Did you read it? — “Why is the U.S. perpetually short of nurses?”

Shutterstock | Jirat Sarmkasat
Shutterstock | Jirat Sarmkasat

If you’re growing weary of all the chatter about the current and future nurse shortage, especially when so little is being done to trigger change, it’s probably because this issue has been around for a long…long…long time.

Below, in a recent article published by The New Yorker, one author explores the curious staying power of the nation’s nurse deficit. The article begins by comparing two earlier editorial pieces, both of which address the shortage.

“The nationwide shortage of nurses is likely to reach crisis proportions… There is not much chance for permanent relief until the nursing profession is made more attractive to young people through better salaries, working conditions and public recognition.”

Then:

In another, titled “We Need More Nurses,” Alexandra Robbins warns of dire consequences in the absence of a larger nursing workforce: “The more patients assigned to a nurse, the higher the patients’ risk of death, infections, complications, falls, failure-to-rescue rates and readmission to the hospital—and the longer their hospital stay.”

“We Need More Nurses” was written in May 2015. The first article was written in 1965.

Different times, same issue.

And it’s not as though the trend has gone unnoticed. Countless studies have been conducted to illustrate, track and forecast the severity of the nurse deficit. Some studies have been geared toward quantitative data; others with a focus on at-risk regions. There are even those highlighting sporadic booms, such as the rise of nurse employment in 2007.

The overall conclusion, however, is that shortages are likely to continue or recur. All of which points to somewhat of an economic anomaly:

In a relatively free society and economy, the tendency with any labor-supply shortage, in the face of steady or increasing demand, is that higher wages and other benefits will attract people to the profession, and the problem will largely resolve itself over time. Why has this not been the case with nursing?

The author goes on to describe the nursing profession as “volatile,” a characteristic that makes measuring balance, as a whole, a difficult task. What’s clear, however, is that the numbers simply aren’t adding up.

According to the article, there are 2.7 million registered nurses employed in the United States. A 2010 government survey revealed that nearly half of all registered nurses were not actively working in the field.

So—what gives? Well, to start, there’s the training.

As both Times editorials suggest, nursing is very demanding, and the education required is rigorous, in terms of both its duration and the level of specialized knowledge required. For those who are prepared to commit, there is a shortage of clinical-training slots, and of teachers.

As it turns out, nurses are who are qualified to teach can pad their pockets more by actually working in the field. Just last year, 78,000 students felt the sting of the scarcity when they were denied admission to nursing school.

Then, of course (as you know), there’s the work itself.

For those in the field, the work is difficult enough that a large percentage of nurses leave the profession at some point in their careers.

While nurses tend to be satisfied with their career choice, fully half of them worry that the job has harmed their health. Some surveys of nurses have also found dissatisfaction with wages, hours, technological complexity, and administrative burdens.

Some regions, such as the West, are taking a harder hit than others. Though, as the article points out, it’s hard to determine a universally adequate nurse-to-patient ratio.

Of course, with ratio being an offshoot of a greater whole, the overarching uncertainty remains.

The perpetual nature of the crisis, and the projections moving forward, naturally lead to the question of whether, given our evolving awareness of the underlying complexities, different policies can hope to create more nurses.

Some medical professionals suggest that the health-care system has reduced its need for nurses by assigning some tasks to other types of workers, such as nursing assistants, technicians, and orderlies.

Such shifts, however, are not necessarily advantageous, leaving just one other option:

A better alternative, however, would be to improve the ways we attract and train nurses.

Nurses, want a full read? Check out the article in its entirety here, then tell us how you think the shortage should be addressed in the comments section below.

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6 Responses to Did you read it? — “Why is the U.S. perpetually short of nurses?”

  1. nan RN

    I understand nursing wanting to appear more educated, and offering not only BSN degrees, but also MSN and PhDs.
    I would like to see a resurgence of the “nursing school” education, like I had. I got hired by the hospital I trained at, so I already knew policies and procedures, and how the hospital worked. Granted, I never climbed the clinical ladder outside of top staff nurse, but that was ok, as patient care was what I wanted to do.

    I ended up having to leave the bedside after 21 years, but went to one of the very first telephonic nursing companies, became a preceptor, and traveled both nationally and internationally. I ended up working for 34 years as a diploma RN, until a bad back necessitated my having to leave the workforce.

    I was able to work in fascinating specialities, worked with many wonderful people, and miss working every day…..

