“Your Healthcare. Your Choice.”

By Shain Waugh

Primary Issue

The critical nursing personnel shortage in America is nothing new to those affected by the shortage. It is evident that the long waits in the emergency room, medical surgical or telemetry unit’s patients not being seen by a nurse for hours, patient’s given the wrong medication, nursing staff burnout, and so forth is a significant sign of the challenges involving this shortage. A study in the Journal of the American Medical Association predicted a 20% shortage in the number of nurses needed in the healthcare system by the year 2020. The U.S. Bureau of Labor Statistics reports that more than one million new and replacement nurses will be needed by 2012.

The immediate challenge is that as more than 77 million baby boomers approach retirement age, it is anticipated that the demand for healthcare, particularly home and community-based care, will almost certainly outpace the supply of quality caregivers. The key question is to determine do you trust your hospital, physician, clinic, and or pharmacy. For many, it’s a challenging question when there is no true method of evaluating these critical factors.

 Those Affected

The ratios of nurses to patients dictate the number of patients a hospital’s unit can handle in a given day. In some states these ratios have been legislated while in other, unions mandate it. There are exceptions and work conditions for nurses and patients are still poor and unsafe. As case in point, there have been studies that illustrate direct correlations between staffing of nurses and medical errors.  Example:

In the 3^rd quarter of 2007, a South Florida hospital, which will remain unknown among this document, admitted a patient to its medical surgical unit for a non-critical diagnosis. There were two nurses that called off that particular day, which mean the other nurse took on three additional patients totaling ten patients for the night. Due to the stress, limited staffing, and not enough time to evaluate patients, one patient die within the hospital. The patient was not discovered until 7 hours later. The result included the nurse losing her nursing license, hospital being suited for millions, and the facility developing a bad name within its community. The parties involved were affected simply by the shortage of nurses and/or medical professional staff that shift. So, as medical facilities struggle to fill nursing vacancies and other medical positions, the greater the chance for an unsafe working and medical practice environment.

The shortage of nurses is growing worldwide on a global scale. The immediate problem is that for many of the poorer countries such as the Philippines and South Africa, there has been a migration of nurses from these countries to other countries such as U.S., Canada, and Australia. The more financially stable countries have been trying to meet critical needs for nurses by encouraging nurses from these countries to emigrate. Unfortunately, this processes is increasing the problems and not contributing a solution.

Hospitals argue that pressures from their relationships with managed-care providers leave them no choice but to experiment with various staffing practices, which result in varied degrees of success. It is believe that medical facilities cutting back on nursing staff to achieve higher profits. As a medical professional, there have been situations where staff ratios are reduced because the acuity of the patients doesn’t call for such staff. As a case in point, if a nursing in cardiovascular ICU is use to taking care of one open heart patient at a time, then if there are three telemetry patient on the that unit then this one nurse to three patient is efficient.

Possible Solution

In evaluating solutions, there is an array of theories to assist with the challenge. If we take the model of New Jersey hospital, it consists of a two-year program where the students attend one 12-hour clinical day per week at a participating hospital, and the hospital is responsible for training the student. The remaining part of the program consists of online classes.  

The promotion of the nursing profession to men is critical. The nursing profession has a women dominated culture. There are approximately 5.4% of the 2.1 million registered nursed employed in the United States that are men. This is according to the National Sample Survey of Registered Nurses.

The initiation of incentive by the government would assist in the promotion of nurses. A suggestion would be to reduce the amount of taxes that nurse are required to pay. If the normal tax bracket is between 25%-30%, then nurse should be required to pay only 15% tax. This tax reduction will increase a nurse salary without forcing the hospitals or medical facilities to increase wages.

In 2002 the Nursing Reinvestment Act was signed by President Bush to address the problem of our nation’s nursing shortage. This initiative was intended to promote people to enter and remain in nursing careers, thus reducing the growing shortage. The law establishes scholarships, loan repayments, public service announcements, retention grants, career ladders, and grants for nursing faculty. The challenge with this Act is that it has stipulations and not all individuals that become a registered nurse are able to utilize or benefit from the act.