People are living longer with more health complications than ever before. As the largest segment of the population ages (the baby boomers), there is a growing need for more nurses. Unfortunately, the largest segment of the nursing populace are among the baby boomers.
History
The registered nurse shortage is not a new problem. This problem, in fact, has been growing in urgency for the last 10 years. According to the American Association of Colleges of Nursing (AACN), the RN population has grown steadily every four years. From 2000 to 2004, however, the percentage of growth was only 7.9% when comparatively the percentage of growth was as high as 14.2% in previous years. Add to that fact that not all RNs are actually employed as nurses. As it stands today, roughly only 80% of RNs work in healthcare.
Misconceptions
One of the biggest misconceptions regarding the nursing shortage is that it is a national problem, affecting every city and state. This is simply not true, there are many areas that have an overabundance of nurses graduating every year from nursing schools. The Pittsburgh area alone, has 21 nursing programs that more than adequately feed whatever demand there may be in that area. Many times nurses must travel more than 50 miles from their homes to find a nursing position. Others will accept part-time or PRN (as needed) positions in order to get their foot in the door at a local hospital or nursing home so they may begin paying back their student loans. Many new nurses, however, become discouraged and return to school to pursue a master's degree in a different field in order to begin working.
Theories/Speculation
For the areas that do have a shortage of nurses, many hospitals and nursing homes rely on agency nurses to fill their needs until it is possible to hire a new RN. Agency nurses are experienced nurses who enjoy the flexibility working as an agency nurse commands as the salary is considerably higher than a regular staff position, and the nurses are able to work the days they choose. Agency nurses also have the option of accepting or refusing particular assignments, a benefit which salaried nurses do not have. If staff RNs had greater autonomy in setting their schedule as well as an increase in salary, perhaps many RNs would not seek out agency opportunities.
Burnout is a key factor in the shortage of RNs as well. Patients are living longer, and their health problems are greater and more complicated than ever. Many people start off with one health issue and develop another while under a doctor's care, or develop other health challenges because of a particular medication the doctor has prescribed. Many times RNs feel they are nothing more than pill pushers. As healthcare costs rise, and insurance companies decide they will no longer pay for hospital acquired problems such as bed sores and C-diff, RNs are being asked to do more with less. As nurse to patient ratios are often stretched to the limit and sometimes beyond, nurses cannot physically and mentally keep up with the demands constantly placed upon them. The burnout factor which normally primarily affected nurses that had been in the profession for more than 20 years, now affects nurses with less than 10 experience.
Prevention/Solution
The most popular remedy to the nursing shortage as set forth by the Department of Health and Human Services appears to be to create more nurse educators from the population of RNs that the country already has. In recent years, nursing programs have been busting at the seams with enrollees and many prospective nursing students have been turned away or placed on a waiting list of two years to begin a nursing program.
While increasing the number of nursing faculty is one solution, it does not solve the job satisfaction challenge. One remedy that appears to have had a modicum of success in this arena, thereby also driving the rates of nurse retention higher, is the Magnet Hospital Award. Each year the AACN awards the status of "Magnet" to hospitals which have met or exceeded 14 criteria aimed at providing the best possible nursing care to patients. These 14 criteria also contain specifications of nursing job satisfaction which must be met in order to attain and keep Magnet status. Once a hospital receives such status, it must also work to retain it as every three years surveyors from the AACN will reevaluate the hospital's nursing program.
Magnet hospitals tend to have the lowest turnover rates in their nursing staff thereby increasing favorable patient outcomes and overall patient confidence in their caregivers and satisfaction in their hospital stays.
Expert Insight
A career as a registered nurse can be very demanding, both physically and mentally, and Magnet facilities give more of a voice in the care the RN provides. Many RNs feel Magnet status gives them more clout. When nurses feel valued and feel they are able to make a difference in patients' lives without administration constantly looking over their shoulder; when they feel they are trusted and listened to by administration, an amazing thing happens. They become happy in their jobs and remain in them, and not only this, but they also tend to speak positively about nursing and want to recruit others into the profession.
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