough patient care. But these values are threatened today with the changes in the delivery of health care.

Facts:

  • Over 126,000 nursing positions are unfilled in hospitals. Nurse shortages are even more acute in long-term care facilities and home-health care agencies.
  • By 2015, it is estimated the U.S.A. will be short 500,000 nurses.
  • By 2020, 65% of the population will be 65 or older. It is predicted we will lack 700,000 nurses to care for them.
  • The need for healthcare workers will triple by 2050.
  • The average age of the nurse today is 46.
  • Of the 2.7 million RNs in this country, 83% are employed in nursing
  • 30% of nurses under the age of 30 plan to leave their jobs within the next year.
  • 41% of nurses are dissatisfied with their current jobs, mostly due to poor staffing ratios.
  • Surveys prove nurses would prefer more help to more pay
  • Hospitals offer free sign-on bonuses from $5,000 to $15,000 to a new Volkswagen Beetle!
  • Thousands of hospital deaths every year can be blamed on a nationwide nurse shortage, according to JCAH (Joint Commission on Accreditation of Healthcare Organizations.) Nursing staffing issues account for 50% of ventilator-related deaths, 42% of surgery-related deaths, 25% of transfusion errors, 19% of medicine errors, 14% of patient falls, and 14% of patient suicides.
  • For every patient over four that a nurse has to care for, patients face a 7% greater risk of dying.
  • Nationwide there is one school nurse for every 3521 students. Meanwhile, the incident of asthma and juvenile diabetes continue to climb.

Problems:

  • Nursing shortages are plaguing most cities, large and small, not only in the USA, but worldwide.
  • Hospital units, and some entire hospitals, are closing, not for lack of rooms, but lack of nurses.An affluent colleague of mine grew deathly ill on a Saturday. She overheard her physician begging the hospital for a bed. “We have beds, just no nurses,” was the reply. She was denied admittance and her physician called 2 more hospitals before he got a room- -and care- – for her.
  • Emergency rooms throughout the country are often on “divert-status” daily, refusing to accept the patient in the ambulance due to lack of personnel in the ER. Paramedics frantically call the closest hospital and are told they cannot transport the critically ill patient there. One Denver paramedic called seven hospitals one night as the patient in the ambulance suffered an increasingly severe heart attack, “Hold on,” he says to the middle -aged man, “hold on…”
  • Hospitals are forcing mandatory overtime to meet the patient-care loads. Nurses feel exhausted, overworked, and under-appreciated. “I’ll work my fingers to the bone and ’til there are holes in my shoes and I won’t complain- – as long as I can go home at the end of the shift and say ‘I gave the best care possible.” But I work that hard and go home feeling sad and defeated and wishing I could have done more…”
  • This shortage is a worldwide problem. Hospitals are recruiting nurses from foreign countries. While these incentives serve to fill our need, it leaves destitute countries with even fewer nurses.
  • Nursing work is hard! Due to changes in health care, hospital stays are much shorter. There are fewer “easier” patients to care for. Hospitals are becoming ICU units, nursing homes are becoming hospitals, and homes are becoming nursing homes.

Causes:

  • Historically, nursing has been “women’s work” and now women have countless career options. Only 5% of nurses are men.
  • Overwork and inability to minister to patients’ physical, mental and emotional needs is causing tremendous burnout, so nurses are quitting.
  • While there are waiting lists for some nursing schools, many have too few instructors to educate more students.
  • National Registered Nurse (RN) organizations have pushed for Baccalaureate entry level into the field. While this has been one way of advancing the career of one level of nurses, it has the side effect of diverting precious resources to that one goal and away from patient care advocacy.

Hopeful Trends:

  • According to a 2002-2003 survey of RN Nursing Programs conducted by the National League for Nursing (NLN), there has been a recent surge in the number of enrollments and graduations in RN nursing programs.
  • Graduations appear to have increased 6% over the prior year, and if all graduates pass their licensure exams, approximately 75,000 new RN nurses will be able to join the workforce.

“Why Should I Care?”

  • Increased errors occur in any profession when the worker is over-fatigued.
  • “Who’s taking care of Mama?” Nurses want more than anything to anticipate and meet every patient need promptly, but staff shortages often don’t allow them to do so. A friend of mine complained that her daughter lay 3 days in the ICU after a car crash, with dried blood and shreds of glass in her hair. Believe me, her nurses wanted more than anything to wash her hair, hold her hand, and minister to the family. But they have to make choices- – wash her hair, or monitor the heart-pump on the man in the next room.
  • The “baby boomers” will put an increased demand on the health care system in the next 10 years, and we don’t have enough nurses to meet the current needs.
  • To meet the immediate, sometimes life-threatening patient-care needs, hospitals are hiring Nursing Assistants/Aides. The level of training of these well-intentioned individuals is inconsistent at best. Another friend had a fractured vertebrae and called the nurse to be turned to her side. A Nurses Aide came in and began to turn her. My friend reminded her that the doctor ordered her to be “log-rolled” to prevent spinal injury. The Aide didn’t know the procedure and went to get help– another Nurses Aide who didn’t know it either. These aides want to do it right, but often aren’t adequately trained.

Solutions: ( So Glad You Asked ! )

  • While Baccalaureate entry level into the profession is ideal, it’s idealistic. Not every bedside-care need must be filled by a Registered Nurse (RN).
  • Licensed Practical/Vocational Nurses (LPN or LVN) must be fully utilized. These nurses are trained specifically (usually for one year) to provide excellent bedside care. They often study from the same texts as Registered Nurses and take state-board exams to be licensed. Just as EMTs and Paramedics are trained for their specific area of expertise, so are LPNs in theirs. There is no empirical evidence that shows more education in non-nursing subjects guarantees better care. “I can’t afford the time or the money to go to college to be a nurse, yet I want more than anything to care for patients. First I’ll be an LPN, then, hopefully, I can go on to school and be an RN someday – but for today, let me be a nurse – let me care for your Mama …”
  • There needs to be standardized training for Nursing Assistants/Aides and certification programs testifying to their training and abilities. Many Nurse Aides go on to become LPNs and many LPNs go on to be RNs. We need education of a full-spectrum work force to meet the full spectrum of patient needs.
  • Efforts and funding must be increased to promote nursing as a career option for Middle School and High School students, as well as non-traditional students of all ages.

So what does this have to do with Chicken Soup for the Nurse’s Soul?

These stories encourage men and women of all ages and walks of life to choose nursing as a vocation to serve others. Stories from students help nurses recall why they entered this profession in the first place. Stories from seasoned nurses reveal why we stay. Some stories reflect on the “good old days” (many of which didn’t seem all that good at the time!) But all of them give us hope for the future. When her feet hurt and his heart aches, the nurse will pick up Chicken Soup for the Nurse’s Soul and be inspired to ‘keep on keeping on!’

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