    I would like to hear that there are no waiting lists to get into a nursing program. Sorry if I sound idealistic or out of touch. I loved my nursing program, and was PROUD to be a diploma grad.

    • Pamela

      I too am a proud hospital based nursing school grad!

  2. jviergutz@frontier.com

    There are many reasons why there is a shortage of nurses. First, there is the lack of nursing schools and instructors. Second, nursing schools are selective about who they take. Third, in some areas there is not a shortage of nurses, but a shortage of experienced nurses. Healthcare facilities do not want to spend the money to train new staff. When new staff are hired, they are often plopped into a position with no training. These nurses struggle and often leave in frustration. Fourth, age discrimination, underlying it may be, is rampant. Fifth, nursing is not a job with longevity. Why should we stay when nurses are treated badly on the job. Nursing is a high stress job. There has to be a work and life balance in order to survive in the long term. Administration is often more concerned about meeting status quo. They don’t see that meeting the needs of their nursing staff is important. We are often short staffed (the issue) and we are asked to do more and more with less and less. We are judge on patient satisfaction, but do not have the resources to do the job to the best of our ability. Administration looks at the bottom line. Administration asks us to work our full shifts as nurses and then come back and work as CNA’s. Simple perks like coffee are taken away. Scheduling is inflexible. It does not matter that your Mom is having surgery (planned three weeks in advance), you had better be there for your shift. Patient loads are high due to lack of nurses, but dollars need to be made, even if the care is not 100%. There are too many meetings that could be handles in an email. Some administrators sit in their office looking for ways to make life for floor nurses harder. Administrators are often out of touch with what happens on the floor. Some would never be able to do a floor nurses jobs even if they had too. Many nurses are nurses because it is who we are. We give 100% or more every time we walk onto that floor. That takes a lot of energy. We are under appreciated and undervalued and often undermined. Why should we keep doing it, we ask ourselves and then decide to leave the profession. It may be who we are, but there has to be a better way to live life and we leave.

  3. Maplessharon

    Part of the problem is the requirement of a BSN for Magnate hospitals. I am a nurse with over 20 years experience yet it took me months to find a job recently due to not having a degree. I finally found a good job, but it was not easy.

  4. Pamela

    The powers that be insist on safety, but that is only lip service. They have certain staffing ratios that take no account of acuity. Staffing is done in a central office by nurses I have never seen, so how do they know the real needs of a floor? When a floor is 1/2 full they staff only for that amount of patients but will then proceed to fill that floor over the next 12 hours, with no additional help offered or given. I ‘am fortunate to work under a wonderful head nurse who tries very hard to get around this type of thinking, but she is wearing out, it is a constant fight that sometimes she wins and sometimes she doesn’t. We are floated to floors we have not been properly trained for because of course ” a nurse is a nurse is a nurse “. Something has got to change in the thinking of the people deciding how hospitals should be run, it feels like the entire design is to make the job harder and less safe. Not only do these shortages occur in nursing, but ancillary services are struggling as well, pharmacy, dietary, blood bank, respiratory, CNA’s and the list grow. Begs the question is it a shortage or an unwillingness to pay for the actual help that is needed to provide excellent, fast paced care?

  5. RNmeansRealNurse

    As a former nursing professor, there are many perks to being a teacher, depending on the university one works for. My children had free tuition, I taught in Italy, and the reimbursement for travel to conferences in my specialty were great. For me, these compensated for the relatively low pay. My students started their new jobs at double what I made teaching. The real reason for the chronic nursing shortage? Not enough teachers! Why go into teaching when you can earn double (or more) the money working? Why go back to school and have debt when a higher degree means… no increase in or even less pay?
    Young people no longer enter nursing for the love of caring for others; they enter for the pay and job security. They leave because the ideal of bedside nursing is no longer there; loss of LPNs and nursing assistants that helped make a team run well has put the “caring” part of nursing in jeopardy. Instead, RNs are handling too many patients who are sicker, there is so much to do that the luxury of sitting with a dying patient or comforting grieving family is gone. They feel that they aren’t compensated for the (often lifesaving) work they do. I had one excellent student (2nd career) who was making twice what I made as a prof within a year of graduating who left nursing to go back to being a flight attendant because she could make twice the pay! Want a cure for the chronic nursing shortage? Fairly compensate the teachers and nurses, and make sure staffing meets the needs of the patients, not the bottom line of the facility.

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