By James L. Martin
According to the American Hospital Association, 126,000 nursing jobs are vacant at American hospitals right now. Economists and demographers alike speculate that the race towards “senior living” that baby boomers are presently running will impact everything from soup to nuts. Numbers don’t lie. 77 million people due to retire in the next 10 years will change wholesale industries like insurance and housing and shake Wall Street to its financial foundations.
In this vein, one item worth noting will be the enormous crush upon U.S. health care services. Boomers approaching retirement have already forced a national dialogue about how to save Social Security, strengthen Medicare and Medicaid, and reign-in costs for prescription drugs; indeed, the 2002 mid-term elections were fraught with these issues.
But nearly overlooked in all this has been the crushing need for more nurses in this country and it won’t be long before it’s time to pay the piper. When we or someone we love takes ill, when a hospital, clinic or emergency room is required, the services of a nurse take a back seat to no one. Remove the bedside activities of the nurse – dispensing medications, offering encouragement and support, assisting physicians and yes, fluffing pillows – and a hospital stay quickly descends from unpleasant to miserable. This is the very scenario now before us because of a severe nursing shortage that will only grow worse unless action is taken to correct the situation.
Right now, critical care nursing is adequately staffed in most places in the country. But the same can no longer be said about nursing in many standard hospital environments, senior living facilities, skilled nursing facilities and home health agencies. The fact is that the current nurse workforce is aging with increasing odds that younger nurses won’t stay long enough to alter patterns anytime soon.
The average practicing RN today is nearly 44 years old; twenty years ago, that average age was more like 38. At the same time, enrollment in nursing programs has decreased consistently over the past five years. And almost 6 out of 10 hospitals today are forced to hire temp nurses whose familiarity with specific hospital protocol, staffing peculiarities and equipment usage all lead to increased likelihood for error. Complicating this, a recent study presented to Congress found a staggering 5-out-of-10 nurses working today considered leaving their chosen occupation for reasons other than retirement. It’s a minor relief that so many suggest their primary reason for unhappiness were for measures that should be relatively easy to correct, highest among them participation in decision-making –and — moving hospitals toward patient-centered rather than insurance-centered environments.
This should come as no surprise to anyone who knows anything about the profession; nurses are largely caring, nurturing types who get into the practice, basically, to help make sick people feel better, quicker. They’re not in it for the money but they need to be remunerated fairly. They’re not in it for bragging rights but they must feel their efforts are appreciated.
The time for health care administrators and insurance companies to reply to this crisis is now. Health and Human Services Tommy Thompson, as compassionate a person as you could ever want, recently announced $30 million in grants to attract more people into this honorable profession, most of that earmarked for colleges and universities. And recently, the Senate approved a modification initiated by Senators Susan Collins (R-ME) and Barbara Mikulski (D-MD) for additional nurse funding under the FY 2004 Labor, Health and Human Services and Education Appropriations bill (HR 2660). The amendment increases by $50 million the nursing workforce development programs within Title VIII of the Public Health Service Act. The US House of Representatives will now have to concur with the Senate’s modification.
These are excellent starts. But we need even more models and best practices that will serve to develop innovative strategies and propel approaches for retaining professional nurses. Some of these measures should include promoting nurse involvement in organizational and decision making processes, advancing on-site collaboration and communication dynamics, promote quality nursing care through the workplace environment while finding better ways to afford nurses increased education and career advancement.
The 60 Plus Association strongly supports HR 2660 on behalf of some 4.5 million citizens it relies on for support and hopes Congress takes up this legislation with the urgency it demands.
Update Medicare? Yes. Repair Social Security? Absolutely. Find a way to help seniors on fixed incomes afford prescription drugs? You bet!
But we’d better get our collective arms around the impending crisis over too few nurses before someone we love — or that person in the mirror — is more than inconvenienced; heck, our very lives may depend upon it!
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James L. Martin is president of the 60 Plus Association, Arlington, Virginia, a senior citizen advocacy group.